K A R A K T E R I S T I K PENDERITA K E R A T I T I S DI RUMAH SAKIT MUHAMMADIYAH PALEMBANG

TAHUN 2011-2012

SKRIPSI Sebagai Salah Satu Syarat Memperoleh

Gelar Saijaua Kedokteran (S.Ked)

Oleh: R I Z K I AMALIA NIM : 702010036

FAKULTAS K E D O K T E R A N UNIVERSITAS MUHAMMADIYAH PALEMBANG

FEBRUARI 2014

HALAMAN PENGESAHAN

K A R A K T E R I S T I K PENDERITA K E R A T I T I S DI RUMAH SAKIT MUHAMMADIYAH PALEMBANG

TAHUN 2011-2012

Disiapkan dan Disusun Oleh R I Z K I A M A L U NIM : 702010036

Sebagai Salah Satu Syarat Memperoleh Gelar Sarjana Kedokteran (S.Ked)

Pada Tanggal 11 Februari 2014

Menyetujui:

Dr. H. Ibrahi^i. Sp.M Dr. H. Iskandar ZADTMAH,DAPKJVl.Kes,Sp.Park Pembimbing Pertam a Pembimbing Kedua

Dekan Fakultas Kedokterao

M. Arsvad. DABIC Sp.And NBM/Nn)N.0603480910S22S3/0002064803

PERNYATAAN

D e n g a n i n i S a y a m e n e r a n g k a n b a h w a :

1 . K a r y a T u l i s S a y a . s k r i p s i i n i a d a l a h a s l l d a n b e l u m p e m a h d i a j u k a n u n t u k

m e n d a p a t k a n g e l a r a k a d e m i k , b a i k d i U n i v e r s i t a s M u h a m m a d i y a h P a l e m b a n g ,

m a u p u n P e r g u r u a n T i n g g i L a i n n y a .

2 . K a r y a T u l i s i n i m u m i g a g a s a n , r u m u s a n d a n p e n e l i t i a n S a y a s e n d i r i , t a n p a

b a n t u a n p i h a k l a i n , k e c u a l i a r a h a n T i m P e m b i m b i n g .

3 . D a l a m K a r y a T u l i s i n i t i d a k t e r d a p a t k a r y a a t a u p e n d a p a t y a n g t e l a h d i t u l i s

a t a u d i p u b l i k a s i k a n o r a n g l a i n , k e c u a l i s e c a r a t e r t u l i s d e n g a n d i c a n t u m k a n

s e b a g a i a c u a n d a l a m n a s k a h d e n g a n d i s e b u t k a n n a m a p e n g a r a n g d a n

d i c a n t u m k a n d a l a m d a f t a r p u s t a k a .

4 . I * e r n y a t a a n i n i S a y a b u a t d e n g a n s e s u n g g u h n y a d a n a p a b i l a d i k e m u d i a n h a r i

t e r d a p a t p c n y i m p a n g a n d a n k e t i d a k b e n a r a n d a l a m p e m y a t a a n i n i , m a k a S a y a

b e r s e d i a m e n e r i m a s a n k s i a k a d e m i k a t a u s a n k s i l a i n n y a s e s u a i d e n g a n n o r m a

y a n g b e r l a k u d i P e r g u m a n T i n g g i i n i .

P a l e m b a n g , F e b r u a r i 2 0 1 4

Y a n g m e m b u a t p e m y a t a a n

( R i z k i A m a l i a )

N I M 7 0 2 0 1 0 0 3 6

i i

HALAMAN PERSEMBAHAN DAN MOTTO

^'Health is a state of complete harmony of the body, m i n d and spirit. When one is

free f r o m physical disabilities and mental distractions, the gates of the soul openJ*

- B X . S Iyengar

Karya ini Saya persembahkan kepada:

1. Kedua orang tua Saya, H. Syaifiil Anwar, SE dan D n . Hj. Leii Usmar.

Terimakasih atas segala yang tak dapat tcnicap.

2. Pcmbimbing-pembimbing Saya, dr. H. Ibrahim, Sp.M. dr. H. Iskandar

Zulkamain Ansori, DTM&H, DAPK, M.Kes, Sp.Park dan dr. Legiran,

M.Kes.

Terimakasih atas masukan dan kritik yang membangun.

3. Kcluarga Saya, H. Umar Said, Hj, Mardiana Rasyid, Misrawati Said, SH,

Eni, Syahnil Said, Yenny, Nuricta, Ruslan Maladi, M.Pd dan Raihanah,

SKM.

Terimakasih atas doa dan dukungan yang mengalir.

4. Rachmad Abrar.

Terimakasih selalu atas bahagia dalam bahagia dan tidak bahagta.

5. Saudara-saudara Saya, Nursieli, Yura Fcbriatma Heriyanto, M.

Andryansyah, Ayu Permatasari, Angrayni Putri, Alif Ramadhan, Rani

Nisaul Karomah dan Rina Adibah.

6. Teman-teman seperjuangan skripsi, Ramona Fihi, Desy Rachmawati, Ike

Yuni Pratiwi, Rosyiidta Janah dan Pamela.

7. Teman-teman sejawat angkatan 2010.

iii

U N I V E R S I T A S MUHAMMADIYAH P A L E M B A N G F A K U L T A S K E D O K T E R A N

S K R I P S I , F E B R U A R I 2014 R I Z K I A M A L I A

Karakteristik Penderita Keratitis di Rumah Sakit Muhammadiyah Palembang Tahun 2011-2012

X I I I + 65 Halaman + 3 Tabel + 19 Gambar

A B S T R A K

K e r a t i t i s m e r u p a k a n i n f e k s i d a n i n f l a m a s i p a d a k o m e a y a n g m e n y e b a b k a n p e n u r u n a n t a j a m p e n g l i h a t a n d a n p e n u r u n a n s e n s i t i f i t a s c a h a y a . P a d a b e b e r a p a k a s u s , k e r a t i t i s d a p a t m e n y e b a b k a n k e h i l a n g a n p e n g l i h a t a n a t a u k e b u t a a n . P e n e l i t i a n i n i b e r t u j u a n u n t u k m e n g e t a h u l k a r a k t e r i s t i k p e n d e r i t a k e r a t i t i s d i R u m a h S a k i t M u h a m m a d i y a h P a l e m b a n g T a h u n 2 0 1 1 - 2 0 1 2 . P e n e l i t i a n i n i m e n g g u n a k a n m e t o d e d e s k r i p t i f cross sectional y a n g d i l a k s a n a k a n p a d a t a n g g a l 2 J a n u a r i s a m p a i d e n g a n 7 J a n u a r i 2 0 1 4 d i b a g i a n r e k a m m e d i k R u m a h S a k i t M u h a m m a d i y a h P a l e m b a n g . S a m p e l d i a m b i l d e n g a n t e k n i k simple random sampling. H a s i l n y a m e n u n j u k k a n , d a r i 1 0 0 s u b j e k p e n e l i t i a n d i d a p a t k a n 8 7 % ( n = 8 7 ) p e n d e r i t a k e r a t i t i s b e r a d a p a d a k e l o m p o k u m u r > I 8 l a h u n , 6 1 % ( n = 6 l ) b e r j e n i s k e l a m i n p e r e m p u a n , 6 6 % ( n = 6 6 ) t i d a k b e k e r j a t e r m a s u k i b u r u m a h t a n g g a , 7 7 % ( n = 7 7 ) d e n g a n j e n i s k e r a t i t i s n o n - u l s e r a t i f , 8 1 % ( n = 8 l ) m e n g a l a m i p e n u m n a n v i s u s d a n 4 8 % ( n = 4 8 ) m e n g a l a m i p e r b a i k a n s e t e l a h d i t e r a p i .

Referensi: 41 (1993-2013) Kata Kunci: Keratitis, Penyakit Mata, Karakteristik.

Iv

U N I V E R S I T Y O F MUHAMMADIYAH P A L E M B A N G M E D I C A L F A C U L T Y

S K R I P S I , F E B R U A R Y 2014 R I Z K I A M A L I A

Characteristics of Patients With Keratitis In Muhammadiyah Palembang Hospital 2011-2012

X I U + 65 Pages + 3 Tables + 19 Figures

A B S T R A C T

K e r a t i t i s i s a n i n f e c t i o n a n d i n f l a m m a t i o n o f t h e c o r n e a t h a t c a u s e s d e c r e a s e d v i s u a l a c t i v i t y a n d d e c r e a s e d s e n s i t i v i t y t o l i g h t . I n s e v e r e c a s e s , k e r a t i t i s c a u s e s b l i n d n e s s . T h i s s t u d y a i m s t o i n v e s t i g a t e t h e c h a r a c t e r i s t i c s o f p a t i e n t s w i t h k e r a t i t i s i n M u h a m m a d i y a h P a l e m b a n g H o s p i t a l 2 0 1 1 - 2 0 1 2 . T h i s s t u d y u s e d a d e s c r i p t i v e c r o s s s e c t i o n a l m e t h o d i m p l e m e n t e d o n J a n u a r y 2 t o J a n u a r y 7 , 2 0 1 4 a t t h e m e d i c a l r e c o r d s o f f i c e o f M u h a m m a d i y a h P a l e m b a n g H o s p i t a l . S a m p l e s w e r e t a k e n w i t h a s i m p l e r a n d o m s a m p l i n g t e c h n i q u e . O f t h e 1 0 0 s u b j e c t s s t u d i e d , 8 7 % ( n = 8 7 ) w e r e i n t h e a g e g r o u p > I 8 y e a r s , 6 1 % ( n = 6 l ) w e r e f e m a l e , 6 6 % ( n = 6 6 ) d i d n o t w o r k ( i n c l u d i n g h o u s e w i v e s ) , 7 7 % ( n = 7 7 ) o f t h e k e r a t i t i s w a s t h e n o n - u l c e r a t i v e t y p e , 8 1 % ( n = 8 l ) o f t h e s u b j e c t s s u f f e r e d f r o m d e c r e a s e d v i s u a l a c t i v i t y a n d 4 8 % ( n = 4 8 ) i m p r o v e d a f t e r t r e a t m e n t .

References: 41 (1993-2013) Keywords: Keratitis, Eye Diseases, Characteristics.

KATA PENGANTAR

F u j i s y u k u r p e n e l i t i p a n j a t k a n k e p a d a A l l a h S W T a t a s s e g a l a r a h m a t d a n

k a r u n i a - N y a s e h i n g g a p e n e l i t i d a p a t m c n y e l e s a i k a n p e n e l i t i a n i n i y a n g b e r j u d u l

"^Karakteristik Penderita Keratitis di Rumah Sakit Muhammadiyah

Palembang Tahun 2011-2012" s e b a g a i s a l a h s a t u s y a r a t u n t u k m e l a k u k a n

p e n e l i t i a n d i F a k u l t a s K e d o k t e r a n U n i v e r s i t a s M u h a m m a d i y a h P a l e m b a n g .

P e n e l i t i m e n y a d a r i b a h w a p e n e l i t i a n i n i j a u h d a r i s e m p u m a . O l e h k a r e n a i t u ,

p e n e l i t i m e n g h a r a p k a n k r i t i k d a n s a r a n y a n g b e r s i f a t m e m b a n g u n g u n a p e r b a i k a n

d i m a s a m e n d a l a n g .

D a l a m h a l p e n y e l e s a i a n p e n e l i t i a n i n i , p e n e l i t i b a n y a k m e n d a p a t b a n t u a n ,

b i m b i n g g a n d a n s a r a n . P a d a k e s e m p a t a n i n i , p e n u l i s i n g i n m e n y a m p a i k a n r a s a

h o n m a t d a n t e r i m a k a s i h k e p a d a :

1 . A l l a h S W T y a n g t e l a h m e m b e r k e h i d u p a n d e n g a n s e j u k n y a k e i m a n a n .

2 . D e k a n d a n p e m b a n t u d e k a n b e s e r t a s t a l T F a k u l t a s K e d o k t e r a n U n i v e r s i t a s

M u h a m m a d i y a h P a l e m b a n g

3 . D r . H . I b r a h i m , S p . M s e l a k u p e m b i m b i n g I .

4 . D r . H . I s k a n d a r Z u l k a m a i n A n s o r i , D T M & H , D A P K , M . K e s , S p . P a r k

s e l a k u p e m b i m b i n g I I .

5 . D r . L e g i r a n , M . K e s s e l a k u p e n g u j i .

S e m o g a A l l a h S W T m e m b e r i k a n b a l a s a n p a h a l a a t a s s e g a l a a m a l y a n g

d i b e r i k a n k e p a d a s e m u a o r a n g y a n g t e l a h m e n d u k u n g p e n e l i t i d a n s e m o g a l a p o r a n

i n i b e r m a n f a a t b a g i k i t a d a n p e r k e m b a n g a n i l m u p e n g e t a h u a n k e d o k t e r a n .

S e m o g a k i t a s e l a l u d a l a m l i n d u n g a n A l l a h S W T . A m i n .

P a l e m b a n g , F e b r u a r i 2 0 1 4

P e n e l i t i

v l

Daftar Isi

J u d u l

H a l a m a n P e r s e t u j u a n i

H a l a m a n P e m y a t a a n "

H a l a m a n P e r s e m b a h a n d a n M o t t o i"

A b s t r a k iv

Abstract v

K a t a P e n g a n t a r vi

D a f t a r I s i vii

D a f t a r T a b e l x

D a f t a r G a m b a r xi

D a f t a r D i a g r a m xii

D a f t a r L a m p i r a n xiii

BAB I Pendahuluan

1.1 L a t a r B e l a k a n g 1

1.2 R u m u s a n M a s a l a h 3

1.3 T u j u a n P e n e l i t i a n 3

1 .3 .1 T u j u a n U m u m 3

1 .3 .2 T u j u a n K h u s u s 3

1.4 M a n f a a t P e n e l i t i a n 3

1 .4 .1 M a n f a a t T e o r i t i s 3

1 .4 .2 M a n f a a t P r a k t i s 3

1.5 K e a s l i a n P e n e l i t i a n 4

BAB I I Tinjauan Pustaka

2 . 1 A n a t o m i d a n F i s i o l o g i M a t a 7

2 . 1 . 1 P a l p e b r a 7

2 . 1 . 2 K o n j u n g t i v a 8

2 . 1 . 3 S i s t e m L a k r i m a l 9

2 . 1 . 4 R o n g g a O r b i t a 9

v i i

2 . 1 . 5 O t o t - o t o t m a t a 10

2 . 1 . 6 K o m e a 11

2 . 1 . 7 S k i e r a 13

2.1.8 B i i i k M a t a D e p a n 14

2 .1 .9 U v e a 15

2.1.10 L e n s a 16

2 . 1 . 1 1 B a d a n K a c a 17

2 . 1 . 1 2 R e t i n a 17

2 . 1 . 1 3 N e r v u s O p t i k u s 18

2 . 2 K e r a t i t i s 19

2 . 2 . 1 D e f i n i s i 19

2 . 2 . 2 F a k t o r R i s i k o 19

2 . 2 . 3 E t i o l o g i 19

2.2 .4 K l a s i f i k a s i 22

2 . 2 . 5 D i a g n o s i s K l i n i s 29

2 . 2 . 6 P e n g o b a t a n 29

2 . 3 K e r a n g k a T e o r i 31

BAB I I I Metode Penelitian

3 . 1 J e n i s P e n e l i t i a n 32

3.2 W a k t u d a n T e m p a t P e n e l i t i a n 32

3 . 2 . 1 W a k t u P e n e l i t i a n 32

3 . 2 . 2 T e m p a t P e n e l i t i a n 32

3 . 3 P o p u l a s i / S u b j e k P e n e l i t i a n 32

3.3 .1 P o p u l a s i P e n e l i t i a n 32

3 . 3 . 2 S a m p e l P e n e l i t i a n 32

3 . 3 . 3 K r i t e r i a I n k l u s i d a n E k s k l u s i 33

3.4 C a r a P e n g a m b i l a n S a m p e l 33

3.5 V a r i a b e l P e n e l i t i a n d a n D e f i n i s i O p e r a s i o n a ! 33

3 . 6 C a r a P e n g u m p u l a n D a t a 35

3 . 7 A n a l i s i s D a t a 35

3.8 A l u r P e n e l i t i a n 36

v i i i

BAB IV Hasil dan Pembahasan

4 . 1 H a s i l P e n e l i t i a n 3 7

4 . 2 P e m b a h a s a n 4 0

4 . 3 K e t e r b a t a s a n P e n e l i t i a n 4 4

BAB V Kesimpulan dan Saran

5 . 1 K e s i m p u l a n 4 5

5 . 2 S a r a n 4 5

Daftar Pustaka 4 6 - 4 9

Lampiran 5 0 - 6 5

Ix

Daftar Tabel

Tabel Halaman

1.1 K e a s l i a n P e n e l i t i a n 4

2 . 1 K l a s i f i k a s i K e r a t i t i s 22

3 . 1 V a r i a b e l P e n e l i t i a n d a n D e f i n i s i O p e r a s i o n a l 32

X

Daftar Gambar

Gambar Halaman

2 . 1 A n a t o m i M a t a 7

2 . 2 R o n g g a O r b i t a 9

2 . 3 L a p i s a n K o m e a I I

2 . 4 H i s t o l o g i K o m e a 12

2 . 5 H i s t o l o g i R e t i n a 18

2 . 6 U l k u s K o m e a 23

2 . 7 K e r a t i t i s B a k t e r i a ! 24

2 . 8 K e r a t i t i s D e n d r i t i k 25

2 . 9 Thygeson Superficial Punctate Keratitis 28

4 . 1 D i a g r a m P e r s e n t a s e P e n y a k i t M a t a d i R S M P 3 7

T a h u n 2 0 1 1 - 2 0 1 2

4 . 2 D i a g r a m P e r s e n t a s e P e n y a k i t I n f e k s i M a t a d i 3 8

R S M P T a h u n 2 0 1 1 - 2 0 1 2

4 . 3 D i a g r a m P e r s e n t a s e K a r a k t e r i s t i k U m u r P e n d e r i t a 3 8

