WHAT TO THINK ABOUT: DIFFERENTIAL DIAGNOSIS OF COMMON OCULAR COMPLAINTS / SYMPTOMS KELUHAN MATA

Mata merah Mata tenan Tra!ma Ruptur bola mata Corneal irregularity Hifema Katarak traumatik "islokasi lensa Perdarahan vitreus Komosio retina Ablasio retina *raumatic optic n pati A"then#$%a Accomodative spasm Uncorrected refractive error Phoria/tropia Convergence insufficiency Pharmacologic & miotics

&%"!" n#rma' D%"*har e +, Pterygium Pinguekula $piskleritis #kleritis Prdrhan subkonj D%"*har e +. Konj is bakteri Konj is virus Konj is alergi Konj is kimia

&%"!" t!r!n Keratitis Ulkus Uveitis anterior !laukoma akut $ndoftalmitis Panoftalmitis Panuveitis 'ftalmia simpatika

&%"!" t!r!n men(a(a) Uveitis posterior Perdarahan vitreus C#R Perdarahan makula CRA'/(RA' CR)'/(R)' Ablasio retina +euritis optik ,A-'+. retrobulbar/ -ntoksikasi alkohol Amaurosis fuga0 (uta kortikal %alingering

&%"!" t!r!n $er'ahan

Katarak !laukoma Uveitis posterior %acular hole %acular edema AR%" Retinopati diabetik Retinopati hipertensi Retinitis pigmentosa A&) shunt -ntoksikasi obat *umor ,hipofisis.meningioma.glioma.serebri/

KELUHAN MATA +LAN/UTAND%$'#$%a F#t#$"%a F'#ater" Gata' N0er%

M#n#)!'ar Refractive error Corneal irregularity Cataract Dislocated lens/IOL Macular diss Retinal detachment

B%n#)!'ar Interm%ttent %yasthenia gravis -ntermittent phoria C#n"tant 3th. 4rd. or 5th nerve palsy 'rbital dis s 1 thyroid. pseudotumor. tumor CC6 #tatus postocular surgery (lo7out fracture dg muscle entrapment C+# lesions ,papilledema/ #pectacle problems

Retinal detachment P)" %igraine Rapid eye movements CNS disorders Retinitis

P)" Posterior uveitis )itreous hemorr )itreous condensations Retinal breaks/RD Corneal opacity Forei n body

Conj is 1 allergic. vernal. viral (lepharitis "ry eye *opical drug allergy !PC Contact lens related problems

O*!'ar/#r1%ta' "ry eye/foreign body -nfectious conj is $piscleritis #cleritis Acute AC! Corneal disorder 1 punctate keratitis 'cular medication to0icity Contact lens&related problems Anterior uveitis Corneal disorder 1erosion. ulcer. U) burn Chemical conj is $ndophthalmitis 'ptic neuritis 'cular ischemic syndr 'rbital pseudotumor/myositis

Per%#r1%ta' Preseptal cellulitis "acryocystitis/dacryoadenitis "ermatitis 1 contact. chemical. 2oster/simple0

'rbital mass/cellulitis/abscess

ORBITAL DISORDERS
2!e"t%#n" t# 1e a")e(: #ymptoms and signs & onset. course. duration Prior disease and therapy -njury #ystemic disease 6amily history 3 P4" Pain Proptosis Progression Palpation 1 letak. batas. ukuran. 7arna. fiksasi ke dasar. nyeri tekan. konsistensi. permukaan ,halus. berbenjol. ulserasi. nekrotik/. pembuluh darah ,telangiektasis. !eedin "essels/. kelenjar getah bening Pulsation & bruit Periorbital changes 1 eyelid retraction ,!raves/. corkscre7 ,A) fistula/. #&shaped eyelid ,neurofibroma/. uveitis anterior ,pseudotumor/. ekimosis ,leukemia/. penebalan pelipis ,meningioma/ Pen!n5an : Hertel 6orced duction test 1 tiroid. untuk melihat restriksi :apang pandang :aboratorium ,"P:. *4. *5. *#H/. biopsi -maging 1 C*&scan. %R-. arteriografi

R!t%n: A) -'P Kedudukan. pergerakan RAP" 6unduskopi8 +9 --

WHAT TO THINK ABOUT: DIFFERENTIAL DIAGNOSIS OF COMMON OCULAR PROPTOSIS

S!$er%#r: %a0illary sinus tumors A6%a': Cavernous hemangioma !lioma %eningioma %etastasis A) malformation Cellulitis Retinoblastoma In7er#'atera': 6rontoetmoidal mucocele Abscess 'steoma #inus carcinoma Capillary hemangioma Rhabdomyosarcoma In7er#me(%a': "ermoid cyst :acrimal gland tumor B%'atera' (%"ea"e": !raves :ymphoma :eukemia +euroblastoma #seudotumor Metastatic tumor CCF Ca"ernous sinus thrombosis

