Konjungtivitis

Penyakit konjungtivitis adalah satu penyakit berjangkit.

Konjungtivitis adalah suatu peradangan pada konjungtiva.

Konjungtivitis Gonokokal

Bayi baru lahir bisa mendapatkan infeksi gonokokus pada konjungtiva dari ibunya ketika melewati jalan lahir. Karena itu setiap bayi baru lahir mendapatkan tetes mata (biasanya perak nitrat, povidin iodin) atau salep antibiotik (misalnya eritromisin) untuk membunuh bakteri yang bisa menyebabkan konjungtivitis gonokokal.

Orang dewasa bisa mendapatkan konjungtivitis gonokokal melalui hubungan seksual (misalnya jika cairan semen yang terinfeksi masuk ke dalam mata). Biasanya konjungtivitis hanya menyerang satu mata.

Dalam waktu 12-48 jam setelah infeksi mulai, mata menjadi merah dan nyeri. Jika tidak diobati bisa terbentuk ulkus kornea, abses, perforasi mata bahkan kebutaan. Untuk mengatasi konjungtivitis gonokokal bisa diberikan tablet, suntikan maupun tetes mata yang mengandung antibiotik.

Tempoh pengeraman

Waktu terekspos sampai kena penyakit 1-3 hari.

Gejala

Mata terasa kasar menggatalkan, merah dan mungkin berair. Kelopak mata mungkin menempel sewaktu bangun tidur. Konjungtiva yang mengalami iritasi akan tampak merah dan mengeluarkan kotoran. Konjungtivitis karena bakteri mengeluarkan kotoran yang kental dan berwarna putih. Konjungtivitis karena virus atau alergi mengeluarkan kotoran yang jernih.

Kelopak mata bisa membengkak dan sangat gatal, terutama pada konjungtivitis karena alergi.

Gejala lainnya adalah: - mata berair - mata terasa nyeri - mata terasa gatal - pandangan kabur - peka terhadap cahaya - terbentuk keropeng pada kelopak mata ketika bangun pada pagi hari.

Pencegahan

1. Konjungtivitis mudah menular, karena itu sebelum dan sesudah membersihkan atau mengoleskan obat, penderita harus mencuci tangannya bersih-bersih.
2. Usahakan untuk tidak menyentuh mata yang sehat sesudah menangani mata yang sakit.
3. Jangan menggunakan handuk atau lap bersama-sama dengan penghuni rumah lainnya.
4. Gunakan lensa kontak sesuai dengan petunjuk dari dokter dan pabrik pembuatnya.

Koloboma

Dari Wikipedia Indonesia, ensiklopedia bebas berbahasa Indonesia.

adalah istilah yang menggambarkan lubang yang terdapat pada struktur mata, seperti lensa mata, kelopak mata, iris, retina, koroid, atau diskus optikus. Lubang ini telah ada sejak lahir dan dapat disebabkan adanya jarak antara dua struktur di mata. Strukturini gagal menutup sebelum bayi dilahirkan. Koloboma dapat terjadi pada satu atau kedua mata.

Kloboma mempengaruhi pandangan, tergantung dari tingkat keparahan sesuai dengan ukuran dan lokasi. Misalnya, bila hanya sebagian kecil dari iris yang rusak, pandangan mungkin saja normal. Namun bila terjadi pada retina atau saraf optik, maka pandangan pasien akan rusak dan sebagian besar lapangan pandang akan hilang. Kadang-kadang mata dapat mengecil atau mikroftalmos, dan bahkan pasien dapat menderita penyakit mata lainnya seperti glaukoma.

Beberapa anak yang menderita koloboma dapat memiliki malformasi pada bagian tubuhnya, seperti yang terjadi pada sindrom CHARGE.