K e r a t i t i s d i R S M P T a h u n 2 0 1 1 - 2 0 1 2

4 . 4 D i a g r a m P e r s e n t a s e K a r a k t e r i s t i k J e n i s K e l a m i n 3 9

P e n d e r i t a K e r a t i t i s d i R S M P T a h u n 2 0 I I - 2 0 1 2

4 . 5 D i a g r a m P e r s e n t a s e K a r a k t e r i s t i k P e k e r j a a n 3 9

P e n d e r i t a K e r a t i t i s d i R S M P T a h u n 2 0 1 1 - 2 0 1 2

4 . 6 D i a g r a m P e r s e n t a s e K a r a k t e r i s t i k J e n i s K e r a t i t i s 4 0

d i R S M P 2 0 1 1 - 2 0 1 2

4 . 7 D i a g r a m P e r s e n t a s e K a r a k t e r i s t i k J e n i s K e r a t i t i s 4 0

N o n - u l s e r a t i f d i R S M P 2 0 1 1 - 2 0 1 2

4 . 8 D i a g r a m P e r s e n t a s e K a r a k t e r i s t i k L a t e r a l i t a s 4 1

y a n g T e r k e n a P a d a P e n d e r i t a K e r a t i t i s d i R S M P

T a h u n 2 0 1 1 - 2 0 1 2

4 . 9 D i a g r a m P e r s e n t a s e I n t e r p r e t a s i H a s i l 4 1

x i

P e m e r i k s a a n V i s u s P e n d e r i t a K e r a t i t i s S e b e l u m

D i t e r a p i d i R S M P T a h u n 2 0 1 1 - 2 0 1 2

4 . 1 0 D i a g r a m P e r s e n t a s e I n t e r p r e t a s i K c m a j u a n 4 2

P e n g o b a t a n D a r i H a s i l P e m e r i k s a a n V i s u s

P e n d e r i t a K e r a t i t i s S e t e l a h D i t e r a p i d i R S M P

T a h u n 2 0 1 1 - 2 0 1 2

x i i

Daftar Lampiran

Lampiran Halaman

I S u r a t I z i n P e n e l i t i a n k e R S . M u h a m m a d i y a h 5 0

P a l e m b a n g

I I S u r a t K e t e r a n g a n T e l a h D i l a k u k a n P e n e l i t i a n d i 5 1

R S . M u h a m m a d i y a h P a l e m b a n g

I I I D a f t a r P e n d e r i t a K e r a t i t i s d i R S . M u h a m m a d i y a h 5 2

P a l e m b a n g

I V T a b e l H a s i l P e m e r i k s a a n V i s u s P e n d e r i t a K e r a t i t i s 5 6

S e b e l u m D i t e r a p i d i R S . M u h a m m a d i y a h

P a l e m b a n g T a h u n 2 0 I I - 2 0 1 2

V T a b e l H a s i l P e m e r i k s a a n V i s u s P e n d e r i t a K e r a t i t i s 6 0

S e t e l a h D i t e r a p i d i R S . M u h a m m a d i y a h

P a l e m b a n g T a h u n 2 0 I I - 2 0 1 2

V I K a r t u A k l i v i t a s B i m b i n g a n S k r i p s i 64

V I I B i o d a t a R i n g k a s 65

xiii

B A B l

PENDAHULUAN

1.1 Latar Belakang

K e r a t i t i s a d a l a h s u a t u i n f e k s i d a n i n f l a m a s i p a d a k o m e a y a n g m e n y e b a b k a n

r a s a n y e r i , m a t a b e r a i r , p e n u r u n a n t a j a m p e n g l i h a t a n d a n p e n u m n a n s e n s i t i f i t a s

c a h a y a . P a d a b e b e r a p a k a s u s , k e r a t i t i s m e n y e b a b k a n k e h i l a n g a n p e n g l i h a t a n a t a u

k e b u t a a n ( J a n u m a l a , S e h g a l amJManda\, 2 0 1 2 ) .

M e n u m t J a n u m a l a , S e h g a l and M a n d a l ( 2 0 1 2 ) , k e r a t i t i s f u n g a l l e b i h b a n y a k

t e r j a d i p a d a d a e r a h y a n g m e m i l i k i c u a c a h a n g a t d a n b e r a n g i n , s e d a n g k a n k e r a t i t i s

b a k t e r i a l b u k a n m e r u p a k a n p e n y a k i t m u s i m a n d a n b a n y a k b e r k e m b a n g p a d a

d a e r a h d e n g a n i k l i m s e d a n g .

D i N e g a r a - n e g a r a d e n g a n i k l i m t r o p i s , a n g k a k e j a d i a n k e r a t i t i s m e n u n j u k k a n

p e r b e d a a n g e o g r a f i s p a d a s e t i a p i n s i d e n n y a . S e h i n g g a c a k u p a n k e r a t i t i s s a n g a t

b e r v a r i a s i s e s u a i d e n g a n l o k a s i g e o g r a f i s y a n g d i p e n g a m h i o l e h i k l i m l o k a l d a n

f a k t o r r e s i k o p e k e r j a a n .

Andhra Pradesh Eye Disease Study ( A P E D S ) y a n g d i l a k s a n a k a n d i L V P r a s a d

E y e I n s t i t u t e , H y d e r a b a d , m e m p e r k i r a k a n a n g k a k e j a d i a n k e b u t a a n k o m e a p a d a

s a t u m a t a a t a u l e b i h s e b e s a r 0 , 6 6 % ( C I 0 , 4 9 - 0 , 8 6 ) a d a l a h k e r a t i t i s p a d a m a s a

a n a k - a n a k ( 3 6 , 7 % ) , t r a u m a ( 2 8 , 6 % ) d a n k e r a t i t i s p a d a m a s a d e w a s a ( 1 7 , 7 % )

( D a n d o n a and D a n d o n a , 2 0 0 3 ) .

A n g k a k e j a d i a n k e r a t i t i s s a n g a t b e r v a r i a s i a n t a r a N e g a r a - n e g a r a b a r a t d a n

N e g a r a - n e g a r a b e r k e m b a n g . N e g a r a - n e g a r a i n d u s t r i y a n g l e b i h s e d i k i t j u m l a h n y a

m e m i l i k i a n g k a p e n g g u n a l e n s a k o n t a k y a n g t i d a k b a n y a k , k a r e n a n y a h a n y a

t e r j a d i b e b e r a p a i n s i d e n i n f e k s i y a n g b e r h u b u n g a n d e n g a n l e n s a k o n t a k . S e b a g a i

c o n t o h , A m e r i k a S e r i k a t m e m i l i k i a n g k a k e j a d i a n k e r a t i t i s 1 1 p e r 1 0 0 . 0 0 0

p e n d u d u k j i k a d i b a n d i n g k a n d e n g a n N e p a l y a n g m e m i l i k i a n g k a k e j a d i a n k e r a t i t i s

s e b e s a r 7 9 9 p e r 1 0 0 . 0 0 0 p e n d u d u k ( A l - M u j a i n i et ai, 2 0 0 9 ) .

H a s i l p e n e l i t i a n y a n g d i l a k u k a n O l a d i g b o l u et ai ( 2 0 1 3 ) d i A h m a d u B e l l o

U n i v e r s i t y T e a c h i n g H o s p i t a l , N i g e r i a , d i d a p a t k a n 2 2 8 k a s u s k e r a t i t i s s e l a m a 10

t a h u n t e r a k h i r . S e b a n y a k 1 2 9 k a s u s ( 5 6 , 6 % ) d i a l a m i o l e h p r i a d a n 9 9 k a s u s

2

( 4 3 , 4 % ) o l e h w a n i t a d e n g a n r e n t a n g u s i a 1 5 b u l a n - 6 6 t a h u n . F a k t o r - f a k t o r y a n g

m e n y e b a b k a n k e r a t i t i s a d a l a h t r a u m a ( 5 1 , 3 % ) , p e n g g u n a a n o b a t m a t a t r a d i s i o n a l

( 1 7 , 1 % ) , p e n g o b a t a n s e n d i r i d e n g a n s t e r o i d t o p i k a l ( 5 , 7 % ) d a n c a m p a k ( 4 , 0 % ) .

A l b a r ( 2 0 1 2 ) m e l a p o r k a n h a s i l p e n e l i t i a n y a n g d i l a k s a n a k a n d i R S U P H .

A d a m M a l i k M e d a n a d a l a h p e n d e r i t a k e r a t i t i s p a d a k e l o m p o k u m u r 2 8 - 3 5 t a h u n

s e b e s a r 2 9 , 5 % d a n u m u r d i a t a s 1 8 t a h u n s e b e s a r 9 3 , 6 % , d e n g a n p r o p o r s i l a k i -

l a k i s e b e s a r 6 1 , 5 % d a n p e r e m p u a n s e b e s a r 3 8 , 5 % . F a k t o r p e k e r j a a n p a l i n g b a n y a k

a d a l a h p e t a n i y a i t u s e b e s a r 2 6 , 9 % . S e d a n g k a n p a d a p e n e l i t i a n y a n g d i l a k u k a n

M i r z a ( 2 0 1 2 ) p a d a r u m a h s a k i t y a n g s a m a d i d a p a t k a n f a k t o r p e k e r j a a n y a n g

p a l i n g b a n y a k m e n g a l a m i k e r a t i t i s a d a l a h w i r a s w a s t a ( 2 7 , 3 % ) .

S e l a i n i n s i d e n s i y a n g t i n g g i p a d a n e g a r a b e r k e m b a n g , k o t a P a l e m b a n g s e c a r a

g e o g r a f i s m e m i l i k i i k l i m u d a r a t r o p i s y a n g m e n d u k u n g b e r k e m b a n g n y a

m i k r o o r g a n i s m e u n t u k t e r j a d i i n f e k s i . S e l a i n i t u j u g a , b a n y a k n y a k a s u s s e r t a

b e l u m a d a n y a d a t a p e n e l i t i a n m e n g e n a i k a r a k t e r i s t i k p e n d e r i t a k e r a t i t i s m e n j a d i

d a s a r b a g i p e n e l i t i u n t u k m e n g e v a l u a s i k a r a k t e r i s t i k p e n d e r i t a k e r a t i t i s .

P a d a p e n e l i t i a n i n i , p e n e l i t i m e m b a t a s i k a r a k t e r i s t i k y a n g a k a n d i t e l i t i p a d a

p e n d e r i t a k e r a t i t i s a n t a r a l a i n b e r d a s a r k a n u m u r , j e n i s k e l a m i n , p e k e r j a a n , j e n i s

k e r a t i t i s , v i s u s p e n d e r i t a s e b e l u m d i t e r a p i , d a n v i s u s p e n d e r i t a s e t e l a h d i t e r a p i

s e l a m a 2 m i n g g u .

1.2 Rumusan Masalah

B a g a i m a n a k a r a k t e r i s t i k p e n d e r i t a k e r a t i t i s d i R u m a h S a k i t M u h a m m a d i y a h

P a l e m b a n g T a h u n 2 0 1 1 - 2 0 1 2 ?

1.3 Tujuan Penelitian

1.3.1 Tujuan Umum

P e n e l i t i a n i n i b e r t u j u a n u n t u k m e n g e t a h u i k a r a k t e r i s t i k p e n d e r i t a

k e r a t i t i s d i R u m a h S a k i t M u h a m m a d i y a h P a l e m b a n g T a h u n 2 0 1 1 - 2 0 1 2 .

1.3.2 Tujuan Khusus

1 . M e n g e t a h u i p e r s e n t a s e u m u r p e n d e r i t a k e r a t i t i s d i R u m a h S a k i t

M u h a m m a d i y a h P a l e m b a n g T a h u n 2 0 1 1 - 2 0 1 2 .

3

2 . M e n g e t a h u i p e r s e n t a s e j e n i s k e l a m i n p e n d e r i t a k e r a t i t i s d i R u m a h

S a k i t M u h a m m a d i y a h P a l e m b a n g T a h u n 2 0 1 1 - 2 0 1 2 .

3 . M e n g e t a h u i p e r s e n t a s e p e k e r j a a n p e n d e r i t a k e r a t i t i s d i R u m a h S a k i t

M u h a m m a d i y a h P a l e m b a n g T a h u n 2 0 1 1 - 2 0 1 2 .

4 . M e n g e t a h u i p e r s e n t a s e j e n i s k e r a t i t i s p e n d e r i t a k e r a t i t i s d i R u m a h

S a k i t M u h a m m a d i y a h P a l e m b a n g T a h u n 2 0 I I - 2 0 1 2 .

5 . M e n g e t a h u i p e r s e n t a s e k a r a k t e r i s t i k l a t e r a l i t a s y a n g t e r k e n a k e r a t i t i s

p a d a p e n d e r i t a k e r a t i t i s d i R u m a h S a k i t M u h a m m a d i y a h P a l e m b a n g

T a h u n 2 0 1 1 - 2 0 1 2 .

6 . M e n g e t a h u i v i s u s p e n d e r i t a k e r a t i t i s s e b e l u m d i t e r a p i d i R u m a h

S a k i t M u h a m m a d i y a h P a l e m b a n g T a h u n 2 0 1 1 - 2 0 1 2 .

7 . M e n g e t a h u i v i s u s p e n d e r i t a k e r a t i t i s s e t e l a h d i t e r a p i s e l a m a 2

m i n g g u d i R u m a h S a k i t M u h a m m a d i y a h P a l e m b a n g T a h u n 2 0 1 1 -

2 0 1 2 .

1.4 Manfaat Penelitian

1.4.1 Manfaat Teoritis/Ilmiah

1 . M e n a m b a h w a w a s a n d a n p e n g a l a m a n t e n t a n g k e r a t i t i s

2 . D a p a t m e n j a d i d a t a a w a l a t a s p e n e l i t i a n p e n d a h u l u a n b a g i p e n e l i t i a n

s e l a n j u t n y a y a n g s e j e n i s a t a u t e r k a i t

1.4.2 Manfaat Praktis

1 . M e d i a p e n y u l u h a n k e p a d a p a s i e n d a n k e l u a r g a u n t u k w a s p a d a

t e r h a d a p k e r a t i t i s

2 . B a h a n p e n y u l u h a n k e p a d a m a s y a r a k a t u n t u k m e n g e t a h u i g e j a l a d a n

t a n d a - t a n d a k e r a t i t i s s e h i n g g a d a p a t m e l a k u k a n p e m e r i k s a a n s e g e r a

3 . S a l a h s a t u s y a r a t u n t u k m e m p e r o l e h g e l a r s a r j a n a k e d o k t e r a n

1.5 Keaslian Penelitian

B e r d a s a r k a n p e n e l u s u r a n t e r h a d a p j u d u l p e n e l i t i a n y a n g t e l a h d i l a k u k a n ,

s e d i k i t n y a p e n u l i s m e n e m u k a n I ( s a t u ) j u d u l t e s i s d a n 2 ( d u a ) j u d u l s k r i p s i t e r k a i t

k a r a k t e r i s t i k p e n d e r i t a k e r a t i t i s y a i t u :

4

T a b e l 1.1 K e a s l i a n P e n e l i t i a n

N a m a

P e n e l i t i l a h u n J u d u l

M e t o d e

P e n e l i t i a n H a s i l P e n e l i t i a n

M a r i n a 2 0 1 2 K a r a k t e r i s t i k

Y u s n i t a P e n d e r i t a

A l b a r K e r a t i t i s

I n f e k t i f d i R S .

H. A d a m

M a l i k M e d a n

T a h u n 2 0 1 0 -

2 0 1 1

D e s k r i p t i f

d e n g a n d e s a i n

case series

P r o p o r s i p e n d e r i t a

k e r a t i t i s i n f e k t i f p a d a

k e l o m p o k u m u r 2 8 - 3 5

t a h u n 2 9 , 5 % . u m u r d i

a t a s 18 t a h u n 9 3 , 6 %

d e n g a n p r o p o r s i l a k i -

l a k i 6 1 , 5 % d a n

p e r e m p u a n 3 8 , 5 % ,

p e k e r j a a n p e t a n i 2 6 , 9 % ,

k e r a t i t i s b a k t e r i a l

5 1 , 3 % , m e d i k a m e n t o s a

9 7 , 4 % .

S a r a h 2 0 1 2 K a r a k t e r i s t i k D e s k r i p t i f D i d a p a t k a n 1 5 4 p a s i e n

Z o r a y a P e n d e r i t a d e n g a n p e n d e r i t a k e r a t i t i s d a n

M i r z a K e r a t i t i s d i p e n d e k a t a n t e r b a n y a k a d a l a h l a k i -

R u m a h S a k i t cross l a k i ( 8 9 p a s i e n , 5 7 , 8 % ) .

U m u m P u s a t sectional B e r d a s a r k a n u s i a p a l i n g

H a j i A d a m r e t r o s p e k t i f b a n y a k a d a l a h > 4 0

M a l i k M e d a n t a h u n ( 7 3 p a s i e n ,

T a h u n 2 0 1 0 - 4 7 , 4 % ) , p e k e r j a a n

2 0 1 1 s e b a g a i w i r a s w a s t a ( 4 2

p a s i e n , 8 , 4 % ) , p a s i e n

y a n g m e m p u n y a i

r i w a y a t t r a u m a k o m e a

t e r b a n y a k d i s e b a b k a n

o l e h d e b u ( 9 5 p a s i e n ,

6 8 , 3 % ) .

