Absolute glaucoma OD and

close angle glaucoma OS

Case Report
By : Widya Melianita (17360158)

Preceptor : dr. Rahmat Syuhada,sp.M

Identity
Name : Mrs. Pr
Age : 62 years old
Gender : Famale
Address : Simpur
Occupation : Housewife
No. RM : 093040
MRS : 07-08-2017
History Talking
Autoanamnesis in August 07, 2017
The right eye can not see
Main complaint
and the left eye is blurred

Additional
complaints

Often complain of headaches

and nausea
 Currently disease

Patient came to his family to the eyes of Pertamina Bintang Amin

Hospital with vision complaints on the right and left eyes began to
decrease since 1 year ago. Originally os felt his right and left eyes blur
like smoke and slowly eyesight is not clear until now, but 1 week lately
for right eye suddenly can not see at all, while left eye os experiencing
decrease of vision. Os also feel frequent headache, headache is heavy on
the night. Os also often complain of nausea and feel sore behind the
eyes. Os had previously been treated for RSPBA eye polish 1 week ago
but no change, on examination of intraocular pressure got pressure on
right eye 19,20 and left eye 26. red eye (-), dirty eyes (-), itchy eyes
( -).
 History of diabetes mellitus is denied
PREVIOUS History of hypertension (+)
DISEASE History of trauma is denied

History of
History of current complained
family diseases in the family is denied
disease

History of drug and food allergy is

History of denied
allergy
Physical examination
Patient status

General Condition : Mild pain

Consciousness : Compos Mentis
Vital Sign :

150/100 88 x 22 x/
36,5 C
mmHg /minutes minutes
Oftamology status

OD OS
0 Visus 1/60
No Corection Corection No Corection
Ortoforia Bulbus oculi Ortoforia
Tcrichiasis (-) Silia Tcrichiasis (-)
Madarosis (-) Madarosis (-)
Oedema (-), Hiperemis (-), Palpebral superior Oedema (-), Hiperemis (-),
Enteropion (-), Ekteropion Enteropion (-), Ekteropion
(-), Trikiasis (-), Distikiasis (-), Trikiasis (-), Distikiasis
(-), (-),
Touch pain (-) Touch pain (-)
Oedema (-), Hiperemis (-), Palpebral inferior Oedema (-), Hiperemis (-),
Enteropion (-), Ekteropion Enteropion (-), Ekteropion
(-), Trikiasis (-), Distikiasis (-), Trikiasis (-), Distikiasis
(-), (-)
Touch pain (-) Touch pain (-)
 OD OS
Hiperemis (-), Folikel (-), Conjungtiva Tarsal Hiperemis (-), Folikel
Papil (-) Superior (-), Papil (-)
Hiperemis (-), Folikel (-), Conjungtiva Tarsal Hiperemis (-), Folikel
Papil (-), Litiasis (-), Inferior (-), Papil (-), Litiasis
Sekret (-) (-), Sekret (-)
Injeksi silier (-), Injeksi Conjungtiva Bulbi Injeksi silier (-), Injeksi
conjungtiva (-) conjungtiva (-)
Clear Cornea Clear
shallow Camera Okuli shallow
Anterior
brown, normal cripta Iris brown, normal cripta
round , light reflect (-) Pupil round , light reflect (-)
cloudy Lens cloudy
81,7 TIO 58,1
Supporting Investigation
Tonometric schiozt
Non contact tonomoter
Funduscopy
RESUME

Patient came to his family to the eyes of Pertamina Bintang Amin Hospital
with vision complaints on the right and left eyes began to decrease since 1
year ago. Originally os felt his right and left eyes blur like smoke and slowly
eyesight is not clear until now, but 1 week lately for right eye suddenly can
not see at all, while left eye os experiencing decrease of vision. Os also feel
frequent headache, headache is heavy on the night. Os also often complain
of nausea and feel sore behind the eyes. Os had previously been treated to
RSPBA eye polyps 1 week ago but no change, on examination of intraocular
pressure got pressure on right eye 19,20 and left eye 26.
From the general physical examination found blood pressure of 150/100
mmHg and from the examination ofthalmology obtained VOD=0, VOS=
1/60, CoA shallow , cloudy lens, pupil light reflex (-), TIOD 81.7 and TIOS
58.1.
DIAGNOSE
Absolute glaucoma OD
and close angle glaucoma
OS
Different DIAGNOSE

Ocular Hypertension
Closed angle glaucoma
Open angle glaucoma
Normal pressure glaucoma
THERAPY
Timol.ed.No.I
S.2dd.gtt.1
Cendo Carpine.ed.No.I

S.gtt/hours.ODS
Glaukon.250 mg.Tab.No.XV

S.3dd.Tab.1
Aspar K.300 mg.Tab.No. X

S.2dd.Tab.1
consult to hospital
 PROGNOSE

OD OS

Quo ad vitam dubia ad malam dubia ad bonam

Quo ad functionam dubia ad malam dubia ad bonam

Quo ad sanationam dubia ad malam dubia ad bonam

Discussion
Definisi

Glaukoma absolut merupakan stadium akhir glaukoma

(sempit/terbuka) dimana sudah terjadi kebutaan total akibat tekanan
bola mata memberikan gangguan fungsi lanjut. Glaukoma absolut
merupakan stadium terakhir pada glaukoma primer yang tidak diobati
ataupun gagal dalam pengobatan.
ETIOLOGI
Peningkatan tekanan intraokuler yang dapat disebabkan
oleh bertambahnya produksi humor akueus oleh badan siliar

Berkurangnya pengeluaran humor akueus di daerah sudut

bilik mata atau di celah pupil.
KLASIFIKASI Primer/ infantile
Glaukoma sudut
tertutp 3. Glaukoma
1. Glaukoma Primer Kongenital
Glaukoma sudut Menyertai kelainan
terbuka kongenital lainnya

4. Glaukoma
2. Glaukoma Sekunder
Dislokasi Absolut
Pembengkakan
Perubahan lensa
Fakolitik

Uveitis
Kelainan uvea
Tumor

Hifema
Trauma
Perforasi kornea
dan prolaps iris
Bedah
Steroid dan
lainnya
GEJALA KLINIS
Kornea terlihat keruh

Bilik mata dangkal

Papil atrofi dengan ekskavasi glautomatosa

Mata keras seperti batu dengan rasa sakit.

Diagnosa banding
Hipertensi Okular
Glaukoma sudut tertutup
Glaukoma sudut terbuka
Glaukoma tekanan normal
Penatalaksanaan
Sinar beta pada badan siliar untuk menekan fungsi menekan
fungsi badan siliar
Prosedur Siklodestruktif
Injeksi alkohol retrobulber
Dapat dilakukan juga pengangkatan bola mata karena mata

telah tidak berfungsi dan memberikan rasa sakit.