Dakriosistitis

Dakriosistitis adalah suatu infeksi pada sakus lakrimalis atau saluran air mata yang berada di dekat hidung. Infeksi ini menyebabkan nyeri, kemerahan, dan pembengkakan pada kelopak mata bawah, serta terjadinya pengeluaran air mata berlebihan (epifora). Radang ini sering disebabkan obstruksi nasolakirmalis oleh bakteri S. aureus, S. pneumoniae, Pseudomonas.

Terapi

Dakriosistitis diobati dengan kompres air hangat, dekongestan nasal, antibiotika topikal dan sistemik. Dalam keadaan tertentu dapat dipertimbangkan tindakan dakriosistorinostomi.

Ablasio

Ablasio adalah suatu keadaan lepasnya retina sensoris dari epitel pigmen retina (RIDE). keadaan ini merupakan masalah mata yang serius dan dapat terjadi pada usia berapapun, walaupun biasanya terjadi pada orang usia setengah baya atau lebih tua.

Ablasio retina lebih besar kemungkinannya terjadi pada orang yang menderita rabun jauh (miopia) dan pada orang orang yang anggota keluarganya ada yang pernah mengalami ablasio retina. Ablasio retina dapat pula disebabkan oleh penyakit mata lain, seperti tumor, peradangan hebat, akibat trauma atau sebagai komplikasi dari diabetes. Bila tidak segera dilakukan tindakan, ablasio retina dapat menyebabkan cacat penglihatan atau kebutaan yang menetap. Retina adalah jaringan tipis dan transparan yang peka terhadap cahaya, yang terdiri dari sel-sel dan serabut saraf. Retina melapisi dinding mata bagian dalam, berfungsi seperti film pada kamera foto, cahaya yang melalui lensa akan difokuskan ke retina. Sel-sel retina yang peka terhadap cahaya inilah yang menangkap “gambar” dan menyalurkannya ke otak melalui saraf optik.

Penyebab

Sebagian besar ablasio retina terjadi akibat adanya satu atau lebih robekan-robekan atau lubang-lubang di retina, dikenal sebagai ablasio retina regmatogen (Rhegmatogenous Retinal Detachment). Kadang-kadang proses penuaan yang normal pun dapat menyebabkan retina menjadi tipis dan kurang sehat, tetapi yang lebih sering mengakibatkan kerusakan dan robekan pada retina adalah menyusutnya korpus vitreum, bahan jernih seperti agar-agar yang mengisi bagian tengah bola mata.Korpus vitreum melekat erat pada beberapa lokasi. Bila korpus vitreum menyusut, ia dapat menarik sebagian retina ditempatnya melekat, sehingga menimbulkan robekan atau lubang pada retina.Beberapa jenis penyusutan korpus vitreum merupakan hal yang normal terjadi pada lanjut usia dan biasanya tidak menimbulkan kerusakan pada retina. Korpus vitreum dapat pula menyusut pada bola mata yang tumbuh menjadi besar sekali (kadang-kadang ini merupakan akibat dari rabun jauh), oleh peradangan, atau karena trauma. Pada sebagian besar kasus retina baru lepas setelah terjadi perubahan besar struktur korpus vitreum.Bila sudah ada robekan-robekan retina, cairan dari korpus vitreum dapat masuk ke lubang di retina dan dapat mengalir di antara lapisan sensoris retina dan epitel pigmen retina. Cairan ini akan mengisi celah potensial antara dua lapisan tersebut diatas sehingga mengakibatkan retina lepas. Bagian retina yang terlepas tidak akan berfungsi dengan baik dan di daerah itu timbul penglihatan kabur atau daerah buta.Bentuk ablasio retina yang lain yaitu ablasio retina traksi ( Traction Retinal Detachment ) dan ablasio retina eksudatif (Exudative Retinal Detachment) umumnya terjadi sekunder dari penyakit lain. Ablasio retina traksi disebabkan adanya jaringan parut ( fibrosis ) yang melekat pada retina. Kontraksi jaringan parut tersebut dapat menarik retina sehingga terjadi ablasio retina. Ablasio retina eksudatif dapat terjadi karena adanya kerusakan epitel pigmen retina ( pada keadaan normal berfungsi sebagai outer barrier ), karena peningkatan permeabilitas dinding pembuluh darah oleh berbagai sebab atau penimbunan cairan yang terjadi pada proses peradangan.