5

F a r i d a 2 0 1 3 K a r a k t e r i s t i k D e s k r i p t i f 1 2 7 p e n d e r i t a k e r a t i t i s

S u l v i a P e n d e r i t a m e m p u n y a i

K e r a t i t i s d i k a r a k t e r i s t i k t e r b a n y a k

R u m a h S a k i t u s i a 1 6 - 3 9 t a h u n 5 8

Dr. Y A P o r a n g ( 4 5 , 6 7 % ) , j e n i s

Y o g y a k a r t a k e l a m i n l a k i - l a k i 7 7

P e r i o d e 1 o r a n g ( 6 0 , 6 3 % ) ,

J a n u a r i - 3 1 p e n d i d i k a n S D 4 1 o r a n g

D e s e m b e r ( 3 2 , 2 8 % ) , b e r a s a l d a r i

2 0 1 1 D I Y 7 4 o r a n g

( 5 8 , 2 6 % ) . p e g a w a i

s w a s t a / w i r a s w a s t a 2 9

o r a n g ( 2 2 , 8 3 % ) ,

r i w a y a t t r a u m a m e k a n i k

8 6 o r a n g ( 6 2 , 7 2 % ) d a n

1 2 7 o r a n g m e n d a p a t k a n

t e r a p i o b a t - o b a t a n .

M e s k i p u n t e r d a p a t p e r s a m a a n j u d u l , n a m u n t e r d a p a t p e r b e d a a n p a d a

p e n e l i t i a n y a n g a k a n d i l a k u k a n y a i t u t e m p a t p e l a k s a n a a n p e n e l i t i a n d a n d e s a i n

p e n e l i t i a n y a n g d a l a m p e n e l i t i a n i n i a k a n d i l a k s a n a k a n d i R u m a h S a k i t

M u h a m m a d i y a h K o t a P a l e m b a n g d e n g a n d e s a i n p e n e l i t i a n d e s k r i p t i f cms-.v

sectional.

BAB I I

TINJAUAN PUSTAKA

2.1 Anatomi dan Fisiologi Mata

C o r n e a

7 ) 1 ^ 8

® L e n s

I r i s

Pupil

Gambar 2.1 Anatomi Mata

S u m b e r : w w w . a a o . o r g / e y e c a r e / a n a t o m y

M a t a a d a l a h o r g a n f o t o s e n s i t i f y a n g k o m p l e k s d a n b e r k e m b a n g l a n j u t y a n g

m e m u n g k i n k a n a n a l i s i s c e r m a t t e n t a n g b e n t u k , i n t e n s i t a s c a h a y a , d a n w a m a y a n g

d i p a n t u l k a n o b y e k . M a t a t e r l e t a k d i d a l a m s t r u k t u r t e n g k o r a k y a n g

m e l i n d u n g i n y a , y a i t u o r b i t a ( V a u g h a n , A s b u r y d a n E v a , 2 0 0 0 ) .

M a t a d i k e l o m p o k k a n m e n j a d i d u a b a g i a n , y a i t u a d n e k s a m a t a d a n b o l a m a t a .

A d n e k s a m a t a m e r u p a k a n j a r i n g a n p e n d u k u n g m a t a y a n g t e r d i r i d a r i p a l p e b r a ,

k o n j u g t i v a , s i s t e m l a k r i m a l , r o n g g a o r b i t a d a n o t o t - o t o t m a t a . S e d a n g k a n a n a t o m i

b o l a m a t a j i k a d i u r u t k a n d a r i y a n g p a l i n g d e p a n t e r d i r i d a r i k o m e a , s k i e r a , b l l i k

m a t a d e p a n , u v e a , p u p i l , l e n s a , b a d a n k a c a , r e t i n a d a n n e r v u s o p t i k u s ( P e r d a m i ,

2 0 0 5 ) .

2.1.1 Palpebra

P a l p e b r a a t a u k e l o p a k m a t a m e m p u n y a i f u n g s i m e l i n d u n g i b o l a m a t a ,

m e m b e r s i h k a n p e r m u k a a n m a t a d a r i k o t o r a n d a n i r i t a s i l a i n d e n g a n b e r k e d i p ,

s e r t a m e n g e l u a r k a n s e k r e s i k e l e n j a m y a y a n g m e m b e n t u k f i l m a i r m a t a d i d e p a n

k o m e a ( l l y a s , 2 0 0 9 ) .

8

L a p i s a n s u p e r f i s i a l d a r i p a l p e b r a t e r d i r i d a r i k u l i t , k e l e n j a r M o l l d a n Z e i s ,

m u s k u l u s o r b i k u l a r i s o k u l i d a n l e v a t o r p a l p e b a r . L a p i s a n d a l a m t e r d i r i d a r i l a p i s a n

t a r s a l , m u s k u l u s t a r s a l i s , k o n j u n g t i v a p a l p e b r a l i s d a n k e l e n j a r m e i b o m ( W a g n e r ,

2 0 0 6 ) .

2.1.2 Konjungtiva

S e c a r a a n a t o m i s k o n j u n g t i v a a d a l a h m e m b r a n m u k o s a y a n g t r a n s p a r a n d a n

t i p i s y a n g m e m b u n g k u s p e r m u k a a n p o s t e r i o r k e l o p a k m a t a ( k o n j u n g t i v a

p a l p e b r a l i s ) d a n p e r m u k a a n a n t e r i o r s k i e r a ( k o n j u n g t i v a b u l b a r i s ) . K o n j u n g t i v a

p a l p e b r a l i s m e i a p i s i p e r m u k a a n p o s t e r i o r k e l o p a k m a t a d a n m e l e k a t e r a t k e t a r s u s

( V a u g h a n , 2 0 1 0 ) .

A r t e r i - a r t e r i k o n j u n g t i v a b e r a s a l d a r i a r t e r i a s i l i a r i s a n t e r i o r d a n a r t e r i a

p a l p e b r a l i s . K e d u a a r t e r i i n i b e r a n a s t o m o s i s d e n g a n b e b a s d a n b e r s a m a d e n g a n

b a n y a k v e n a k o n j u n g t i v a m e m b e n t u k j a r i n g a n v a s k u l a r k o n j u n g t i v a y a n g s a n g a t

b a n y a k ( V a u g h a n , 2 0 1 0 ) . K o n j u n g t i v a j u g a m e n e r i m a p e r s a r a f a n d a r i

p e r c a b a n g a n p e r t a m a n e r v u s V d e n g a n s e r a b u t n y e r i y a n g r e l a t i f s e d i k i t ( T o r t o r a

and D e r r i c k s o n , 2 0 0 9 ) .

M e n u r u t K a n s k i ( 2 0 0 3 ) , p a d a k o n j u n g t i v a t e r d a p a t b e b e r a p a j e n i s k e l e n j a r

y a n g d i b a g i m e n j a d i d u a g r u p b e s a r y a i t u :

1 . P e n g h a s i l m u s i n

a . S e l g o b l e t

T e r l e t a k d i b a w a h e p i t e l d a n p a l i n g b a n y a k d i t e m u k a n p a d a d a e r a h

i n f e r o n a s a l .

b . C r y p t s o f H e n l e

T e r l e t a k s e p a n j a n g s e p e r t i g a a t a s d a r i k o n j u n g t i v a t a r s a l i s s u p e r i o r d a n

s e p a n j a n g s e p e r t i g a b a w a h d a r i k o n j u n g t i v a t a r s a l i s i n f e r i o r .

c . K e l e n j a r M a n z

M e n g e i i l i n g i d a e r a h l i m b u s .

2 . K e l e n j a r a k s e s o r i s l a k r i m a l i s .

K e l e n j a r a k s e s o r i s i n i t e r m a s u k k e l e n j a r K r a u s e d a n k e l e n j a r W o l f r i n g .

K e d u a k e l e n j a r i n i t e r l e t a k d a l a m d i b a w a h s u b s t a n s i p r o p r i a .

9

2.1.3 Sistem lakrimal

G l a n d u l a l a k r i m a l i s t e r d i r i a t a s p a r s o r b i t a i i s y a n g b e s a r d a n p a r s p a l p e b r a l i s

y a n g k e c i l . K e d u a n y a s a l i n g b e r h u b u n g a n p a d a u j u n g l a t e r a l a p o n e u r o s i s

m u s k u l u s l e v a t o r p a l p e b r a e s u p e r i o r i s . G l a n d u l a i n i t e r l e t a k d i a t a s b o l a m a t a , d i

b a g i a n a n t e r i o r d a n s u p e r i o r o r b i t a l e . K i r a - k i r a 12 d u k t u s k e l u a r d a r i p e r m u k a a n

b a w a h k e l e n j a r d a n b e r m u a r a p a d a b a g i a n l a t e r a l f o r n i x s u p e r i o r k o n j u n g t i v a

( S n e l l , 2 0 0 6 ) .

S i s t e m l a k r i m a l d i b a g i m e n j a d i d u a b a g i a n y a i t u s i s t e m s e k r e s i d a n s i s t e m

e k s k r e s i a i r m a t a ( W a g n e r , 2 0 0 6 ) . A i r m a l a m e n g a l i r m e m b a s a h i k o m e a d a n

b e r k u m p u l d i d a l a m i a c u s l a c r i m a l i s . D a r i s i n i , a i r m a t a m a s u k k e c a n a l i c u l i

l a c r l m a l e s m e l a l u i p u n c t a l a c r i m a l i a ( S n e l l , 2 0 0 6 ) .

C a n a l i c u l i l a c r i m a l e s b e r j a l a n k e m e d i a l d a n b e r m u a r a k e s a c c u s l a c r i m a l i s

y a n g t e r l e t a k d i d a l a m a l u r l a c r i m a l i s d i b e l a k a n g l i g a m e n t u m p a l p e b r a m e d i a l e

d a n m e r u p a k a n u j u n g a t a s y a n g b u n t u d a r i d u c t u s n a s o l a c r i m a l i s . D u c t u s

n a s o l a c r i m a l i s p a n j a n g n y a l e b i h k u r a n g 0 , 5 i n c i ( 1 , 3 c m ) d a n k e l u a r d a r i u j u n g

b a w a h s a c c u s l a c r i m a l i s ( S n e l l , 2 0 0 6 ) .

2.1.4 Rongga Orbita

Gambar 2.2 Rongga Orbita

S u m b e r : w w w . m e d i c i n e s i a . c o m

10

O r b i t a d a l a h r u a n g y a n g b e r b e n t u k p i r a m i d y a n g b e r s i s i e m p a t y a n g

m e r u p a k a n t e m p a t b o l a m a t a ( M o o r e , D a l l e y and A g u r . 2 0 1 0 ; R i o r d a n - E v a ,

2 0 0 7 ) . B a s i s o r b i t m e n g h a d a p a n t e r o l a t e r a l s e d a n g k a n a p e k s m e n g h a d a p

p o s t e r o m e d i a l . O r b i t m e m i l i k i d i n d i n g m e d i a l , y a n g d i b e n t u k o l e h a p p a r a t u s n a s a l

d a n OS e t m o i d a l i s . s e r t a d i n d i n g l a t e r l a . P a d a b a g i a n s u p e r i o r , o r b i t b e r b a t a s a n

d e n g a n s i n u s f r o n t a l i s , s e d a n g k a n p a d a I n f e r i o r s i n u s m a k s i l a r i s . V o l u m e o r b i t

p a d a o r a n g d e w a s a a d a l a h s e k i t a r 3 0 m l , d i m a n a h a n y a s e p e r e n a m y a n g d i t e m p a t i

o l e h b o l a m a t a ( R i o r d a n - E v a , 2 0 0 7 ) .

M e n u r u t M o o r e , D a l l e y and A g u r ( 2 0 1 0 ) , o r b i t m e m i l i k i e m p a t p e r m u k a a n

y a i t u :

1 . D i n d i n g s u p e r i o r ( a l a p ) , h a m p i r h o r i z o n t a l , d i b e n t u k o l e h b a g i a n o r b i t a l o s

f r o n t a l i s , b e r f u n g s i u n t u k p r o t e k s i d a n t e m p a t p e r l e k a t a n s e p t u m o r b i t a l .

2 . D i n d i n g i n f e r i o r ( l a n t a i ) , t e r u t a m a d i b e n t u k o l e h o s m a k s i l a d a n s e b a g i a n k e c i l

o l e h OS z i g o m a l i k d a n p a l a t i n e .

3 . D i n d i n g m e d i a l , b a l a s k u r a n g j e l a s , t e r b e n t u k o l e h o s e t h m o i d a l l s y a n g s e t i p i s

k e r t a s d a n m e n e b a l s a a t b e r l e m u d e n g a n o s l a c r i m a l ( R i o r d a n - E v a , 2 0 0 7 ) .

B e b e r a p a t u l a n g l a i n n y a y a n g m e m b e n t u k b a t a s m e d i a l a d a l a h o s m a x i l l a , o s

l a c r i m a l i s d a n o s s p h e n o i d .

4 . D i n d i n g l a t e r a l , d i b e n t u k o l e h p r o s s e s u s f r o n t a l i s o s z i g o m a l i k d a n s a y a p

m a y o r o s s p h e n o i d . D i n d i n g i n i m e r u p a k a n d i n d i n g t e r k u a t d i b a n d i n g k a n

d e n g a n y a n g l a i n n y a .

2.1.5 Otot-otot Mata

U n t u k m e n g g e r a k k a n b o l a m a t a , m a t a d i l e n g k a p i d e n g a n e n a m o t o t

e k s t r i n s i k . O t o t - o t o t t e r s e b u t y a i t u m u s k u l u s r e k t u s s u p e r i o r , m u s k u l u s r e k t u s

i n f e r i o r , m u s k u l j s r e k t u s m e d i a l i s , m u s k u l u s r e k t u s l a t e r a l i s , m u s k u l u s o b l i k

s u p e r i o r d a n m u s k u l u s o b l i k i n f e r i o r . P e r g e r a k a n b o l a m a t a d a p a t d i g a m b a r k a n

s e c a r a g r a f i k m e n y e r u p a i h u r u f H s e h i n g g a u j i k l i n i s y a n g d i g u n a k a n u n t u k

m e n g u j i g e r a k a n b o l a m a t a d i s e b u t s e b a g a i H test. M u s k u l u s r e k t u s l a t e r a l i s

d i i n e r v a s i o l e h n e r v u s a b d u s e n . K e e m p a t o t o t m a t a l a i n n y a d i i n e r v a s i o l e h n e r v u s

o k u l o m o t o r i u s ( S e e l e y , 2 0 0 6 ) .

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2.1.6 Kornea

Cornea

Bowman's Epithelium Mem bf o n e I

Gambar 2.3 Lapisan Kornea

S u m b e r : w w w . l a s e r v i s i o D . c o . u k

K o m e a m e r u p a k a n j a r i n g a n y a n g a v a s k u l a r , b e r s i f a t t r a n s p a r a n , b e r u k u r a n 1 1 -

1 2 m m h o r i z o n t a l d a n 1 0 - 1 1 m m v e r t i k a i , s e r t a m e m i l i k i i n d c k s r e f r a k s i 1 , 3 7 .

K o m e a m e m b e r i k a n k o n t r i b u s i 7 4 % a t a u s e t a r a d e n g a n 4 3 , 2 5 d i o p t r i ( D ) d a r i

t o t a l 5 8 , 6 0 k e k u a t a n d i o p t r i m a t a m a n u s i a . D a l a m n u l r i s i n y a , k o m e a b e r g a n l u n g

p a d a d i f u s i g l u k o s a d a r i a k u o s h u m o r d a n o k s i g e n y a n g b e r d i f u s i m e l a l u i l a p i s a n

a i r m a t a . S e b a g a i t a m b a h a n , k o m e a p e r i f e r d i s u p l a i o k s i g e n d a r i s i r k u l a s i l i m b u s .

K o m e a a d a l a h s a l a h s a t u o r g a n t u b u h y a n g m e m i l i k i d e n s i t a s u j u n g - u j u n g s a r a f

t e r b a n y a k d a n s e n s i t i f i t a s n y a a d a l a h 1 0 0 k a l i j i k a d i b a n d i n g k a n d e n g a n

k o n j u n g t i v a . K o m e a d e w a s a r a t a - r a t a m e m p u n y a i t e b a l 5 5 0 | j m , d i a m e t e r

h o r i z o n t a l n y a s e k i t a r 1 1 , 7 5 m m d a n v e r t i k a l n y a 1 0 , 6 m m ( R i o r d a n - E v a , 2 0 1 0 ) .

K o m e a m e n d a p a t n u t r i s i d a r i p e m b u l u h - p e m b u l u h d a r a h l i m b u s , a k u o s

h u m o r , d a n a i r m a t a . S a r a f - s a r a f s e n s o r i k k o m e a d i d a p a t d a r i c a b a n g p e r t a m a

( o f t a l m i k u s ) d a n n e r v u s k r a n i a l i s t r i g e m i n u s ( R i o r d a n - E v a , 2 0 1 0 ) . S a r a f

t r i g e m i n u s i n i m e m b e r i k a n s e n s i t i v i t a s t i n g g i t e r h a d a p n y e r i b i l a k o m e a d i s e n t u h

( H o l l w i c h , 1 9 9 3 ) .

S e c a r a h i s t o l o g i s , l a p i s a n s e l k o m e a t e r d i r i d a r i l i m a l a p i s a n , y a i t u l a p i s a n

e p i t e l , l a p i s a n B o w m a n , s t r o m a , m e m b r a n D e s c e m e t , d a n l a p i s a n e n d o t e l

( R i o r d a n - E v a , 2 0 1 0 ) .

12

Cornea HKE a n i e r t o r c o r n e a l e p t h e t l w n s t r a t i f i e d s q u a m o u s

p o s t e r i o r e n d o t t i e t i u m

Gambar 2.4 Histologi Kornea

S u m b e r : w w w . l a b . a n h b . u w a . e d u . a u

P e r m u k a a n a n t e r i o r k o m e a d i t u t u p i e p i t e l b e r l a p i s g e p e n g t a n p a l a p i s a n

t a n d u k d a n t a n p a p a p i l . D i b a w a h e p i t e l k o m e a t e r d a p a t m e m b r a n limilans

anterior ( m e m b r a n B o w m a n ) y a n g b e r a s a l d a r i s t r o m a k o m e a ( s u b s t a n s i p r o p i a ) .

S t r o m a k o m e a t e r d i r i a t a s b e r k a s s e r a t k o l a g e n p a r a l e l y a n g m e m b e n t u k l a m e l l a

t i p i s d a n l a p i s a n - l a p i s a n f i b r o b l a s g e p e n g d a n b e r c a b a n g ( E r o s c h e n k o , 2 0 0 3 ) .