WHAT TO THINK ABOUT: DIFFERENTIAL DIAGNOSIS OF COMMON NEUROLOGIC SYMPTOMS / SIGNS

&%"!" 8 mata tenan Men(a(a) Sat! mata C RA' C R)' A -'+ + euritis optik A blasio retina D!a mata P apilits bilateral - ntoksikasi metanol Co rtical visual impairrment :e ber ,:H'+/ %a lingering Sat! mata A 1) shunt # indrom 6oster&Kennedy *u mor hipofisis ! lioma %en ingioma Per'ahan D!a mata -ntoksikasi obat * umor serebri * umor hipofisis # indrom 6oster&Kennedy D%$'#$%a Pa rese + ---. -). ) Pa pilledema !raves %yasthenia 6raktur Pa$%' atr#7% Pr%mer Se)!n(e r #': Pa$%'e(ema #': (enign intracranial hypertension

P 'A! A -'+ *u hipofisis * '+

(iasa; jembatan keledai; CC ANA PIC#LeMa

AST!GMen

Int#)"%)a"% TTS

PaPa kena Gra9e": M0a"then%a: nd 7ra)t!r

PAT!T

De*rea"e( 9%"%#n

Ret%na' *han e" +.-

Ret%na' *han e" +,-

 CRA' CR)' ischemic %$<"# +N- A&

+N- (%"*

A1+N- (%"*

D%"* e(ema

A1+N- A&

+N- A&

A1+N- A&

+N- A&

A1+N- A&

RAPD +.-

RAPD +,-

RAPD +.-

RAPD +,-

RAPD +.-

RAPD +,-

RAPD +.-

RAPD +,-

RAPD +.-

RAPD +,-

RAPD +.-

RAPD +,-

+euritis retrobulbar

)isul field defect 'ccult retinal dis s

+ is retrobulbar !raves *'+ P-'+ Acute compressive '+ P :H'+ -nfiltrative '+ P Perioptic meningeal Ca

Amblyopia *o0ic '+ P Cone&rod dystrophy (ilateral acute retrobulb compression Paraneoplastic syndr Cancer&associated %elanoma&associated Acute 2onal occult outer retinopathy

!laucoma 'ptic disc drusen "iabetic papillopathy Congenital tilted disc syndr

,&/

'ptic atrophy -ntraorbital / intra& canalicular compressive '+ P :H'+ + II hypoplasia $0cavated disc anomaly

Chiasmal glioma "ominant optic atrophy

,&/

Papilledema Papillophlebitis -ntracranial hypertension

A-'+ Papillitis Chronic papilledema 'rbital

,&/

compression -nfiltrative '+ P

DIFFERENTIAL DIAGNOSIS OF OCULAR SYMPTOMS BURNING (lepharitis %eibomianitis "ry&eye Conjunctivitis Corneal problems $ stainin o! the cornea #tery ium% in!lamed &piscleritis SL' Ocular to(icity $ medication% makeup% contact lens !luid DECREASED &ISION Tran"%ent +n#rma' ;%th%n <= h #econds8 bilateral 1 papilledema %inutes8 unilateral 1 amaurosis fuga0 =>&3> 8 migraine Impendin CR)O Ischemic optic npathy *laucoma Sudden chan e in +# *iant cell arteritis M#re than <= h S!((en: $a%n'e"" RA'/R)' -schemic optic n pathy )itreous hemorrhage Retinal detachment 'ptic neuritis ,pain 7ith movement/ #udden discovery of visual loss Stroke Methanol poisonin Gra(!a': $a%n'e"" Cataract Refractive error 'A! AR%" Retinopathy. diabetic Pa%n7!' Acute AC! 'ptic neuritis Uveitis $ndophthalmitis P#"ttra!ma Corneal irregularity Hyphema Ruptured globe *raumatic cataract :ens dislocation Commotio retinae Retinal detachment )itreous hemorrhage *raumatic optic n pathy DOUBLE &ISION