Gejala

Gejala yang sering dikeluhkan penderita adalah :

1. Floaters (terlihatnya benda melayang-layang). yang terjadi karena adanya kekeruhan di vitreus oleh adanya darah, pigmen retina yang lepas atau degenerasi vitreus itu sendiri.
2. Photopsia/Light flashes(kilatan cahaya). tanpa adanya sumber cahaya di sekitarnya, yang umumnya terjadi sewaktu mata digerakkan dalam keremangan cahaya atau dalam keadaan gelap.
3. Penurunan tajam penglihatan. penderita mengeluh penglihatannya sebagian seperti tertutup tirai yang semakin lama semakin luas. Pada keadaan yang telah lanjut, dapat terjadi penurunan tajam penglihatan yang berat.

Diagnosa

Untuk menentukan apakah ada ablasio retina maka dokter spesialis mata akan melakukan pemeriksaan mata menyeluruh terutama bagian dalam mata. Beberapa pemeriksaan yang dilakukan untuk mengetahui keutuhan retina:

• Oftalmoskopi direk dan indirek
• Ketajaman penglihatan
• Tes refraksi
• Respon refleks pupil
• Gangguan pengenalan warna
• Pemeriksaan slit lamp
• Tekanan intraokuler
• USG mata
• Angiografi fluoresensi
• Elektroretinogram.

Pengobatan

• Operasi

Teknik operasinya bermacam macam, tergantung pada luasnya lapisan retina yang lepas dan kerusakan yang terjadi, tetapi semuanya dirancang untuk mendekatkan dinding mata ke lubang retina, menahan agar kedua jaringan itu tetap menempel sampai jaringan parut terbentuk dan melekatkan lagi robekan. Kadang-kadang cairan harus dikeluarkan dari bawah retina untuk memungkinkan retina menempel kembali ke dinding belakang mata. Seringkali sebuah pita silikon atau bantalan penekan diletakkan di dinding luar mata untuk dengan lembut menekan dinding belakang mata ke retina. Dalam operasi ini dilakukan pula tindakan untuk menciptakan jaringan parut yang akan merekatkan robekan retina, misalnya dengan pembekuan, dengan laser atau dengan panas diatermi (aliran listrik dimasukkan dengan sebuah jarum). Pada ablasio retina yang lebih rumit mungkin diperlukan teknik yang disebut vitrektomi. Dalam operasi ini korpus vitreum dan jaringan ikat di dalam retina yang mengkerut dikeluarkan dari mata. Pada beberapa kasus bila retina itu sendiri sangat berkerut dan menciut maka retina mungkin harus didorong ke dinding mata untuk sementara waktu dengan mengisi rongga yang tadinya berisi korpus vitreum dengan udara, gas atau minyak silikon. Lebih dari 90% lepasnya retina dapat direkatkan kembali dengan teknik-teknik bedah mata modern, meskipun kadang-kadang diperlukan lebih dan satu kali operasi.

• Prognosis

Bila retina berhasil direkatkan kembali mata akan mendapatkan kembali sebagian fungsi penglihatan dan kebutaan total dapat dicegah. Tetapi seberapa jauh penglihatan dapat dipulihkan dalam jangka enam bulan sesudah tindakan operasi tergantung pada sejumlah faktor. Pada umumnya fungsi penglihatan akan lebih sedikit pulih bila ablasio retina telah terjadi cukup lama atau muncul pertumbuhan jaringan di permukaan retina.