P e r m u k a a n p o s t e r i o r k o m e a d i t u t u p i e p i t e l k u b o i d r e n d a h d a n e p i t e l p o s t e r i o r

y a n g j u g a m e r u p a k a n e n d o t e l k o m e a . M e m b r a n D e s c e m e t m e r u p a k a n m e m b r a n

b a s a l e p i t e l k o m e a ( E r o s c h e n k o , 2 0 0 3 ) d a n m e m i l i k i r e s i s t e n s i y a n g t i n g g i , t i p i s

t e t a p i l e n t u r s e k a l i ( H o l l w i c h , 1 9 9 3 ) .

K o m e a b e r f u n g s i s e b a g a i m e m b r a n p e l i n d u n g d a n " j e n d e l a " y a n g d i l a l u i

b e r k a s c a h a y a m e n u j u r e t i n a . S i f a t l e m b u s c a h a y a n y a d i s e b a b k a n o l e h s t r u k l u m y a

y a n g uniform, a v a s k u l e r d a n d e t u r g e s e n s i . D e t u r g e s e n s i a t a u k e a d a a n d e h i d r a s i

r e l a t i f j a r i n g a n k o m e a . d i p e r t a h a n k a n o l e h " p o m p a " b i k a r b o n a t a k t i f p a d a e n d o t e l

d a n o l e h f u n g s i s a w a r e p i t e ! d a n e n d o t e l . D a l a m m e k a n i s m e d e h i d r a s i i n i , e n d o t e l

j a u h l e b i h p e n t i n g d a r i p a d a e p i t e l . K e r u s a k a n k i m i a w i a t a u f i s i s p a d a e n d o t e l

b e r d a m p a k j a u h l e b i h p a r a h d a r i p a d a k e r u s a k a n p a d a e p i t e l . K e r u s a k a n s e l - s e l

13

e n d o t e l m e n y e b a b k a n e d e m a k o m e a d a n h i l a n g n y a s i f a t t r a n s p a r a n . S e b a l i k n y a ,

k e r u s a k a n p a d a e p i t e l h a n y a m e n y e b a b k a n e d e m a s t r o m a k o m e a l o k a l s e s a a t y a n g

a k a n m e g h i l a n g b i l a s e l - s e l e p i t e l t e l a h b e r e g e n e r a s i . P e n g u a p a n a i r d a r i l a p i s a n

a i r m a l a p r e k o m e a l m e n g h a s i l k a n h i p e r t o n i s i t a s r i n g a n p a d a l a p i s a n a i r m a t a

t e r s e b u t . H a l i n i m u n g k i n m e r u p a k a n f a k t o r l a i n d a l a m m e n a r i k a i r d a r i s t r o m a

k o m e a s u p e r f i s i a l d a n m e m b a n l u m e m p e r t a h a n k a n k e a d a a n d e h i d r a s i .

P e n e t r a s i k o m e a u t u h o l e h o b a t b e r s i f a t b i f a s i k . S u b s t a n s i l a m t - l e m a k d a p a t

m e l a l u i e p i t e l u t u h d a n s u b s t a n s i l a r u t - a i r d a p a t m e l a l u i s t r o m a y a n g u t u h . A g a r

d a p a t m e l a l u i k o m e a , o b a t h a r u s l a r u t - l e m a k d a n l a r u t - a i r s e k a l i g u s .

E p i t e l a d a l a h s a w a r y a n g e f i s i e n t e r h a d a p m a s u k n y a m i k r o o r g a n i s m e k e d a l a m

k o r n e a . N a m u n s e k a l i k o m e a i n i c e d e r a , s t r o m a y a n g a v a s k u l a r d a n m e m b r a n

B o w m a n m u d a h t e r k e n a i n f e k s i o l e h b e r b a g a i m a c a m o r g a n i s m e . s e p e r t i b a k t e r i ,

v i r u s , a m u b a , d a n j a m u r ( B i s w e l l , 2 0 1 0 ) .

2.1.7 Skiera

S k i e r a y a n g j u g a d i k e n a l s e b a g a i b a g i a n p u t i h b o l a m a t a , m e r u p a k a n

k e l a n j u t a n d a r i k o m e a . S k i e r a b e r w a m a p u t i h b u r a m d a n t i d a k t e m b u s c a h a y a ,

k e c u a l i d i b a g i a n d e p a n b e r s i f a t t r a n s p a r a n y a n g d i s e b u t k o m e a . S k i e r a

m e r u p a k a n d i n d i n g b o l a m a t a y a n g p a l i n g k e r a s d e n g a n j a r i n g a n p e n g i k a t y a n g

t e b a l , y a n g t e r s u s u n o l e h s e r a t k o l a g e n , j a r i n g a n fibrosa d a n p r o t e o g l i k a n d e n g a n

b e r b a g a i u k u r a n . P a d a a n a k - a n a k , s k i e r a l e b i h t i p i s d a n m e n u n j u k k a n s e j u m l a h

p i g m e n , y a n g t a m p a k s e b a g a i w a m a b i r u . S e d a n g k a n p a d a d e w a s a k a r e n a

t e r d a p a l n y a d e p o s i t l e m a k , s k i e r a t a m p a k s e b a g a i g a r i s k u n i n g ( F o u l k s a n d

L a n g s t o n , 1 9 8 8 ) .

S k i e r a d i m u l a i d a r i l i m b u s , d i m a n a b e r l a n j u t d e n g a n k o m e a d a n b e r a k h i r p a d a

k a n a l i s o p t i k u s y a n g b e r l a n j u t d e n g a n d u r a , e n a m o t o t e k s l r a o k u l e r d i s i s i p k a n k e

d a l a m s k i e r a . j a r i n g a n s k i e r a m e n e r i m a r a n g s a n g a n s e n s o r i s d a r i n e r v u s s i l i a r i s

p o s t e r i o r . S k i e r a m e r u p a k a n o r g a n t a n p a v a s k u l a r i s a s i . m e n e r i m a r a n g s a n g a n

t e r s e b u t d a r i j a r i n g a n p e m b u l u h d a r a h y a n g b e r d e k a t a n . P l e k s u s k o r o i d a l i s

t e r d a p a t d i b a w a h s k i e r a d a n p l e k s u s e p i s k l e r a l d i a t a s n y a . E p i s k l e r a m e m p u n y a i

d u a c a b a n g , y a n g p e r t a m a p a d a p e r m u k a a n d i m a n a p e m b u l u h d a r a h t e r s u s u n

14

m e l i n g k a t , d a n y a n g s a t u n y a l a g i y a n g l e b i h d i d a l a m , t e r d a p a t p e m b u l u u h d a r a h

y a n g m e l e k a t p a d a s k i e r a ( F o u l k s a n d L a n g s t o n , 1 9 8 8 ) .

M e n u r u t G a l o r d a n T h o m e ( 2 0 0 7 ) , s k i e r a m e m p u n y a i 2 l u b a n g u t a m a y a i t u :

1 . F o r a m e n s k l e r a s i s a n t e r i o r , y a n g b e r d e k a t a n d e n g a n k o m e a d a n m e r u p a k a n

t e m p a t m e l e k a l n y a k o r n e a p a d a s k i e r a .

2 . F o r a m e n s k l e r a s i s p o s t e r i o r a t a u k a n a l i s s k l e r a s i s . m e r u p a k a n p i n t u k e l u a r

n e r v u s o p t i k u s . P a d a f o r a m e n i n i t e r d a p a t l a m i n a k r i b r o s a y a n g t e r d i r i d a r i

s e j u m l a h m e m b r a n s e p e r t i s a r i n g a n y a n g t e r s u s u n t r a n s v e r s a l m e l i n t a s

f o r a m e n s k l e r a s i s p o s t e r i o r . S e r a b u t s a r a f o p t i k u s l e w a t l u b a n g i n i u n t u k

m e n u j u k e o t a k .

S k i e r a b e r f u n g s i u n t u k m e n y e d i a k a n p e r l i n d u n g a n t e r h a d a p k o m p o n e n i n t r a

o k u l a r . P e m b u n g k u s o k u l a r y a n g b e r s i f a t v i s k o e l a s t i s i n i m e m u n g k i n k a n

p e r g e r a k a n b o l a m a t a t a n p a m e n i m b u l k a n d e f o r m i t a s o t o t - o t o t p e n g g e r a k n y a .

P e n d u k u n g d a s a r d a r i s k i e r a a d a l a h a d a n y a a k t i f i t a s s k i e r a y a n g r e n d a h d a n

v a s k u l a r i s a s i y a n g b a i k p a d a s k i e r a d a n k o r o i d . H i d r a s i y a n g t e r l a l u t i n g g i p a d a

s c l e r a m e n y e b a b k a n k e k e r u h a n p a d a j a r i n g a n s c l e r a ( F o u l k s a n d L a n g s t o n , 1 9 8 8 ) .

J a r i n g a n k o l a g e n s k i e r a d a n j a r i n g a n p e n d u k u n g n y a b e r p e r a n s e p e r t i c a i r a n

s i n o v i a l y a n g m e m u n g k i n k a n p e r b a n d i n g a n y a n g n o r m a l s e h i n g g a t e r j a d i

h u b u n g a n a n t a r a b o l a m a t a d a n s o c k e t . P e r b a n d i n g a n i n i s e r i n g t e r g a n g g u

s e h i n g g a m e n y e b a b k a n b e b e r a p a p e n y a k i t y a n g m e n g e n a i s t r u k t u r a r t i k u l a r

s a m p a i p e m b u n g k u s s k i e r a d a n e p i s k l e r a ( F o u l k s a n d L a n g s t o n , 1 9 8 8 ) .

2.1.8 Biiik Mata Depan

S u d u t k a m e r a o k u l i a n t e r i o r , y a n g d i b e n t u k o l e h p e r t a u t a n a n t a r a k o m e a

p e r i f e r d a n p a n g k a l i r i s , m e r u p a k a n k o m p o n e n p e n t i n g d a l a m p r o s e s p e n g a l l r a n

a q u e o u s h u m o r . S t r u k t u r i n i t e r d i r i d a r i Schwalbe's line, trabecular meshwork d a n

scleral spur ( R i o r d a n - E v a , 2 0 0 9 ) .

Trabecular meshwork m e r u p a k a n j a r i n g a n a n y a m a n y a n g t e r s u s u n a t a s

l e m b a r - l e m b a r b e r l u b a n g j a r i n g a n k o l a g e n d a n e l a s t i k ( R i o r d a n - E v a , 2 0 0 9 ) .

Trabecular meshwork d i s u s u n a t a s t i g a b a g i a n , y a i t u uvea meshwork ( b a g i a n

p a l i n g d a l a m ) , corneoscleral meshwork ( l a p i s a n t e r b e s a r ) d a n

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juxtacanalicular/endothelial meshwork ( l a p i s a n p a l i n g a t a s ) . Juxtacanalicular

meshwork a d a l a h s t r u k t u r y a n g b e r h u b u n g a n d e n g a n b a g i a n d a l a m k a n a l i s

S c h l e m m ( C i b i s e t a l , 2 0 0 7 - 2 0 0 8 ) .

2.1.9 Uvea

U v e a t e r d i r i d a r i i r i s , k o r p u s s i i i a r e d a n k h o r o i d . B a g i a n i n i a d a l a h l a p i s a n

v a s k u l a r t e n g a h m a t a d a n d i l i n d u n g i o l e h k o m e a d a n s k i e r a . B a g i a n i n i i k u t

m e m a s u k k a n d a r a h k e r e t i n a ( R i o r d a n - E v a , 2 0 1 0 ; K a n s k i , 2 0 0 5 ) .

• I r i s

I r i s a d a l a h p e r p a n j a n g a n k o r p u s s i i i a r e k e a n t e r i o r . I r i s b e m p a s u a t u

p e r m u k a a n p i p i h d e n g a n a p e r t u r a b u l a t y a n g t e r l e t a k d i t e n g a h p u p i l . I r i s t e r l e t a k

b e r s a m b u n g a n d e n g a n p e r m u k a a n a n t e r i o r l e n s a , y a n g m e m i s a h k a n k a m e r a

a n t e r i o r d a r i k a m e r a p o s t e r i o r , y a n g m a s i n g - m a s i n g b e r i s i a q u e u s h u m o r . D i

d a l a m s t r o m a i r i s t e r d a p a t s f i n g t e r d a n o t o t - o t o t d i l a t o r . K e d u a l a p i s a n b e r p i g m e n

p e k a t p a d a p e r m u k a a n p o s t e r i o r i r i s m e r u p a k a n p e r l u a s a n n e u r o r e t i n a d a n l a p i s a n

e p i t e l p i g m e n r e t i n a k e a r a h a n t e r i o r ( R i o r d a n - E v a , 2 0 1 0 ) .

P a s o k d a r a h k e i r i s a d a l a h d a r i s i r k u l u s m a j o r i r i s . K a p i l e r - k a p i l e r i r i s

m e m p u n y a i l a p i s a n e n d o t e l y a n g t i d a k b e r l u b a n g s e h i n g g a n o r m a l n y a t i d a k

m e m b o c o r k a n f l u o r e s e i n y a n g d i s u n t i k k a n s e c a r a i n t r a v e n a . P e r s a r a f a n i r i s a d a l a h

m e l a l u i s e r a t - s e r a t d i d a l a m n e r v u s s i l i a r e s ( R i o r d a n - E v a , 2 0 1 0 ) .

I r i s m e n g e n d a l i k a n b a n y a k n y a c a h a y a y a n g m a s u k k e d a l a m m a t a . U k u r a n

p u p i l p a d a p r i n s i p n y a d i t e n t u k a n o l e h k e s e i m b a n g a n a n t a r a k o n s t r i k s i a k i b a t

a k t i v i t a s p a r a s i m p a t i s y a n g d i h a n t a r k a n m e l a l u i n e r v u s k r a n i a l i s I I I d a n d i l a t a s i

y a n g d i t i m b u l k a n o l e h a k t i v i t a s s i m p a t i k ( R i o r d a n - E v a , 2 0 1 0 ) .

• K o r p u s S i l i a r i s

K o r p u s s i l i a r i s y a n g s e c a r a k a s a r b e r b e n t u k s e g i t i g a p a d a p o t o n g a n m e l i n t a n g ,

m e m b e n t a n g k e d e p a n d a r i u j u n g a n t e r i o r k h o r o i d k e p a n g k a l i r i s ( s e k i t a r 6 m m ) .

K o r p u s s i l i a r i s t e r d i r i d a r i s u a t u z o n a a n t e r i o r y a n g b e r o m b a k o m b a k , p a r s p l i k a t a

d a n z o n a p o s t e r i o r y a n g d a t a r , p a r s p l a n a . P r o s e s u s s i l i a r i s b e r a s a l d a r i p a r s

p l i k a t a . P r o s e s u s s i l i a r i s i n i t e r u t a m a t e r b e n t u k d a r i k a p i l e r k a p i l e r d a n v e n a y a n g

b e r m u a r a k e v e n a - v e n a v o r t e x . K a p i l e r - k a p i l e m y a b e s a r d a n b e r l o b a n g - l o b a n g

16

s e h i n g g a m e m b o c o r k a n f l o r e s e i n y a n g d i s u n t i k k a n s e c a r a i n t r a v e n a . A d a 2 l a p i s a n

e p i t e l s i l i a r i s , s a t u l a p i s a n t a n p a p i g m e n d i s e b e l a h d a l a m , y a n g m e r u p a k a n

p e r l u a s a n n e u r o r e t i n a k e a n t e r i o r , d a n l a p i s a n b e r p i g m e n d i s e b e l a h l u a r , y a n g

m e r u p a k a n p e r l u a s a n d a r i l a p i s a n e p i t e l p i g m e n r e t i n a . P r o s e s u s s i l i a r i s d a n e p i t e l

s i l i a r i s p e m b u n g k u s n y a b e r f u n g s i s e b a g a i p e m b e n t u k a q u e u s h u m o r ( R i o r d a n -

E v a , 2 0 1 0 ) .

• K o r o i d

K o r o i d a d a l a h s e g m e n p o s t e r i o r u v e a , d i a n t a r a r e t i n a d a n s k i e r a . K h o r o i d

t e r s u s u n d a r i t i g a l a p i s a n p e m b u l u h d a r a h k h o r o i d ; b e s a r , s e d a n g d a n k e c i l .

S e m a k i n d a l a m p e m b u l u h t e r l e t a k d i d a l a m k h o r o i d , s e m a k i n l e b a r l u m e n n y a .

B a g i a n d a l a m p e m b u l u h d a r a h k h o r o i d d i k e n a l s e b a g a i k h o r i o k a p i l a r i s . D a r a h d a r i

p e m b u l u h d a r a h k h o r o i d d i a l i r k a n m e l a l u i e m p a t v e n a v o r t e x , s a t u d i m a s i n g -

m a s i n g k u a d r a n p o s t e r i o r . K h o r o i d d i s e b e l a h d a l a m d i b a t a s i o l e h m e m b r a n B r u c h

d a n d i s e b e l a h l u a r o l e h s k i e r a . R u a n g s u p r a k o r o i d t e r l e t a k d i a n t a r a k h o r o i d d a n

s k i e r a . K h o r o i d m e l e k a t e r a t k e p o s t e r i o r k e t e p i - t e p i n e r v u s o p t i k u s . K e a n t e r i o r ,

k h o r o i d b e r s a m b u n g d e n g a n k o r p u s s i i i a r e . A g r e g a t p e m b u l u h d a r a h k h o r o i d

m e m p e r d a r a h i b a g i a n l u a r r e t i n a y a n g m e n d a s a r i n y a ( R i o r d a n - E v a , 2 0 1 0 ) .