M#n#*!'ar Refractive error Corneal opacity/irregularity Cataract Dislocated lens/IOL Macular diss Retinal detachment B%n#*!'ar Interm%ttent %yasthenia gravis -ntermittent phoria C#n"tant -solated 3th. 4rd. or 5th nerve palsy 'rbital dis s 1 thyroid. pseudotumor. tumor CC6 #tatus postocular surgery #tatus posttrauma 1 orbital 7all fracture 7ith e0traocular muscle entrapment C+# lesions #pectacle problems FLASHES OF LIGHT Retinal break/detachment P)" %igraine Rapid eye movements CNS disorders Retinitis FLOATERS Tran"%ent %igraine Permanent P)" posterior uveitis )itreous hemorrhage )itreous condensations Retinal break/detachment Corneal opacity Forei n body FOREIGN BODY SENSATION "ry eye (lepharitis Conj is *richiasis Corneal abnormality 1 abrasion/foreign body. recurrent erosion. punctate keratitis Contact lens&related problems $piscleritis Pterygium GLARE Cataract Corneal edema/opacity Altered pupillary structure or response

#tatus postrefractive surgery P)" Pharmacologic 1 atropine

HALOS AROUND LIGHTS Cataract Acute AC! Corneal edema 1 bullous keratopathy. contact lens over7ear Corneal dystrophies Corneal ha2iness/mucus Pigment dispersion syndr )itreous opacities "rugs 1 digitalis. chloro?uine ITCHY EYES Conj is 1 allergic. vernal. viral (lepharitis "ry eye *opical drug allergy or contact dermatitis !iant papillary conj is Contact lens&related problems LIGHT SENSITI&ITY +PHOTOPHOBIAA1n#rma' e0e e6am%nat%#n Corneal abnormality Anterior uveitis N#rma' e0e e6am%nat%#n %igraine %eningitis Retrobulbar optic neuritis PAIN O*!'ar/#r1%ta' "ry eye -nfectious conj is $piscleritis/scleritis 6oreign body Corneal disorder 1 punctate keratitis 'cular medication to0icity Contact lens&related problems 'cular ischemic syndr Corneal disorder 1 abrasion. erosion. ulcer. U) burn Chemical conj is Anterior uveitis $ndophthalmitis Acute AC! 'rbital pseudotumor/myositis 'rbital mass/cellulitis/abscess 'ptic neuritis Per%#r1%ta' Preseptal cellulitis "acryocystitis/acute dacryoadenitis "ermatitis 1 contact. chemical. 2oster/simple0

A"then#$%a Uncorrected refractive error Phoria/tropia Convergence insufficiency Accomodative spasm Pharmacologic & miotics

Retrobulbar hemorrhage Kr#n%" P'A! HIPOTONI Ruptur bola mata Ptisis Retinal detachment Postoperasi NEO&ASKULARISASI "% CR)'/CRA' (R)' *umor intraokular DISLOKASI LENSA *rauma #indrom %arfan #indrom <eill&%archesani LEUKOKORIA Retinoblastoma PHP) Katarak Coat s R'P DEFEK LAPANG PANDANG A't%t!(%na' -schemic optic neuropathy !laukoma Ar)!ata !laukoma +A-'+ B%na"a' !laukoma (itemporal retinal disease ,RP/ B%tem$#ra' :esi kiasma ,tumor hipofisis. meningioma/ Hem%an#$"%a h#m#n%m :esi post/retrokiasma ,lesi di traktus optik. lesi di genikulatum lateral/ S)#t#ma "entra' %acular disease +euritis optik Atrofi optik ,toksik alkohol/ Pem1e"aran 1%nt%) 1!ta Papilledema 'ptic nerve disease KEKERUHAN &ITREUS Perdarahan vitreus )itritis/uveitis posterior Pars planitis #ineresis #el tumor

Abeey
DIFFERENTIAL DIAGNOSIS OF COMMON OCULAR SIGNS HIPOPION Ulkus $ndoftalmitis %assa intraokular ,retinoblastoma/ Uveitis ,(eh@et/ BONE SPICULE Retinitis pigmentosa BULL4S EYE AR%" #targard Klorokuin Cone dystrophy %acular hole COTTON WOOL SPOT A-"# Retinopati hipertensi "% 'klusi arteri/vena NEO&ASKULARISASI RETINA P#'!" $#"ter%#r "% CR)' Per%7er R'P CR)' "% ROTH SPOTS :eukemia Korioretinitis Anemia SHEATHING OF RETINAL &EINS +PERIPHLEBITIS #ifilis Pars planitis #arkoidosis (ehcet PENINGKATAN TIO A)!t Acute AC! Poshner&#chlossman !laukoma maligna