Korpus vitreum yang terus menyusut dan munculnya pertumbuhan jaringan di permukaan retina menyebabkan tidak semua retina yang terlepas dapat direkatkan kembali. Bila retina tidak dapat direkatkan kembali, maka mata akan terus menurun penglihatannya dan akhirnya menjadi buta.

Pencegahan

• Gunakan kaca mata pelindung untuk mencegah terjadinya trauma pada mata.
• Penderita diabetes sebaiknya mengontrol kadar gula darahnya secara seksama.
• Jika anda memiliki resiko menderita ablasio retina, periksakan mata minimal setahun sekali

Vitreous

The vitreous is a thick, transparent substance that fills the center of the eye. It is composed mainly of water and comprises about 2/3 of the eye's volume, giving it form and shape. The viscous properties of the vitreous allow the eye to return to its normal shape if compressed.

In children, the vitreous has a consistency similar to an egg white. With age it gradually thins and becomes more liquid. The vitreous is firmly attached to certain areas of the retina. As the vitreous thins, it separates from the retina, often causing floaters.

Tear Production System

The eye's tears are composed of three layers: oil, water and mucous. The outermost oily layer is produced by the meibomian glands which line the edge of the eyelids. The watery portion of the tear film is produced by the lacrimal gland. This gland lies underneath the outer orbital rim bone, just below the eyebrow. The mucous layer comes from microscopic goblet cells in the conjunctiva.

With each blink, the eyelids sweep across the eye, spreading the tear film evenly across the surface. The blinking motion of the eyelids forces the tears into tiny drains found at the inner corners of the upper and lower eyelids. These drains are called puncta (plural for punctum).

The tear film travels from the puncta into the upper and lower canaliculus, which empty into the lacrimal sac. The lacrimal sac drains into the nasolacrimal duct which connects to the nasal passage. This connection between the tear production system and the nose is the reason your nose runs when you cry. Some patients can actually taste eye drops as they drain from the nasal passage into the throat.

Tear Film

Tears are formed by tiny glands that surround the eye. The tear film is comprised of three layers: oil, water, and mucous. The lower mucous layer serves as an anchor for the tear film and helps it adhere to the eye. The middle layer is comprised of water. The upper oil layer seals the tear film and prevents evaporation.

The tear film serves several purposes: it keeps the eye moist, creates a smooth surface for light to pass through the eye, nourishes the front of the eye, and provides protection from injury and infection.

Sclera

The sclera is commonly known as "the white of the eye." It is the tough, opaque tissue that serves as the eye's protective outer coat. Six tiny muscles connect to it around the eye and control the eye's movements. The optic nerve is attached to the sclera at the very back of the eye.

In children, the sclera is thinner and more translucent, allowing the underlying tissue to show through and giving it a bluish cast. As we age, the sclera tends to become more yellow.

Retina

The retina is a multi-layered sensory tissue that lines the back of the eye. It contains millions of photoreceptors that capture light rays and convert them into electrical impulses. These impulses travel along the optic nerve to the brain where they are turned into images.

There are two types of photoreceptors in the retina: rods and cones. The retina contains approximately 6 million cones. The cones are contained in the macula, the portion of the retina responsible for central vision. They are most densely packed within the fovea, the very center portion of the macula. Cones function best in bright light and allow us to appreciate color.

There are approximately 125 million rods. They are spread throughout the peripheral retina and function best in dim lighting. The rods are responsible for peripheral and night vision.

This photograph shows a normal retina with blood vessels that branch from the optic nerve, cascading toward the macula.

Pupil

The pupil is the opening in the center of the iris. The size of the pupil determines the amount of light that enters the eye. The pupil size is controlled by the dilator and sphincter muscles of the iris. Doctors often evaluate the reaction of pupils to light to determine a person's neurological function.

Optic Nerve

The optic nerve transmits electrical impulses from the retina to the brain. It connects to the back of the eye near the macula. When examining the back of the eye, a portion of the optic nerve called the optic disc can be seen.