2.1.10 Lensa

L e n s a a d a l a h s t r u k t u r k r i s t a l i n b e r b e n t u k b i k o n v e k s d a n t r a n s p a r a n . L e n s a

m e m i l i k i d u a p e r m u k a a n , y a i t u p e r m u k a a n a n t e r i o r d a n p o s t e r i o r . P e r m u k a a n

p o s t e r i o r l e b i h c e m b u n g d a r i p a d a p e r m u k a a n a n t e r i o r . R a d i u s k u r v a t u r a a n t e r i o r

1 0 m m d a n r a d i u s k u r v a t u r a p o s t e r i o r 6 m m . D i a m e t e r l e n s a a d a l a h 9 - 1 0 m m d a n

k e t e b a l a n l e n s a a d a l a h 3 , 5 m m s a a t l a h i r h i n g g a 5 m m s a a t u s i a l a n j u t . B e r a t l e n s a

1 3 5 m g p a d a u s i a 0 - 9 t a h u n h i n g g a 2 5 5 m g p a d a u s i a 4 0 - 8 0 t a h u n ( K h u r a n a ,

2 0 0 7 ) .

L e n s a t e r l e t a k d i b i i i k p o s t e r i o r b o l a m a t a , d i a n t a r a p e r m u k a a n p o s t e r i o r i r i s

d a n b a d a n v i t r e u s p a d a l e n g k u n g a n b e r b e n t u k c a w a n b a d a n v i t r e u s y a n g d i s e b u t

f o s s a h y a l o i d . L e n s a b e r s a m a d e n g a n i r i s m e m b e n t u k d i a f r a g m a o p t i k a l y a n g

m e m i s a h k a n b i i i k a n t e r i o r d a n p o s t e r i o r b o l a m a t a ( L a n g , 2 0 0 0 ) .

L e n s a t i d a k m e m i l i k i s e r a b u t s a r a f , p e m b u l u h d a r a h , d a n j a r i n g a n i k a t . L e n s a

17

d i p e r t a h a n k a n d i t e m p a t n y a o l e h s e r a t z o n u l a y a n g b e r a d a d i a n t a r a l e n s a d a n

b a d a n s i l i a r . S e r a t z o n u l a i n i , y a n g b e r s a l d a r i e p h i t e l s i l i a r , a d a l a h s e r a t k a y a

fibrilin y a n g m e n g e i i l i n g i l e n s a s e c a r a s i r k u l a r ( K h u r a n a , 2 0 0 7 ) .

2.1.11 Badan Kaca (vitreous body)

B a d a n k a c a a d a l a h s u a t u s t r u k t u r y a n g b u l a t , m i r i p a g a r - a g a r y a n g k u n i n g d a n

m e n g i s i r o n g g a d i a n t a r a l e n s a d a n r e t i n a d a n m e r u p a k a n d u a p e r t i g a b a g i a n d a r i

s e l u r u h v o l u m e m a t a . P e r m u k a a n a n t e r i o r b a d a n k a c a a g a k l e g o k (fossa patellar).

S u a t u p e r l e k a t a n s i r k u l a r y a n g h a l u s m e n g h u b u n g k a n b a d a n k a c a d a n p e r m u k a a n

p o s t e r i o r l e n s a (ligament hialoideokapsular). D i t e n g a h - t e n g a h b a d a n k a c a

t e r d a p a t s e b u a h k a n a l y a n g a g a k b e r k e l o k - k e l o k ( k a n a l Cloquet) y a n g m e r u p a k a n

s i s a a r t e r i h i a l o i d e m b r i o n a l ( H o l l w i c h , 1 9 9 3 ) .

B a d a n k a c a m e m i l i k i n i l a i m e t a b o l i c y a n g r e n d a h , s e c a r a o p t i s j e m i h d a n

t e r d i r i a t a s a g a r - a g a r d e n g a n k a n d u n g a n a i r y a n g t i n g g ( 9 8 % ) . T i d a k m e n g a n d u n g

p e m b u l u h d a r a h d a n s a r a f . B a d a n k a c a t e r d i r i a t a s d u a k o m p o n e n u t a m a y a n g

m e n j a m i n k e m a n t a p a n b a d a n k a c a , y a i t u s e r a b u t - s e r a b u t k o l a g e n d a n a s a m

h i a l u r o n . K e l e n t u r a n b a d a n k a c a d i s e b a b k a n o l e h j a r i n a n s e r a b u t - s e r a b u t k o l a g e n

y a n g j a l i n m e n j a l i n d e n g a n j a l i n a n k e d u a y a n g t e r d i r i a t a s m o l e k u l - m o l e k u l a s a m

h i a l u r o n r a k s a s a . K a r e n a b e r a t m o l e k u l n y a y a n g t i n g g i ( l e b i h d a r i 5 0 0 . 0 0 0 ) , a s a m

h i a l u r o n m e m b e r i k a n k e l e n t u r a n c a i r a n b a d a n k a c a ( H o l l w i c h , 1 9 9 3 ) .

2.1.12 Retina

R e t i n a m e r u p a k a n r e s e p t o r p e r m u k a a n u n t u k i n f o r m a s i v i s u a l . S e b a g a i m a n a

h a l n y a n e r v u s o p t i k u s , r e t i n a m e r u p a k a n b a g i a n d a r i o t a k m e s k i p u n s e c a r a fisik

t e r l e t a k d i p e r i f e r d a r i s i s t e m s a r a f p u s a t ( S S P ) . K o m p o n e n y a n g p a l i n g u t a m a d a r i

r e t i n a a d a l a h s e l - s e l r e s e p t o r s e n s o r i s a t a u f o t o r e s e p t o r d a n b e b e r a p a j e n i s n e u r o n

d a r i j a r a s p e n g l i h a t a n ( F r o e t s c h e r a n d B a e h r , 2 0 0 5 ) .

R e t i n a m e r u p a k a n r e s e p t o r p e r m u k a a n u n t u k i n f o r m a s i v i s u a l . S e b a g a i m a n a

h a l n y a n e r v u s o p t i k u s , r e t i n a m e r u p a k a n b a g i a n d a r i o t a k m e s k i p u n s e c a r a f i s i k

t e r l e t a k d i p e r i f e r d a r i s i s t e m s a r a f p u s a t ( S S P ) . K o m p o n e n y a n g p a l i n g u t a m a d a r i

r e t i n a a d a l a h s e l - s e l r e s e p t o r s e n s o r i s a t a u f o t o r e s e p t o r d a n b e b e r a p a j e n i s n e u r o n

18

d a r i j a r a s p e n g l i h a t a n ( F r o e t s c h e r a n d B a e h r , 2 0 0 5 ) .

Gambar 2.5 Histologi Retina

S u m b e r : w w w . w e b v i s i o n . m e d . u t a h . e d u

L a p i s a n t e r d a l a m ( n e u r o n p e r t a m a ) r e t i n a m e n g a n d u n g f o t o r e s e p t o r ( s e l

b a t a n g d a n s e l k e r u c u t ) d a n d u a l a p i s a n y a n g l e b i h s u p e r f i s i a l m c n g a n d u n g n e u r o n

b i p o l a r l a p i s a n n e u r o n k e d u a ) s e r t a s e l - s e l g a n g l i o n ( l a p i s a n n e u r o n k e t i g a )

( F r o e t s c h e r a n d B a e h r , 2 0 0 5 ) .

S e k i t a r s a t u j u t a a k s o n d a r i s e l - s e l g a n g l i o n i n i b e r j a l a n p a d a l a p i s a n s e r a t

r e t i n a k e p a p i l a a t a u k a p u t n e r v u s o p t i k u s . P a d a b a g i a n t e n g a h k a p u t n e r v u s

o p t i k u s t e r s e b u t k e l u a r c a b a n g - c a b a n g d a r i a r t e r i c e n t r a l i s r e t i n a y a n g m e r u p a k a n

c a b a n g d a r i a . o f t a l m i k a ( F r o e t s c h e r a n d B a e h r , 2 0 0 5 ) .

2.1.13 Nervus Optikus

N e r v u s o p t i k u s m e m a s u k i r u a n g i n t r a k r a n i a l m e l a l u i f o r a m e n o p t i k u m . D i

d e p a n t u b e r s i n e r i u m ( t a n g k a i h i p o f i s i s ) n e r v u s o p t i k u s k i r i d a n k a n a n b e r g a b u n g

m e n j a d i s a t u b e r k a s m e m b e n t u k k i a s m a o p t i k u m . D i d e p a n t u b e r s i n e r i u m n e r v u s

19

o p t i k u s k a n a n d a n k i r i b e r g a b u n g m e n j a d i s a t u b e r k a s m e m b e n t u k k i a s m a

o p t i k u m , d i m a n a s e r a b u t b a g i a n n a s a l d a r i m a s i n g - m a s i n g m a t a a k a n b e r s i l a n g a n

d a n k e m u d i a n m e n y a t u d e n g a n s e r a b u t t e m p o r a l m a t a y a n g l a i n m e m b e n t u k

t r a k t u s o p t i k u s d a n m e l a n j u t k a n p e r j a l a n a n u n t u k k e k o r p u s g e n i k u l a t u m l a t e r a l

d a n k o l i k u l u s s u p e r i o r ( M a r d j o n o d a n S i d h a r t a , 2 0 0 4 ) .

K i a s m a o p t i k u m t e r l e t a k d i t e n g a h a n t e r i o r d a r i s i r k u l u s W i l l i s ) . S e r a b u t s a r a f

y a n g b e r s i n a p s d i k o r p u s g e n i k u l a t u m l a t e r a l m e r u p a k a n j a r a s v i s u a l s e d a n g k a n

s e r a b u t s a r a f y a n g b e r a k h i r d i k o l i k u l u s s u p e r i o r m e n g h a n t a r k a n i m p u l s v i s u a l

y a n g m e m b a n g k i t k a n r e f l e k s o p s o m a t i k s e p e r t i r e f l e k s p u p i l ( M a r d j o n o d a n

S i d h a r t a , 2 0 0 4 ) .

2.2 Keratitis

2.2.1 Definisi

K e r a t i t i s m e r u p a k a n k e l a i n a n a k i b a t t e r j a d i n y a i n f i l t r a s i s e l r a d a n g p a d a

k o m e a y a n g a k a n m e n g a k i b a t k a n k o m e a m e n j a d i k e r u h . A k i b a t t e r j a d i n y a

k e k e m h a n p a d a m e d i a k o m e a i n i , m a k a t a j a m p e n g l i h a t a n a k a n m e n u r u n . M a t a

m e r a h p a d a k e r a t i t i s t e r j a d i a k i b a t i n j e k s i p e m b u l u h d a r a h p e r i k o m e a l y a n g d a l a m

a t a u i n j e k s i s i l i a r . K e r a t i t i s b i a s a n y a d i k l a s i f i k a s i k a n d a l a m l a p i s y a n g t e r k e n a

s e p e r t i k e r a t i t i s s u p e r f i s i a l d a n p r o f i j n d a a t a u i n t e r s t i s i a l ( l l y a s , 2 0 0 4 ) .

2.2.2 Faktor Risiko

M e n u m t G r e e n , A p e l and S t a p l e t o n ( 2 0 0 8 ) , f a k t o r r i s i k o t e r j a d i n y a k e r a t i t i s

a n t a r a l a i n :

1 . P e n g g u n a a n l e n s a k o n t a k

2 . R i w a y a t t i n d a k a n b e d a h p a d a m a t a

3 . P e n y a k i t m a t a s u p e r f i s i a l s e p e r t i k o n j u n g t i v i t i s

4 . P a p a r a n s i n a r u l t r a v i o l e t y a n g b e r l e b i h a n

2.2.3 Ftiologi

A d a p u n p e n y e b a b y a n g s e r i n g m e n y e b a b k a n k e l a i n a n p a d a k o m e a a d a l a h :

1 . I n f e k s i

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a . B a k t e r i : Staphylococcus aureus, Staphylococcus epidermidis,

Streptococcus pneumoniae and other Streptococcus spp, Pseudomonas

aeruginosa, Enterobacteriaceae (Proteus, Enterobacter, Serratia),

Neisseria spp, Moraxella spp, Mycobacterium spp, Nocardia spp.

b . J a m u r : j a m u r b e r f i l a m e n {filamentous fungi), j a m u r b e r s e p t a , j a m u r t i d a k

b e r s e p t a , j a m u r r a g i ( y e a s 7 ) , j a m u r d i f a s i k .

c . V i r u s : Herpes Simplex Virus, Herpes Taster Virus, Varicella-zoster Virus,

Variola Virus, Vacinia Virus.

d . P r o t o z o a (Acanthamoeba)

2. Dry eye

K e l a i n a n i n i m u n c u i k e t i k a l a p i s a n a i r m a t a m e n g a l a m i d e f i s i e n s i s e h i n g g a

t i d a k d a p a t m e m e n u h i b a t a s - b a t a s k e c u k u p a n , b a i k s e c a r a k u a n t i t a t i f m a u p u n

k u a l i t a t i f , y a n g k e m u d i a n d i i k u t i d e n g a n k e l u h a n s u b j e k t i f . K e k u r a n g a n c a i r a n

l u b r i k a s i f i s i o l o g i s m e r u p a k a n f a k t o r y a n g d a p a t m e n y e b a b k a n t e r j a d i n y a i n f e k s i

m i k r o b a p a d a m a t a ( B a n g u n , 2 0 0 9 ) .

3 . D e f i s i e n s i v i t a m i n A

K e l a i n a n k o m e a o l e h k a r e n a d e f i s i e n s i v i t a m i n A d a p a t m e n y e b a b k a n

k e k e r i n g a n y a n g m e n g g a m b a r k a n b e r c a k B i t o t y a n g w a m a n y a s e p e r t i m u t i a r a

y a n g b e r b e n t u k s e g i t i g a d e n g a n p a n g k a l d i d a e r a h l i m b u s . B e r c a k B i t o t s e p e r t i

a d a b u s a d i a t a s n y a . B e r c a k i n i t i d a k d i b a s a h i o l e h a i r m a t a d a n a k a n t e r b e n t u k

k e m b a l i b i l a d i l a k u k a n debridement. T e r d a p a t d u g a a n b a h w a b e n t u k b u s a i n i

m e r u p a k a n a k i b a t k u m a n Corynebacterium xerosis. H i p o v i t a m i n A i n i j u g a d a p a t

m e n y e b a b k a n k e r a t o m a l a s i a d a n t u k a k k o m e a d i m a n a a k a n t e r l i h a t k o m e a

n e k r o s i s d e n g a n v a s k u l a r i s a s i k e d a l a m n y a ( l l y a s , 2 0 0 9 ) .

4 . A b n o r m a l i t a s u k u r a n d a n b e n t u k k o r n e a

A b n o r m a l i t a s u k u r a n d a n b e n t u k k o m e a y a n g t e r j a d i a d a l a h m i k r o k o m e a d a n

m e g a l o k o m e a . M i k r o k o m e a a d a l a h s u a t u k o n d i s i y a n g t i d a k d i k e t a h u i

p e n y e b a b n y a , b i s a b e r h u b u n g a n d e n g a n g a n g g u a n p e r t u m b u h a n k o m e a f e t a l p a d a

21

b u l a n k e - 5 . S e l a i n i t u b i s a j u g a b e r h u b u n g a n d e n g a n p e r t u m b u h a n y a n g

b e r l e b i h a n d a r i p u n c a k anterior optic cup y a n g m e n i n g g a l k a n s e d i k i t r u a n g b a g i

k o m e a u n t u k b e r k e m b a n g ( B a n g u n , 2 0 0 9 ) .

M i k r o k o m e a b i s a b e r h u b u n g a n d e n g a n a u t o s o m a l d o m i n a n a t a u r e s e s i f

d e n g a n p r e d i k s i s e k s y a n g s a m a , w a l a u p u n t r a n s m i s i d o m i n a n l e b i h s e r i n g

d i t e m u k a n . M e g a l o k o m e a a d a l a h s u a t u p e m b e s a r a n s e g m e n a n t e r i o r b o l a m a t a .

P e n y e b a b n y a b i s a b e r h u b u n g a n d e n g a n k e g a g a l a n optic cup u n t u k t u m b u h d a n

anterior tip m e n u t u p y a n g m e n i n g g a l k a n r u a n g a n b e s a r b a g i k o m e a u n t u k u n t u k

d i i s i ( B a n g u n , 2 0 0 9 ) .

5 . D i s t r o f i k o m e a

D e p o s i t a b n o r m a l y a n g d i s e r t a i o l e h p e r u b a h a n a r s i t e k t u r k o m e a , b i l a t e r a l

s i m e t r i k d a n h e r e d i t e r , t a n p a s e b a b y a n g d i k e t a h u i . P r o s e s d i m u l a i p a d a u s i a b a y i

1-2 t a h u n d a p a t m e n e t a p a t a u b e r k e m b a n g l a m b a t d a n b e r m a n i s f e s t a s i p a d a u s i a

1 0 - 2 0 t a h u n . P a d a k e l a i n a n i n i t a j a m p e n g l i h a t a n b i a s a n y a t e r g a n g g u d a n d a p a t

d i s e r t a i d e n g a n e r o s i k o m e a ( l l y a s , 2 0 0 4 ) .

6 . T r a u m a k o m e a

T r a u m a k o r n e a b i s a d i s e b a b k a n o l e h t r a u m a t u m p u l , l u k a p e n e t r a s i a t a u

p e r f o r a s i b e n d a a s i n g . K e m u n g k i n a n k o n t a m i n a s i j a m u r a t a u b a k t e r i h a m s d i i n g a t

d e n g a n k u l t u r u n t u k b a k t e r i d a n j a m u r d i a m b i l p a d a s a a t p e m e r i k s a a n p e r t a m a

j i k a m e m u n g k i n k a n . T r a u m a t u m p u l k o m e a d a p a t m e n i m b u l k a n a b e r a s i , e d e m a ,

r o b e k n y a m e m b r a n D e s c e m e t d a n l a s e r a s i k o m e o s k l e r a l d i l i m b u s ( B a n g u n ,

2 0 0 9 ) . P e r f o r a s i b e n d a a s i n g y a n g t e r d a p a t p a d a k o m e a d a p a t m e n i m b u l k a n g e j a l a

b e m p a r a s a p e d a s d a n s a k i t p a d a m a t a . K e l u h a n i n i m u n g k i n t e r j a d i a k i b a t s u d a h

t e r d a p a t n y a k e r a t i t i s a t a u t u k a k p a d a m a t a t e r s e b u t ( l l y a s , 2 0 0 9 ) .

