CORNE

DR. YULIA FITRIANI, SPM

LAPISAN CORNEA

KORNEA
FISIOLOGI
- Sebagi media referakta (+ 45
D)
- Pelindung / dinding bola mata.
- Kejernihan kornea
dipertahankan oleh :
* Kondisi dehidrasi relatif
* Susunan sel / serat kolagen
yang teratur
* Tidak adanya pembuluh
darah (Avaskuler)

Standard shape
o

Central zone of 1-3 mm closely fits a

spherical surface
Paracentral zone, 3-4 mm ring, with an
outer diameter of 7-8 mm, area of
progressive flattening (prolate)
Peripheral zone, outer diameter of 11
mm, greatest flattening and asphericity
Limbus, outer diameter that averages 12
mm, the cornea steepens before joining
the sclera

LIMBUS

NEOVASKULARISASI
KORNEA

SENSIBILITAS KORNEA

PLACIDO DISK

KERATOCONUS

KERATOGLOBUS

ERROSIO KORNEA

DEFEK EPITEL KORNEA

TRIKIASIS

CORPUS ALIENUM CORNEA

KERATITIS

PERADANGAN PADA KORNEA YANG DITANDAI

DENGAN :
DEFEK EPITEL KORNEA
INFILTRAT DI SEKELILING DEFEK
OEDEMA DI SEKITAR INFILTRAT

KERATITIS

Radang pada kornea

Distribusi : difus, fokal,
multifokal
Kedalaman : epitel, sub epitel,
stroma, endotel
Lokasi : sentral, perifer
Bentuk : dendritik, disciform,
numular, geografika, pungtata
Causa : virus, bakteri, jamur

CORNEAL DRAWING

GEJALA

NYERI

FOTOFOBIA

Iris meradang kontraksi nyeri

BERAIR

memburuk dengan pergerakan palpebra

Refleks karena syaraf mata di kornea yg

meradang

Penurunan visus
Sensasi benda asing

TANDA

Penurunan visus
Injeksi silier
Kornea edem
Infiltrat : Superfisial, Profunda
Sel radang di bilik mata depan :
Tyndall effect, Hypopion

PEMERIKSAAN SPESIFIK

SLIT LAMP
BIOMICROSCOPY
FLUORESCEIN TEST
SENSITIVITAS
KORNEA
PEMERIKSAAN
MIKROBIOLOGI

Injeksi silier

OEDEMA KORNEA

Tyndal effect

SLIT LAMP BIOMICROSCOPY

Infiltrat pungtata
superfisial

Infiltrat numularis
(stromal)

Infiltrat dendritik

Infiltrat disciformis
(stromal)

Infiltrat geografika

FLUORESCEIN TEST

PEMERIKSAAN
MIKROBIOLOGI

ARCUS SENILIS

TIMBUNAN LIPID

Band Shaped keratopathy

Horizonal opacity ( in the interpalpebral area )

Old degenerated eyes
Hyaline degeneration + Ca deposition

MICROBIAL KERATITIS
(Bacterial)
Pathogens which can produce corneal
infection in intact epithelium.
1.Neisseria gonorrhoeae
2.Corynebacterium diphtheriae
3.Listeria
4.Haemophilus

Staph. aureus and strep.

pneumoniae

Oval, yellowwhite, densely

opaque
stromal
suppuration
surrounded by
relatively clear
cornea

FUNGAL KERATITIS

Filamentous fungal keratitis

Aspergillus
Fusarium

Greyish-white ulcer with indistinct

margins
Surrounded by feathery infilterates
Ring infilterate
Endothelial plaque
Hypopyon

Candida keratitis

Usually develops in pre-existing corneal

disease or immunocompromised patient
Satelite lession
Yellow-white ulcer
Dense suppuration

ACANTHAMOEBA KERATITIS

Protozoan
active (trophozoite)
dormant (cystic)
Common in swimmers and CL wearers
Blurred vision and disproportionate pain
Patchy anterior stromal infilterates
Perineural infilterates (radial keratoneuritis)
Infilterates coalesce ring abcess,
ulceration and hypopyon
White satellite lesions

HERPES SIMPLEX KERATITIS

Primary ocular herpes:

Blepharoconjunctivitis
Keratitis (punctate epithelial)

Dendritic ulcer

Moorens Ulcer ( chronic serpeginous

ulcer )
1ry non infective corneal ulcer
Rare
Common in old age

Aetiology

( unknown )

Limbal vasculitis
Autoimmune disease

Symptoms
Signs

Proteolytic enzymes

necrosis of sup. layers

12345

Marginal grey infiltration

Crescentic Ulcer
Advanced edge ( undermined and creeps toward the center )
Healed edge ( Peripheral and vascularised )
Thin cornea
Extension is slow and perforation is rare

Treatment
Usual ttt + Topical Steroids
Topical Cyclosporine
Conj. Excision // to the ulcer
Lamellar keratoplasty
Systemic Steroids & Immunosuppressive drugs

Keratitis profunda

ULKUS KORNEA

DEFEK EPITEL
KORNEA
INFILTRAT DI
SEKELILING DEFEK
OEDEMA KORNEA
JARINGAN
NEKROTIK

PERFORASI KORNEA

Seidel test

STAPHYLOMA KORNEA

KERATOPLASTY

MEMBUANG
SEBAGIAN KORNEA
YANG RUSAK
MENGGANTI
DENGAN KORNEA
DONOR
MEMBERIKAN
JALAN CAHAYA
MASUK KE DALAM
BOLA MATA

SIKATRIKS KORNEA
NEBUL
A

MAKUL
A

LEKOM
A

Keratic precipitate

granulomatous

Non granulomatous