The retina's sensory receptor cells of retina are absent from the optic nerve. Because of this, everyone has a normal blind spot. This is not normally noticeable because the vision of both eyes overlaps.

Macula

he macula is located roughly in the center of the retina, temporal to the optic nerve. It is a small and highly sensitive part of the retina responsible for detailed central vision. The fovea is the very center of the macula. The macula allows us to appreciate detail and perform tasks that require central vision such reading.

Lens

The crystalline lens is located just behind the iris. Its purpose is to focus light onto the retina. The nucleus, the innermost part of the lens, is surrounded by softer material called the cortex. The lens is encased in a capsular-like bag and suspended within the eye by tiny "guy wires" called zonules.

In young people, the lens changes shape to adjust for close or distance vision. This is called accommodation. With age, the lens gradually hardens, diminishing the ability to accommodate.

Iris

The colored part of the eye is called the iris. It controls light levels inside the eye similar to the aperture on a camera. The round opening in the center of the iris is called the pupil. The iris is embedded with tiny muscles that dilate (widen) and constrict (narrow) the pupil size.

The sphincter muscle lies around the very edge of the pupil. In bright light, the sphincter contracts, causing the pupil to constrict. The dilator muscle runs radially through the iris, like spokes on a wheel. This muscle dilates the eye in dim lighting.

The iris is flat and divides the front of the eye (anterior chamber) from the back of the eye (posterior chamber). Its color comes from microscopic pigment cells called melanin. The color, texture, and patterns of each person's iris are as unique as a fingerprint.

Eyelids

The eyelids protect the eyes from the environment, injury and light. They also maintain a smooth corneal surface by spreading tears evenly over the eye. The lids are composed of an outer layer of skin, a middle layer of muscle and tissue that gives them form, and an inner layer of moist conjunctival tissue. Several muscles work together to control the actions of the lids. Located in the middle layer of the eyelid is the orbicularis oculi, a circular muscle that closes the lids. The levator muscle is attached inside the upper lid and elevates it. A smooth muscle called Mueller's gives the lids tone and helps maintain elasticity. Tiny oil-producing meibomian glands line the inner edge of the lids. These glands produce oil that lubricates the eye. Rows of lashes protect the eyes from the elements and debris. Not only do the eyelids provide protection and moisture, they display expression and emotions that are an important part of our individuality.

Extraocular Muscles

The six tiny muscles that surround the eye and control its movements are known as the extraocular muscles (EOMs). The primary function of the four rectus muscles is to control the eye's movements from left to right and up and down. The two oblique muscles move the eye rotate the eyes inward and outward.

All six muscles work in unison to move the eye. As one contracts, the opposing muscle relaxes, creating smooth movements. In addition to the muscles of one eye working together in a coordinated effort, the muscles of both eyes work in unison so that the eyes are always aligned.

Cornea

The cornea is the transparent, dome-shaped window covering the front of the eye. It is a powerful refracting surface, providing 2/3 of the eye's focusing power. Like the crystal on a watch, it gives us a clear window to look through.

Because there are no blood vessels in the cornea, it is normally clear and has a shiny surface. The cornea is extremely sensitive - there are more nerve endings in the cornea than anywhere else in the body.

The adult cornea is only about 1/2 millimeter thick and is comprised of 5 layers: epithelium, Bowman's membrane, stroma, Descemet's membrane and the endothelium.

The layers of the cornea

The epithelium is layer of cells that cover the surface of the cornea. It is only about 5-6 cell layers thick and quickly regenerates when the cornea is injured. If the injury penetrates more deeply into the cornea, it may leave a scar. Scars leave opaque areas, causing the corneal to lose its clarity and luster.

Boman's membrane lies just beneath the epithelium. Because this layer is very tough and difficult to penetrate, it protects the cornea from injury.

The stroma is the thickest layer and lies just beneath Bowman's. It is composed of tiny collagen fibrils that run parallel to each other. This special formation of the collagen fibrils gives the cornea its clarity.