7 . R e a k s i O b a t d a n B e n d a A s i n g

R e a k s i o b a t s e p e r t i n e o m i s i n , t o b r a m i s i n m a u p u n b e n d a a s i n g s e p e r t i p o l u s i ,

a t a u p a r t i k e l u d a r a s e p e r t i d e b u d a n s e r b u k s a r i ( W i j a y a , T e r a b u n a n d a n P e r w i r a ,

2 0 1 2 ) .

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2.2.4 Klasifikasi

M e n u r u t K h u r a n a ( 2 0 0 7 ) , k e r a t i t i s d i k l a s i f i k a s i k a n s e b a g a i b e r i k u t .

T a b e l 2 . 1 K l a s i f i k a s i K e r a t i t i s

K l a s i f i k a s i K e r a t i t i s

1 . B e r d a s a r k a n T o p o g r a f i / M o r f o l o g i

A . Ulcerative Keratitis ( U l k u s K o m e a )

a . B e r d a s a r k a n L o k a s i

• U l k u s K o m e a S e n t r a l

• U l k u s K o m e a P e r i f e r / M a r g i n a l

b . B e r d a s a r k a n T i n g k a t K e d a l a m a n

• U l k u s K o m e a S u p e r f i s i a l

• U l k u s K o m e a P r o f u n d a

• U l k u s K o m e a d e n g a n P e r f o r a s i y a n g S e g e r a T e r j a d i

• U l k u s K o m e a d e n g a n P e r f o r a s i

c . B e r d a s a r k a n P i m l e n s i

• U l k u s K o m e a P u m l e n / S u p u r a t i f

• U l k u s K o m e a N o n - p u r u l e n

d . B e r d a s a r k a n K e b e r a d a a n H i p o p i o n

• U l k u s K o m e a S i m p e l ( T a n p a H i p o p i o n )

• U l k u s K o m e a d e n g a n H i p o p i o n

B. Non-ulcerative Keratitis

a . K e r a t i t i s S u p e r f i s i a l P u n g t a l a

b . K e r a t i t i s P r o f u n d a / I n t e r s t i s i a l

2 . B e r d a s a r k a n E t i o l o g i

A . K e r a t i t i s I n f e k t i f

a . K e r a t i t i s B a k t e r i a l

b . K e r a t i t i s V i r a l

c . K e r a t i t i s F u n g a l

d . K e r a t i t i s P r o t o z o a l

B . K e r a t i t i s A l e r g i

23

a . K e r a t i t i s F l i k t e n

b. K e r a t i t i s V e r n a l

c. K e r a t i t i s A t o p i k

3 . K e r a t i t i s T r o p i k

A . K e r a t i t i s N e u r o p a r a l i t i k

B . U l k u s A r e t o m a t o s a

4 . K e r a t i t i s I d i o p a t i k

A . U l k u s K o m e a M o o r e n ' s

B . K e r a t i t i s S u p e r f i s i a l P u n g t a t a Thygeson

Sumber: Khurana ( 2 0 0 7 )

A. U l c e r a t i v e Keratitis (Ulkus Kornea)

. . . . . . . . . A

Gambar 2.6 Ulkus Kornea

Sumber: www.webeye.ophth.uiowa.edu

Ulcerative keratitis ( u l k u s k o m e a ) a d a l a h h i l a n g n y a s e b a g i a n p e r m u k a a n

k o m e a a k i b a t k e m a t i a n j a r i n g a n k o m e a y a n g d i t a n d a i d e n g a n a d a n y a i n f i l t r a t

s u p u r a t i f d i s e r t a i d e f e k k o m e a b e r g a u n g , d a n d i s k o n t i n u i t a s j a r i n g a n k o m e a y a n g

d a p a t t e i j a d i d a r i e p i t e l s a m p a i s t r o m a ( R i o r d a n - E v a , 2 0 0 7 ) . B i a s a n y a d i t a n d a i

d e n g a n t a n d a i n j e k s i s i l i a r y a n g n y a t a , i n j e k s i k o n j u n g t i v a l b e r w a m a m e r a h t u a ,

a d a a r e a b e r b e n t u k c a k r a m a b u - a b u d i t e n g a h k o m e a , f o t o f o b i a , b l e f a r o s p a s m e

y a n g n y e r i d a n p e n g l i h a t a n k a b u r ( H o l l w i c h , 1 9 9 3 ) .

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B, N o n - u l c e r a t i v e Keratitis

1 ) K e r a t i t i s S u p e r f i s i a l

a . K e r a t i t i s E p i t e l i a l

K e r a t i t i s p u n g t a t a s u p e r f i s i a l a d a l a h k e r a t i t i s d e n g a n i n f i l t r a t h a l u s

p a d a k o m e a . B i a s a n y a g e j a l a y a n g t i m b u l a d a l a h m a t a t e r a s a p e d i h , b e r a i r

d a n s e n s a s i k e l i l i p a n ( l l y a s , 2 0 0 4 ) .

b . K e r a t i t i s S u b e p i t e l i a l

• K e r a t i t i s N u m u l a r i s

B e n t u k k e r a t i t i s d e n g a n d i t e m u k a n n y a i n f i l t r a t y a n g b u n d a r

b e r k e l o m p o k d a n d i t e p i n y a b e r b a t a s t e g a s s e h i n g g a m e m b e r i k a n

g a m b a r a n h a l o ( l l y a s , 2 0 0 4 ) .

• K e r a t i t i s D i s i f o r m i s

K e r a t i t i s y a n g m e m b e n t u k k e k e r u h a n i n f i l t r a t y a n g b u l a t d a n

l o n j o n g d i d a l a m j a r i n g a n k o m e a . K e r a t i t i s d i s i f o r m i s m e r u p a k a n

r e a k s i a l e r g i a t a u i m u n o l o g i k t e r h a d a p i n f e k s i v i r u s h e r p e s s i m p l e k s

p a d a p e r m u k a a n k o m e a . K e r a t i t i s i n i m e n i m b u l k a n g e j a l a m a t a m e r a h ,

f o t o f o b i a , t a j a m p e n g l i h a t a n m e n u r u n j i k a i n f i l t r a t b e r a d a p a d a t e n g a h

k o m e a , m a t a b e r a i r d a n r a s a m e n g g a n j a l d i m a t a . P a d a m a t a d i t e m u k a n

a d a n y a i n j e k s i s i l i a r d a n i n f i l t r a t p a d a s t r o m a k o m e a ( l l y a s , 2 0 0 4 ) .

2 ) K e r a t i t i s P r o f u n d a / I n t e r s t i s i a l

K e r a t i t i s i n t e r s t i s i a l a d a l a h s u a t u r e a k s i i m u n o l o g i k t e r h a d a p t r e p o n e m a

p a i i d u m k a r e n a k u m a n i n i t i d a k d i j u m p a i d i k o m e a p a d a f a s e a k u t ( P e r d a m i ,

2 0 0 2 ) . M e n u r u t l l y a s ( 2 0 0 0 ) , k e r a t i t i s a s a l a h s u a t u p e r a d a n g a n k o m e a b a g i a n

d a l a m y a n g ( p a l i n g ) s e r i n g d i s e b a b k a n o l e h s i f i l i s c o n g e n i t a l . G e j a l a y a n g

t i m b u l a n t a r a l a i n n y e r i , f o t o f o b i a , b l e f a r o s p a s m e , i n j e k s i g a b u n g a n

( k o n j u n g t i v a d a n s i l i a r ) d a n t a j a m p e n g l i h a t a n m e n u r u n .

C . Keratitis Infektif

1 ) K e r a t i t i s B a k t e r i a l

K e r a t i t i s b a k t e r i a l a d a l a h k e r a t i t i s y a n g d i s e b a b k a n o l e h i n f e k s i b a k t e r i .

26

P e n u l a r a n d a p a t t e r j a d i m e l a l u i k o n t a k d e n g a n c a i r a n d a n j a r i n g a n m a t a ,

r o n g g a h i d u n g , m u l u t , a l a t k e l a m i n y a n g m e n g a n d u n g v i r u s . P a s i e n d e n g a n

H S V k e r a t i t i s m e n g e l u h n y e r i p a d a m a t a , f o t o f o b i a , p e n g l i h a t a n k a b u r , m a t a

b e r a i r , m a t a m e r a h , t a j a m p e n g l i h a t a n t u r u n t e r u t a m a j i k a b a g i a n p u s a t y a n g

t e r k e n a ( l l y a s , 2 0 0 4 ) .

3 ) K e r a t i t i s F u n g a l

I n f e k s i j a m u r p a d a k o m e a y a n g d a p a t d i s e b u t j u g a mycotic keratitis

( D o r l a n d , 2 0 0 0 ) . M e n u r u t S u s e t i o ( 1 9 9 3 ) u n t u k m e n e g a k k a n d i a g n o s i s k l i n i k

k e r a t i t i s f u n g a l d a p a t d i p a k a i p e d o m a n b e r i k u t :

• R i w a y a t t r a u m a t e m t a m a t u m b u h a n , p e m a k a i a n s t e r o i d t o p i k a l l a m a .

• L e s i s a t e l i t .

• T e p i u l k u s s e d i k i t m e n o n j o l d a n k e r i n g , t e p i y a n g i r e g u l e r d a n t o n j o l a n

s e p e r t i h i f a d i b a w a h e n d o t e l u t u h .

• P l a k e n d o t e l .

• H i p o p i o n , k a d a n g - k a d a n g r e k u r e n .

• F o r m a s i c i n c i n s e k e l i l i n g u l k u s .

• L e s i k o m e a y a n g i n d o l e n .

4 ) K e r a t i t i s P r o t o z o a l {Acaruhamoeba)

K e r a t i t i s y a n g b e r h u b u n g a n d e n g a n i n f e k s i Acanthamoeba y a n g b i a s a n y a

d i s e r t a i d e n g a n p e n g g u n a a n l e n s a k o n t a k ( D o r l a n d , 2 0 0 2 ) . R a s a s a k i t y a n g

t i d a k s e b a n d i n g d e n g a n t e m u a n k l i n i k n y a y a i t u k e m c r a h a n , d a n f o t o f o b i a .

T a n d a k l i n i k k h a s a d a l a h u l k u s k o m e a i n d o l e n , c i n c i n s t r o m a , d a n i n f i l t r a t

p e r i n e u r a l ( B i s w e l l , 2 0 1 0 ) .

D. Keratitis Alergi

1 ) K e r a t i t i s F l i k t e n

T e r j a d i k a r e n a r e a k s i a l e r g i y a n g m e n i m b u l k a n p e r a d a n g a n . G e j a l a y a n g

t i m b u l b i a s a n y a f o t o f o b i a , b l e f a r o s p a s m e , p e m b e n g k a k a n e k s e m a t o s a k u l i t

d a n m e m b r a n e m u k o s a , t e m t a m a h i d u n g d a n b i b i r . E k s e m a k u l i t k e p a l a d a n

27

w a j a h . R i n i t i s , r a g a d e d i s e k i t a r m u l u t d a n m e m b r a n m u k o s a . H i p e r p l a s i a

a d e n o i d d i d a l a m h i d u n g d a n f a r i n g , d i a t e s i s e k s u d a t i f . S e r i n g t e r j a d i r e a k s i

y a n g k u a t t e r h a d a p u j i t u b e r c u l i n p a d a k o n j u n g t i v a / k u l i t ( H o l l w i c h , 1 9 9 3 ) .

2 ) K e r a t i t i s V e r n a l

K e r a t i t i s v e r n a l a t a u y a n g l e b i h d i k e n a l d e n g a n k e r a t o k o n j u n g t i v i t i s v e r n a l

a d a l a h s u a t u k e a d a a n p e n y a k i t m a t a y a n g d i s e b a b k a n o l e h r e a k s i a l e r g i .

B i a s a n y a d i s e r t a i d e n g a n r i w a y a t a s m a , e k s e m a , r h i n i t i s d a n a l e r g i m u s i m a n .

G e j a l a n y a b e r u p a m a t a g a t a l d e n g a n s e k r e t , k o n j u n g t i v a t a m p a k p u t i h s u s u

d a n b a n a k p a p i l l a h a l u s d i k o n j u n g t i v a t a r s a l i s i n f e r i o r ( A s o k a n , 2 0 0 7 ) .

3 ) K e r a t i t i s A t o p i k

K e r a t i t i s a t o p i k b i a s a n y a t e r j a d i p a d a p a s i e n d e n g a n r i w a y a t d e r m a t i t i s

a t o p i k . G e j a l a n y a b e r u p a s e n s a s i t e r b a k a r , p e n g e l u a r a n s e k r e t m u k o i d , m a t a

m e r a h , f o t o f o b i a d a n k e t a j a m a n p e n g l i h a t a n m e n u r u n ( V a u g h a n , 2 0 0 0 ) .

E . Keratitis Tropik

1 ) K e r a t i t i s N e u r o p a r a l i t i k

K e r a t i t i s n e u r o p a r a l i t i k d i m u l a i d e n g a n t e r k e l u p a s n y a e p i t e l k o m e a

k e m u d i a n d i s u s u n d e n g a n t e r b e n t u k n y a v e s i k e l p a d a k o m e a d a n a k a n m e n j a d i

l e b i h b e r a t b i l a t e r j a d i i n f e k s i s e k u n d e r ( l l y a s , 2 0 0 5 ) . G e j a l a y a n g t i m b u l

a n t a r a l a i n s e n s i t i b i l i t a s k o m e a b e r k u r a n g a t a u h i l a n g , m a t a m e n j a d i m e r a h

t a n p a r a s a s a k i t ( l l y a s , 2 0 0 5 ) . S e l a i n i t u j u g a d a p a t t e i j a d i p e n u r u n a n t a j a m

p e n g l i h a t a n , f o t o f o b i a , i n j e k s i s i l i a r , h i l a n g n y a r e f l e k s m e n g e d i p d a n

p e r m u k a a n k o m e a k u s a m ( l l y a s , 2 0 0 0 ) .

2 ) U l k u s A t e r o m a t o u s

U l k u s a t e r o m a t o u s a d a l a h u l k u s y a n g t e r j a d i p a d a j a r i n g a n p a r u t k o m e a

( l l y a s , 2 0 0 0 ) . B i a s a n y a p e n d e r i t a m e n g a l a m i m a t a m e r a h d a n k e s u l i t a n d a l a m

m e l i h a t .

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F. Keratitis Idiopatik

1 ) U l k u s K o m e a M o o r e n ' s

U l k u s k o m e a M o o r e n ' s p e r t a m a k a l i d i d e s k r i p s i k a n o l e h B o w m a n p a d a

t a h u n 1 8 4 9 d a n M c K e n z i e p a d a t a h u n 1 8 5 4 s e b a g a i " u l k u s k o r n e a p r o g r e s i f

k r o n i k a t a u u l k u s r o d e n " . N a m u n . u l k u s k o m e a M o o r e n ' s p e r t a m a

d i p e r k e n a l k a n s e b a g a i k o n d i s i p e n y a k i t y a n g b e r a t p a d a t a h u n 1 8 6 3 d a n j u g a

p e r t a m a d i d e s k r i p s i k a n j e l a s k o n d i s i k o m e a i n i s e b a g a i k e s a t u a n k l i n i s

( N g u y e n , 2 0 1 2 ) .

P e n y a k i t i n i d a p a t m e n i m b u l k a n n y e r i h e b a t , u l k u s k o m e a k r o n i k y a n g

m u l a i d a r i b a g i a n p e r i f e r k e m u d i a n b e r l a n g s u n g s e c a r a m e l i n g k a r h i n g g a

s a m p a i k e b a g i a n s e n t r a l . M e n u m t d e f i n i s i , u l k u s k o m e a M o o r e n ' s m e m p a k a n

k e l a i n a n i d i o p a t i k d a n t i d a k b e r h u b u n g a n d e n g a n s k l e r i t i s . P e n d e r i t a u l k u s

k o m e a M o o r e n ' s t i p i k a l m e m i l i k i g e j a l a m a t a m e r a h , b e r a i r , f o t o f o b i a , d a n

k e b a n y a k a n d e n g a n n y e r i y a n g l u a r b i a s a ( N g u y e n , 2 0 1 2 ) .

2) K e r a t i t i s S u p e r f i s i a l P u n g t a t a Thygeson

Gambar 2.9 Thygeson S u p e r f i c i a l Punctate Keratitis (TSPK)

S u m b e r : w w w . w e b e y e . o p h t h . u i o w a . e d u

P e n y e b a b Thygeson Superficial Punctate Keratitis ( T S P K ) b e l u m

d i k e t a h u i , t e t a p i v i r u s d a n m e k a n i s m e i m u n m e r u p a k a n d u g a a n s e m e n t a r a i n i .

29

V i r u s s e b a g a i p e n y e b a b T S P K d i u s u l k a n b e r d a s a r k a n t i d a k a d a n y a g a m b a r a n

b a k t e r i d a n a g e n i n f e k s i l a i n n y a , p e n y a k i t y a n g r e s i s t e n t e r h a d a p a n t i b i o t i k

d a n g a m b a r a n l e s i y a n g m e n y e r u p a i c a m p a k d a n i n f e k s i a d e n o v i r u s

( L e i b o w i t z , 1 9 9 8 ) .

G e j a l a y a n g d i a l a m i p e n d e r i t a T S P K a n t a l a i n m a t a s e p e r t i t e r b a k a r d a n

p e r i h , s e n s a s i a d a n y a b e n d a a s i n g ( k e l i l i p a n ) , m a t a b e r a i r , d a n f o t o f o b i a .

K a d a n g - k a d a n g t e r j a d i s e d i k i t p e n u r u n a n t a j a m p e n g l i h a t a n ( A r f f a , 1 9 9 7 ) .

2.2.5 Diagnosis Klinis

P a d a k e r a t i t i s i n f e k t i f m a u p u n u l k u s k o m e a , d a p a t d i l a k u k a n k e r o k a n d a n

b i a k a n y a n g d a p a t m e m p e r l i h a t k a n m i k r o o r g a n i s m e p e n y e b a b s e p e r t i b a k t e r i ,

v i r u s m a u p u n j a m u r . B i a s a n y a j u g a a k a n t e r l i h a t a d a n y a i n f i l t r a t k o m e a y a n g

l e t a k n y a d i t e n g a h - t e n g a h k o m e a ( H o l l w i c h , 1 9 9 3 ) . U j i f l o u r e s e i n p a d a k e r a t i t i s

d a p a t m e m p e r l i h a t k a n b e n t u k l e s i y a n g t e r j a d i . B e n t u k a n l e s i d a p a t m e n e n t u k a n

j e n i s m a u p u n e t i o l o g i k e r a t i t i s t e r s e b u t . S e p e r t i a d a n y a l e s i d e n d r i t i k t e r j a d i p a d a

k e r a t i t i s v i r a l y a n g d i s e b a b k a n o l e h i n f e k s i H S V . P a d a k e r a t i t i s p u n g t a t a

s u p e r f i s i a l t e r j a d i k e k e r u t a n e p i t e l y a n g m e n i n g g i b e r b e n t u k l o n j o n g d a n j e l a s

y a n g m e n a m p a k k a n b i n t i k - b i n t i k . t e r u t a m a d i d a e r a h p u p i l ( l l y a s , 2 0 0 4 ) .

2.2.6 Pengobatan

A. Medikamentosa

I ) P e n g o b a t a n b e r d a s a r k a n e t i o l o g i

• I n f e k s i b a k t e r i d a p a t d i b e r i k a n a n t i b i o t i c s p e k t r u m l u a s u n t u k t a h a p

p e r t a m a s a m b i l m e n u n g g u h a s i l k u l t u r b a k t e r i . S e t e l a h h a s i l k u l t u r

d i t e r i m a , d a p a t d i b e r i k a n a n t i b i o t i k s e s u a i o r g a n i s m e p e n y e b a b n y a .

I n f e k s i b a k t e r i g r a m - n e g a t i f d a p a t d i b e r i k a n Tobramycin,

Ceftazimidine atau Fluoroquinolone.

• P a d a i n f e k s i v i r u s s e p e r t i i n f e k s i H S V d a p a t d i b e r i k a n a n t i v i r a l

I D U (Idoxuridine) a n a l o g p i r i m i d i n d a n a s i k l o v i r s a l e p a t a u

a s i k l o v i r o r a l u n t u k i n f e k s i y a n g b e r a t ( l l y a s , 2 0 0 4 ) .

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• D a p a t d i b e r i k a n g o l o n g a n imidazole p a d a i n f e k s i f u n g a l y a n g

b e l u m d i k e t a h u i j e n i s f u n g a l n y a ( S u s e t i o , 1 9 9 3 ) .

2) P e n g o b a t a n S i m p t o m a t i k

P e m b e r i a n a t r o p i n a t a u m i d r i a t i k a b e r f u n g s i u n t u k m e n g i s t i r a h a t k a n

m a t a d a n m e n g u r a n g i r a s a s a k i t ( P e r d a m i , 2 0 0 2 ) . S e l a i n i t u j u g a d a p a t

d i b e r i k a t e l e s m a t a d e k o n g e s t a n , z i n k s u l f a t , m e t i l s e l u l o s a , p o l i v i n i i

a l k o h o l a t a u k o r t i k o s t e r o i d ( l l y a s , 2 0 0 4 ) .

B. Tindakan bcdah

K e r a t o p l a s t i m u n g k i n d i p e r l u k a n p a d a p e n y a k i t y a n g t e l a h l a n j u t u n t u k

m e n g h e n t i k a n b e r l a n j u t n y a i n f e k s i a t a u s e t e l a h r e s o l u s i d a n t e r b e n t u k n y a

p a r u t u n t u k m e m u l i h k a n p e n g l i h a t a n . J i k a o r g a n i s m e i n i s a m p a i k e s k i e r a ,

t e r a p i o b a t d a n b e d a h t i d a k b e r g u n a ( B i s w e l l , 2 0 1 0 ) .

2.3 Kerangka Teori

Faktor Risiko/Faktor Sosiodemografi

1. Umur 2. Jenis Kelamin 3. Pekerjaan 4. Pendidikan

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F a k t o r P e n y e b a b

1 . I n f e k s i a . B a k t e r i b . V i r u s c . J a m u r d . P r o t o z o a

2 . A l e r g i 3 . I d i o p a t i k

R e a k s i i n f e k s i d a n i n f l a m a s i

K e r a t i t i s

Ulseratif Non-Ulseratif

Visus menurun

Sumber: Modifikasi dari llyas, 2004; Oladigbolu el al. 2013

BAB 111

M E T O D E P E N E L I T I A N

3.1 Jenis Penelitian

J e n i s p e n e l i t i a n y a n g d i l a k u k a n a d a l a h d e s k r i p t i f cross sectional d e n g a n

m e n y a j i k a n a n g k a - a n g k a k e j a d i a n d a n k a r a k t e r i s t i k p e n d e r i t a k e r a t i t i s d i R u m a h

S a k i t M u h a m m a d i y a h P a l e m b a n g ( R S M P ) T a h u n 2 0 1 1 - 2 0 1 2 .

3.2 Waktu dan Tempat Penelitian

3.2.1 Waktu Penelitan

P e n e l i t i a n i n i d i l a k u k a n p a d a b u l a n N o v e m b e r 2 0 1 3 - F e b r u a r i 2 0 1 4 .

3.2.2 Tempat Penelitian

P e n e l i t i a n i n i d i l a k u k a n d i B a g i a n R e k a m M e d i k I l m u P e n y a k i t M a t a

R u m a h S a k i t M u h a m m a d i y a h P a l e m b a n g .

3.3 Populasi dan Subjek/Sampel Penelitian

3.3.1 Populasi Penelitian

A. Populasi Target

P o p u l a s i t a r g e t p a d a p e n e l i t i a n i n i a d a l a h s e l u r u h s u b j e k p e n e l i t i a n

d a r i p e n d e r i t a p e n y a k i t m a t a y a n g t e r c a t a t d a l a m l a p o r a n r e k a m m e d i k

R S M P .

B. Populasi Terjangkau

P o p u l a s i t e r j a n g k a u p a d a p e n e l i t i a n i n i a d a l a h s e l u r u h s u b j e k

p e n e l i t i a n d a r i p e n d e r i t a k e r a t i t i s d i B a g i a n R e k a m M e d i k I l m u P e n y a k i t

M a t a R S M P T a h u n 2 0 1 1 - 2 0 I 2 .

3.3.2 Sampel Penelitian

S a m p e l p a d a p e n e l i t i a n i n i d i t e n t u k a n m e n u r u t S u l i s t y a n i n g s i h y a n g

m e n y a t a k a n b a h w a p a d a s u r v e i d e s k r i p t i f d i g u n a k a n s a m p e l m i n i m a l

s e b a n y a k 1 0 0 s a m p e l . J a d i , b e s a r s a m p e l y a n g a k a n d i t e l i t i p a d a p e n e l i t i a n i n i

a d a l a h 1 0 0 d a t a r e k a m m e d i k .

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3.3.3 Kriteria Inklusi dan Eksklusi

A. Kriteria inklusi

K r i t e r i a i n k l u s i p a d a p e n e l i t i a n i n i a d a l a h s e l u r u h d a t a r e k a m m e d i k

p e n d e r i t a k e r a t i t i s d e n g a n c a t a t a n l e n g k a p m e n g e n a i u m u r , j e n i s

k e l a m i n . p e k e r j a a n , j e n i s k e r a t i t i s d a n v i s u s p e n d e r i t a . A n a k - a n a k

d e n g a n u m u r < 8 t a h u n t i d a k d i a m b i l s e b a g a i s a m p e l .

B. Kriteria Eksklusi

K r i t e r i a e k s k l u s i p a d a p e n e l i t i a n i n i a d a l a h d a t a r e k a m m e d i k

p e n d e r i t a k e r a t i t i s y a n g m e m p u n y a i p e n y a k i t s i s t e m i k t e r t e n t u .

3.4 Cara Pengambilan Sampel

S a m p e l p a d a p e n e l i t i a n i n i a k a n d i a m b i l d a r i p o p u l a s i s e c a r a a c a k s e d e r h a n a

(Simple Random Sampling).

3.5 Variabel Penelitian dan Definisi Operasional

V a r i a b e l - v a r i a b e l d a l a m p e n e l i t i a n i n i d a n d e f i n i s i o p e r a s i o n a l n y a a d a l a h

s e b a g a i b e r i k u t .

T a b e l 3 . 1 [ > e f i n i s i O p e r a s i o n a l

N o V a r i a b e l D e f i n i s i

O p e r a s i o n a l

A l a t

U k u r

C a r a

U k u r H a s i l U k u r

S k a l a

U k u r

1 U m u r L a m a n y a

w a k t u h i d u p

y a i t u t e r h i t u n g

s e j a k l a h i r

s a m p a i

d e n g a n

s e k a r a n g

R e k a m M e l i h a t M e n u r u t h a s i l N o m i n a l

m e d i k r e k a m p e n e l i t i a n

m e d i k A l b a r ( 2 0 1 2 )

y a n g

d i l a k s a n a k a n

d i R S U P H .

A d a m M a l i k

M e d a n , u m u r

34

p e n d e r i t a

k e r a t i t i s

d i b a g i

m e n j a d i d u a

k e l o m p o k

y a i t u < I 8

t a h u n d a n > 1 8

t a h u n .

2 J e n i s P e r b e d a a n R e k a m M e l i h a t 1 . L a k i - l a k i N o m i n a l

K e l a m i n a n t a r a m e d i k r e k a m 2 . P e r e m p u a n

p e r e m p u a n m e d i k

d e n g a n l a k i -

laki s e c a r a

b i o l o g i s s e j a k

s e s e o r a n g

l a h i r

P e k e r j a a n S u a t u R e k a m M e l i h a t 1 . T i d a k

k e g i a t a n a k t i f M e d i k r e k a m B e k e r j a

y a n g m e d i k ( I b u

d i l a k u k a n R u m a h

u n t u k t u j u a n T a n g g a )

t e r t e n t u 2 . P N S

3 . S w a s t a

4 . P e t a n i

5 . B u r u h

6 . P e l a j a r

N o m i n a l

35

4 J e n i s K e r a t i t i s y a n g R e k a m M e l i h a t 1 . U l s e r a t i f N o m i n a l

K e r a t i t i s d i b a g i M e d i k r e k a m 2 . N o n -

b e r d a s a r k a n m e d i k u l s e r a t i f

t e r j a d i n y a a . N u m u l a r i s

u l s e r a s i a t a u b . F l i k t e n

t i d a k c . P u n g t a t a

5 L a t e r a l i t a s K e r a t i t i s y a n g R e k a m M e l i h a t 1 . B i l a t e r a l N o m i n a l

y a n g d i b a g i M e d i k R e k a m 2 . U n i l a t e r a l

T e r k e n a b e r d a s a r k a n M e d i k

b a g i a n k a n a n

d a n k i r i m a t a

y a n g t e r k e n a

6 V i s u s K e t a j a m a n R e k a m M e l i h a t 1 . M e n u r u n O r d i n a l

p e n g l i h a t a n M e d i k r e k a m 2 . N o r m a l

p e n d e r i t a m e d i k

s e b e l u m

d i t e r a p i d a n

s e t e l a h 2

m i n g g u t e r a p i .

3.5 Cara Pengumpulan Data

D a t a p e n e l i t i a n i n i m e r u p a k a n d a t a s e k u n d e r y a n g m e l i p u t i u m u r , j e n i s

k e l a m i n , p e k e r j a a n , p e n d i d i k a n , j e n i s k e r a t i t i s d a n v i s u s p e n d e r i t a y a n g d i p e r o l e h

d a r i r e k a m m e d i k d i B a g i a n R e k a m M e d i k I l m u P e n y a k i t M a t a R S M P T a h u n

2 0 1 1 - 2 0 1 2 . U n t u k m e n d a p a t k a n d a t a - d a t a v a r i a b e l d i a t a s , m a k a d a t a r e k a m m e d i k

d i l i h a t s a t u p e r s a t u .

3.6 Analisis Data

D a t a y a n g d i p e r o l e h d a r i r e k a m m e d i k p a s i e n k e r a t i t i s t a h u n 2 0 1 1 - 2 0 1 2

d i t a b u l a s i d a n d i s a j i k a n d a l a m b e n t u k t a b e l a t a u d i a g r a m d a n n a r a s i .

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. 7 Alur Penelitian

D a t a r e k a m m e d i k :

P o p u l a s i s e l u r u h p e n y a k i t m a t a d i B a g i a n R e k a m M e d i k I l m u P e n y a k i t

M a t a R u m a h S a k i t M u h a m m a d i y a h P a l e m b a n g

S a m p e l d i a c a k

D i d a p a t k a n b a g i a n d a r i s u b j e k p e n e l i t i a n y a i t u p e n y a k i t k e r a t i t i s d a n

p e n y a k i t m a t a l a i n n y a

A n a l i s i s d a t a d i p e r o l e h d a r i r e k a m m e d i k d i B a g i a n R e k a m M e d i k I l m u

P e n y a k i t M a l a R S M P T a h u n 2 0 1 1 - 2 0 1 2

D a t a d i t a b u l a s i , d i o l a h d a n d i s a j i k a n d a l a m b e n t u k t a b e l a t a u d i a g r a m d a n

n a r a s i

BAB IV

HASIL DAN PEMBAHASAN

4.1 Hasil Penelitian

P e n e l i t i a n i n i d i l a k s a n a k a n d i B a g i a n R e k a m M e d i k R u m a h S a k i t

M u h a m m a d i y a h P a l e m b a n g ( R S M P ) p a d a t a n g g a l 2 J a n u a r i 2 0 1 4 s a m p a i d e n g a n

7 J a n u a r i 2 0 1 4 . P e n d e r i t a k e r a t i t i s d i R S M P t a h u n 2 0 1 1 - 2 0 1 2 b e r j u m l a h 1 6 5

o r a n g . S a m p e l m i n i m a l y a n g d i a m b i l s e b e s a r 1 0 0 s a m p e l m e n u r u t

S u l i s t y a n i n g s i h . T e k n i k p e n g a m b i l a n s a m p e l p a d a p e n e l i t i a n i n i a d a l a h simple

random sampling d e n g a n m e n g g u n a k a n u n d i a n . V a r i a b e l y a n g d i t e l i t i a d a l a h ,

u s i a , J e n i s k e l a m i n , p e k e r j a a n , j e n i s k e r a t i t i s , l a t e r a l i t a s y a n g t e r k e n a k e r a t i t i s d a n

v i s u s p e n d e r i t a s e b e l u m d i t e r a p i m a u p u n s e t e l a h d i t e r a p i .

• Katarak

• Pseudophakia

• Infeksi

• Pterygium

• Glaukoma

• Aphakia

• Kelainan Refraksi

• Tumor Palpebra

• Hordeolum

• Chalazion

G a m b a r 4 . 1 D i a g r a m P e r s e n t a s e P e n y a k i t M a t a d i R S M P T a h u n 2 0 1 1 - 2 0 1 2

J u m l a h k u n j u n g a n p a s i e n p e n y a k i t m a t a d i R S M P t a h u n 2 0 1 1 - 2 0 1 2 y a i t u

s e b e s a r 4 8 3 2 k u n j u n g a n . G a m b a r 4 . 1 m e m p e r l i h a t k a n 1 0 p e n y a k i t m a t a t e r b a n y a k

d i R S M P t a h u n 2 0 1 1 - 2 0 1 2 . P e r s e n t a s e k a t a r a k s e b e s a r 2 7 % ( n = l 3 l 7 ) ,

p s e u d o p h a k i a 2 4 % ( n = I I 5 0 ) , i n f e k s i m a t a 1 2 % ( n = 5 6 2 ) , p t e r y g i u m 1 0 % ( n = 5 0 8 ) .

3% 3% 2%

38

g l a u k o m a 8 % ( n = 3 6 7 ) , a p h a k i a 6 % ( n = 2 7 9 ) , k e l a i n a n r e f r a k s i 5 % { n = 2 4 2 ) , t u m o r

p a l p e b r a 3 % ( n = l 6 0 ) , h o r d e o l u m 3 % ( n = l 6 0 ) d a n c h a l a z i o n 2 % ( 8 7 ) .

2%m 1 %

30K • K o n j u n c t i v i t i s

• K e r a t i t i s

• B l e p h a r i t i s

• E n d o p t h a l m i t i s

G a m b a r 4 . 2 D i a g r a m P e r s e n t a s e P e n y a k i t I n f e k s i M a t a d i R S M P T a h u n 2 0 1 1 -

2 0 1 2

P e r s e n t a s e p e n y a k i t i n f e k s i m a t a s e p e r t i y a n g d i g a m b a r k a n p a d a G a m b a r 4 . 2

a d a l a h k o n j u n c t i v i t i s s e b e s a r 6 7 % ( n = 3 7 7 ) , k e r a t i t i s s e b e s a r 3 0 % ( n = l 6 5 ) ,

b l e p h a r i t i s s e b e s a r 2 % ( n = l 3 ) d a n e n d o p h t h a l m i t i s s e b e s a r 1 % ( n = 7 ) .