Descemet's membrane lies between the stroma and the endothelium. The endothelium is just underneath Descemet's and is only one cell layer thick. This layer pumps water from the cornea, keeping it clear. If damaged or disease, these cells will not regenerate.

Tiny vessels at the outermost edge of the cornea provide nourishment, along with the aqueous and tear film.

Conjunctiva

The conjunctiva is the thin, transparent tissue that covers the outer surface of the eye. It begins at the outer edge of the cornea, covering the visible part of the sclera, and lining the inside of the eyelids. It is nourished by tiny blood vessels that are nearly invisible to the naked eye.

The conjunctiva also secretes oils and mucous that moisten and lubricate the eye.

Ciliary Body

The ciliary body lies just behind the iris. Attached to the ciliary body are tiny fiber "guy wires" called zonules. The crystalline lens is suspended inside the eye by the zonular fibers. Nourishment for the ciliary body comes from blood vessels which also supply the iris.

One function of the ciliary body is the production of aqueous humor, the clear fluid that fills the front of the eye. It also controls accommodation by changing the shape of the crystalline lens. When the ciliary body contracts, the zonules relax. This allows the lens to thicken, increasing the eye's ability to focus up close. When looking at a distant object, the ciliary body relaxes, causing the zonules to contract. The lens becomes thinner, adjusting the eye's focus for distance vision.

With age, everyone develops a condition known as presbyopia. This occurs as the ciliary body muscle and lens gradually lose elasticity, causing difficulty reading.

Choroid

The choroid lies between the retina and sclera. It is composed of layers of blood vessels that nourish the back of the eye. The choroid connects with the ciliary body toward the front of the eye and is attached to edges of the optic nerve at the back of the eye.

Aqueous Humor

The aqueous is the thin, watery fluid that fills the space between the cornea and the iris (anterior chamber). It is continually produced by the ciliary body, the part of the eye that lies just behind the iris. This fluid nourishes the cornea and the lens and gives the front of the eye its form and shape.

Angle Structures

The area in the anterior chamber where the cornea and iris join is known as the angle. This is comprised of several structures that make up the eye's drainage system. The angle structures include: the outermost part of the iris, the front of the ciliary body, the trabecular meshwork, and the Canal of Schlemm.

Aqueous is formed in the ciliary body behind the iris. It flows through the pupillary space into the anterior chamber. From there, the fluid travels into the angle structures and drains from the eye.

As the aqueous fluid leaves the angle, it passes through a filter called the trabecular meshwork. After leaving the trabecular meshwork, the aqueous travels through a tiny channel in the sclera called the Canal of Schlemm. The aqueous flows into other tiny channels and eventually into the eye's blood vessels.

The production and drainage of aqueous fluid determines the eye's intraocular pressure (IOP).

Eye Anatomy

A guide to the many parts of the human eye and how they function.

The ability to see is dependent on the actions of several structures in and around the eyeball. The graphic below lists many of the essential components of the eye's optical system.

When you look at an object, light rays are reflected from the object to the cornea, which is where the miracle begins. The light rays are bent, refracted and focused by the cornea, lens, and vitreous. The lens' job is to make sure the rays come to a sharp focus on the retina. The resulting image on the retina is upside-down. Here at the retina, the light rays are converted to electrical impulses which are then transmitted through the optic nerve, to the brain, where the image is translated and perceived in an upright position!

Think of the eye as a camera. A camera needs a lens and a film to produce an image. In the same way, the eyeball needs a lens (cornea, crystalline lens, vitreous) to refract, or focus the light and a film (retina) on which to focus the rays. If any one or more of these components is not functioning correctly, the result is a poor picture. The retina represents the film in our camera. It captures the image and sends it to the brain to be developed. The macula is the highly sensitive area of the reti

na. The macula is responsible for our critical focusing vision. It is the part of the retina most used. We use our macula to read or to stare intently at an object.

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