• < l 8 T a h u n • > I 8 T a h u n

G a m b a r 4 . 3 D i a g r a m P e r s e n t a s e K a r a k t e r i s t i k U m u r P e n d e r i t a K e r a t i t i s d i R S M P

T a h u n 2 0 1 1 - 2 0 1 2

M e n u r u t A l b a r ( 2 0 1 2 ) . k e l o m p o k u m u r p e n d e r i t a k e r a t i t i s d i b a g i m e n j a d i s u a

k e l o m p o k y a i t u < I 8 t a h u n d a n > I 8 t a h u n . B e r d a s a r k a n G a m b a r 4 3 1 d a p a t d i l i h a t

39

G a m b a r 4 . 4 D i a g r a m P e r s e n t a s e K a r a k t e r i s t i k J e n i s K e l a m i n P e n d e r i t a K e r a t i t i s

d i R S M P T a h u n 2 0 I I - 2 0 I 2

B e r d a s a r k a n G a m b a r 4 . 4 d a p a t d i l i h a t p e r s e n t a s e p e n d e r i t a k e r a t i t i s l a k i - l a k i

s e b e s a r 3 9 % ( n ^ 3 9 ) d a n p e r e m p u a n s e b e s a r 6 1 % ( n = 6 l ) .

• T i d a k B e k e r j a ( I R I ) • PNS • P e g a w a i S w a s t a • P e t a n i

B u r u h P e l a j a r

G a m b a r 4 . 5 D i a g r a m P e r s e n t a s e K a r a k t e r i s t i k P e k e r j a a n P e n d e r i t a K e r a t i t i s d i

R S M P T a h u n 2 0 1 1 - 2 0 1 2

40

P a d a G a m b a r 4 . 5 d a p a t d i l i h a t k e l o m p o k t i d a k b e k e r j a ( i b u r u m a h t a n g g a )

m e m i l i k i p e r s e n t a s e s e b e s a r 6 6 % ( n = 6 6 ) d a n p e l a j a r s e b e s a r 2 0 % ( n = 2 0 ) .

U l s e r a t i f

N o n - u l s e r a t i f

G a m b a r 4 . 6 D i a g r a m P e r s e n t a s e K a r a k t e r i s t i k J e n i s K e r a t i t i s d i R S M P 2 0 1 1 -

2 0 1 2

1% 1%

85%

1% 3% • P u n g t a t a

S N u m u l a r i s

• F l i k t e n

• T r a u m a t i c

• K e r a t o k o n j u n c t i v i t i s

• L a i n - l a i n

G a m b a r 4 . 7 D i a g r a m P e r s e n t a s e K a r a k t e r i s t i k J e n i s K e r a t i t i s N o n - u l s e r a t i f d i

R S M P 2 0 1 1 - 2 0 1 2

G a m b a r 4 . 6 d a n G a m b a r 4 . 7 m e m p e r l i h a t k a n b a h w a p e r s e n t a s e k e r a t i t i s

u l s e r a t i f m e m i l i k i p e r s e n t a s e s e b e s a r 2 3 % ( n = 2 3 ) d a n n o n - u l s e r a t i f s e b e s a r 7 7 %

( n = 7 7 ) . K e r a t i t i s n o n - u l s e r a t i f d i b a g i m e n j a d i b e b e r a p a k e l o m p o k y a i t u k e r a t i t i s

p u n g t a t a s e b e s a r 1 % ( n ^ l ) , k e r a t i t i s n u m u l a r i s 1 % ( n = l ) , k e r a t i t i s f l i k t e n 9 %

41

( n = 7 ) , k e r a t i t i s t r a u m a t i c 1 % ( n = l ) , k e r a t o k o n j u n c t i v i t i s 3 % ( n = 2 ) d a n k e r a t i t i s

I a i n - I a i n 8 5 % ( n = 6 5 ) .

46% U n i l a t e r a l

• B i l a t e r a l

G a m b a r 4 . 8 D i a g r a m P e r s e n t a s e K a r a k t e r i s t i k L a t e r a l i t a s y a n g T e r k e n a P a d a

P e n d e r i t a K e r a t i t i s d i R S M P T a h u n 2 0 1 1 - 2 0 1 2

P e r s e n t a s e k e r a t i t i s y a n g t e r l i h a t p a d a G a m b a r 4 . 8 y a i t u k e r a t i t i s y a n g t e r j a d i

s e c a r a u n i l a t e r a l s e b e s a r 4 6 % { n = 4 6 ) d a n b i l a t e r a l s e b e s a r 5 4 % ( n = 5 4 ) .

• P e n u r u n a n V i s u s

• V i s u s N o r m a l / T i d a k M e n u r u n

• T i d a k D a p a t D i i n t e r p r e t a s i

G a m b a r 4 . 9 D i a g r a m P e r s e n t a s e I n t e r p r e t a s i H a s i l P e m e r i k s a a n V i s u s P e n d e r i t a

K e r a t i t i s S e b e l u m D i t e r a p i d i R S M P T a h u n 2 0 1 1 - 2 0 1 2

42

I n t e r p r e t a s i h a s i l p e m e r i k s a a n v i s u s ( h a s i l p a d a l a m p i r a n I V ) y a n g t e r l i h a t

p a d a G a m b a r 4 . 9 y a i t u p e r s e n t a s e p e n d e r i t a y a n g m e n g a l a m i p e n u r u n a n v i s u s

s e b e s a r 8 1 % ( n = 8 l ) , v i s u s n o r m a l s e b e s a r 7 % ( n = 7 ) d a n t i d a k d a p a t d i i n t e r p r e t a s i

s e b e s a r 1 2 % ( n = 1 2 ) .

• P e r b a i k a n

T i d a k A d a P e r u b a h a n

• P e n u r u n a n V i s u s

T i d a k D a p a t D i i n t e r p r e t a s i

G a m b a r 4 . 1 0 D i a g r a m P e r s e n t a s e I n t e r p r e t a s i K c m a j u a n P e n g o b a t a n D a r i H a s i l

P e m e r i k s a a n V i s u s P e n d e r i t a K e r a t i t i s S e t e l a h D i t e r a p i d i R S M P

T a h u n 2 0 1 1 - 2 0 1 2

B e r d a s a r k a n G a m b a r 4 . 1 0 ( h a s i l p a d a l a m p i r a n V ) d i d a p a t k a n p e r s e n t a s e

p e n d e r i t a y a n g m e n g a l a m i p e r b a i k a n s e b e s a r 4 8 % ( n = 4 8 ) , t i d a k a d a p e r u b a h a n

s e b e s a r 1 4 % ( n = l 4 ) , v i s u s s e m a k i n m e n u r u n k a r e n a m e n g a l a m i k o m p l i k a s i

s e b e s a r 1 % ( n = l ) , d a n t i d a k d a p a t d i i n t e r p r e t a s i s e b e s a r 3 7 % ( n = 3 7 ) .

4.2 Pembahasan

P e n d e r i t a k e r a t i t i s t e r b a n y a k p a d a k e l o m p o k u m u r > 1 8 t a h u n y a n g m e m i l i k i

p r o p o r s i s e b e s a r 8 7 % ( n = 8 7 ) . S e d a n g k a n k e l o m p o k u m u r < I 8 t a h u n m e m i l i k i

p r o p o r s i s e b e s a r 1 3 % ( n = l 3 ) . H a s i l y a n g d i d a p a t k a n m e m i l i k i a n g k a y a n g l e b i h

k e c i l d i b a n d i n g k a n d e n g a n h a s i l p e n e l i t i a n A l b a r ( 2 0 1 2 ) d i R S U P H . A d a m M a l i k

M e d a n y a n g m e l a p o r k a n b a h w a p e r s e n t a s e p e n d e r i t a k e r a t i t i s p a d a k e l o m p o k

u m u r > I 8 t a h u n s e b e s a r 9 3 , 6 % .

B e r d a s a r k a n j e n i s k e l a m i n , d i d a p a t k a n h a s i l p e n d e r i t a k e r a t i t i s t e r b a n y a k p a d a

p e r e m p u a n y a n g m e m i l i k i p e r s e n t a s e s e b e s a r 6 1 % ( n ^ 6 l ) . H a s i l i n i l e b i h t i n g g i

43

d i b a n d i n g k a n d e n g a n h a s i l p e n e l i t i a n O l a d i g b o l u et al ( 2 0 1 3 ) d i A h m a d u B e l l o

U n i v e r s i t y T e a c h i n g H o s p i t a l , N i g e r i a , y a n g m e l a p o r k a n b a h w a 4 3 , 4 % d i a l a m i

o l e h p e r e m p u a n d a n h a s i l p e n e l i t i a n A l b a r ( 2 0 1 2 ) y a n g m e l a p o r k a n b a h w a

p e n d e r i t a k e r a t i t i s d i a l a m i o l e h 3 8 , 5 % p e r e m p u a n . S e d a n g k a n p e n d e r i t a k e r a t i t i s

l a k i - l a k i m e m i l i k i p e r s e n t a s e s e b e s a r 3 9 % ( n = 3 9 ) . H a s i l i n i l e b i h r e n d a h

d i b a n d i n g k a n d e n g a n h a s i l p e n e l i t i a n O l a d i g b o l u et al ( 2 0 1 3 ) y a n g m e l a p o r k a n

b a h w a s e b a n y a k 5 6 , 6 % k a s u s d i a l a m i o l e h l a k i - l a k i d a n h a s i l p e n e l i t i a n A l b a r

( 2 0 1 2 ) y a n g m e l a p o r k a n b a h w a 6 1 , 5 % k a s u s d i a l a m i o l e h l a k i - l a k i .

P a d a p e n e l i t i a n i n i d i d a p a t k a n b a h w a k e l o m p o k y a n g m e m i l i k i p e r s e n t a s e

t e r b e s a r a d a l a h k e l o m p o k t i d a k b e k e r j a t e r m a s u k i b u r u m a h t a n g g a 6 6 % ( n = 6 6 ) .

B e r b e d a d e n g a n h a s i l p e n e l i t i a n y a n g d i l a k u k a n o l e h M i r z a ( 2 0 1 2 ) d i R S U P H .

A d a m M a l i k M e d a n y a n g m e l a p o r k a n b a h w a f a k t o r p e k e r j a a n p a l i n g b a n y a k p a d a

p e n d e r i t a k e r a t i t i s a d a l a h p e g a w a i s w a s t a s e b e s a r 2 7 , 3 % .

J e n i s k e r a t i t i s y a n g p a l i n g b a n y a k d i t e m u k a n d i R S M P t a h u n 2 0 1 1 - 2 0 1 2

a d a l a h k e r a t i t i s n o n - u l s e r a t i f y a i t u 7 7 % ( n = 7 7 ) , s e d a n g k a n k e r a t i t i s u l s e r a t i f

s e b e s a r 2 3 % ( n = 2 3 ) . K e r a t i t i s n o n - u l s e r a t i f d i b a g i m e n j a d i k e r a t i t i s p u n g t a t a

s e b e s a r 1 % ( n = l ) , k e r a t i t i s n u m u l a r i s 1 % ( n = l ) , k e r a t i t i s flikten 9 % ( n = 7 ) ,

k e r a t i t i s t r a u m a t i c 1 % ( n = l ) , k e r a t o k o n j u n c t i v i t i s 3 % ( n = 2 ) d a n k e r a t i t i s l a i n - l a i n

8 5 % ( n = 6 5 ) . K e r a t i t i s l a i n - l a i n m e r u p a k a n k e r a t i t i s y a n g t i d a k d a p a t d i t e n t u k a n

j e n i s n y a k a r e n a p e m e r i k s a a n p e n u n j a n g y a n g d i l a k u k a n d i p o l i m a t a R S M P

m e r u p a k a n p e m e r i k s a a n p e n u n j a n g s e d e r h a n a . S e h i n g g a t i d a k d a p a t d i l a k u k a n

p e n g e l o m p o k k a n j e n i s k e r a t i t i s s e s u a i d e n g a n e t i o l o g i n y a . P a d a b e b e r a p a k a s u s

k e r a t i t i s l a i n - l a i n d i t e m u k a n a d a n y a r i w a y a t t i n d a k a n b e d a h p a d a m a t a . H a l i n i

s e s u a i d e n g a n t e o r i y a n g d i k e m u k a k a n o l e h G r e e n , A p e l and S t a p l e t o n ( 2 0 0 8 )

y a n g m e n y a t a k a n b a h w a s a l a h s a t u f a k t o r r i s i k o t e r j a d i n y a k e r a t i t i s a d a l a h r i w a y a t

t i n d a k a n b e d a h p a d a m a t a y a n g m e m u d a h k a n t e r j a d i n y a i n f e k s i . D a r i d a t a r e k a m

m e d i k j u g a d i d a p a t k a n k e r a t i t i s y a n g t e r j a d i s e c a r a b i l a t e r a l m e r u p a k a n k a s u s

t e r b a n y a k y a i t u s e b e s a r 5 4 k a s u s ( 5 4 % ) d a n k e r a t i t i s u n i l a t e r a l s e b a n y a k 4 6 k a s u s

( 4 6 % ) .

P e m e r i k s a a n v i s u s p a d a p e n d e r i t a k e r a t i t i s d i m a k s u d k a n u n t u k m e n g e t a h u i

a d a n y a p e n u r u n a n v i s u s a t a u t i d a k . P e n u r u n a n v i s u s t e r j a d i p a d a 8 1 k a s u s ( 8 1 % ) ,

44

t i d a k t e r j a d i p e n u r u n a n v i s u s a t a u v i s u s n o r m a l s e b e s a r 7 k a s u s ( 7 % ) . P a d a r e k a m

m e d i k j u g a d i d a p a t k a n b e b e r a p a p a s i e n t i d a k t e r l e r a h a s i l p e m e r i k s a a n v i s u s n y a .

S e b a n y a k I I o r a n g ( 1 1 % ) p e n d e r i t a k e r a t i t i s t i d a k d i l a k u k a n p e m e r i k s a a n v i s u s

d a n I o r a n g ( ! % ) t i d a k d a p a t d i l a k u k a n p e m e r i k s a a n v i s u s k a r e n a m e n d e r i t a p t i s i s

b u l b i . S e h i n g g a p a d a b e b e r a p a k a s u s , d i a g n o s i s d i l a k u k a n m e n u r u t k e l u h a n

p e n d e r i t a d a n t a n d a y a n g t i m b u l . H a l i n i s e s u a i d e n g a n t e o r i y a n g d i k e m u k a k a n

l l y a s ( 2 0 0 4 ) b a h w a s e b a g i a n b e s a r k e r a t i t i s m e n g a l a m i p e n u r u n a n k e t a j a m a n

p e n g l i h a t a n t e r u t a m a p a d a k e r a t i t i s u l s e r a t i f d a n k e r a t i t i s y a n g m e n g e n a i b a g i a n

s e n t r a l . S e t e l a h d i t e r a p i d i l a k u k a n p e m e r i k s a a n v i s u s k e m b a l i p a d a p e n d e r i t a

k e r a t i t i s u n t u k m e n i l a i a d a n y a p e r b a i k a n a t a u t i d a k . D a r i d a t a r e k a m m e d i k

d i d a p a t k a n 13 o r a n g p e n d e r i t a k e r a t i t i s ( 1 3 % ) t i d a k d i l a k u k a n p e m e r i k s a a n v i s u s

d a n 1 9 o r a n g p e n d e r i t a k e r a t i t i s ( 1 9 % ) t i d a k k o n t r o l . S e h i n g g a p a d a b e b e r a p a

k a s u s t i d a k d a p a t d i i n t e r p r e t a s i k c m a j u a n p e n g o b a t a n n y a . I n t e r p r e t a s i k e m a j u a n

p e n g o b a t a n p e n d e r i t a k e r a t i t i s m e n u r u t h a s i l p e m e r i k s a a n v i s u s y a i t u m e n g a l a m i

p e r b a i k a n s e b e s a r 4 8 % ( n = 4 8 ) , t i d a k d a p a t d i i n t e r p r e t a s i s e b e s a r 3 7 % ( n = 3 7 ) ,

t i d a k a d a p e r u b a h a n s e b e s a r 1 4 % ( n = 1 4 ) d a n v i s u s s e m a k i n m e n u r u n k a r e n a

m e n g a l a m i k o m p l i k a s i s e b e s a r l % ( n = l ) .

4.3 Keterbatasan Penelitian

1 . D a t a y a n g d i g u n a k a n p a d a p e n e l i t i a n i n i y a n g b e r u p a r e k a m m e d i k b a n y a k

t i d a k l e n g k a p , t i d a k t e r b a c a d a n h i l a n g .

2 . P e n e l i t i a n i n i t i d a k m e n g g a m b a r k a n p e r j a l a n a n p e n y a k i t , i n s i d e n s , m a u p u n

p r o g n o s i s .

BAB V

K E S I M P U L A N DAN SARAN

5.1 Kesimpulan

D a r i h a s i l p e n e l i t i a n y a n g d i l a k u k a n d i B a g i a n R e k a m M e d i k R u m a h S a k i t

M u h a m m a d i y a h P a l e m b a n g ( R S M P ) m e n g e n a i k a r a k t e r i s t i k p e n d e r i t a k e r a t i t i s d i

R S M P T a h u n 2 0 1 1 - 2 0 1 2 , m a k a d a p a t d i s i m p u l k a n :

1 . P e n d e r i t a k e r a t i t i s t e r b a n y a k p a d a u m u r > 1 8 t a h u n .

2 . K e l o m p o k j e n i s k e l a m i n t e r b a n y a k p a d a p e n d e r i t a k e r a t i t i s a d a l a h p e r e m p u a n

3 . P e n d e r i t a k e r a t i t i s t e r b a n y a k p a d a k e l o m p o k t i d a k b e k e i j a ( t e r m a s u k i b u

r u m a h t a n g g a ) .

4 . J e n i s k e r a t i t i s t e r b a n y a k a d a l a h k e r a t i t i s n o n - u l s e r a t i f .

5 . K e r a t i t i s b i l a t e r a l l e b i h b a n y a k t e i j a d i .

6 . P e n d e r i t a k e r a t i t i s t e r b a n y a k s e b e l u m d i t e r a p i m e n g a l a m i p e n u r u n a n v i s u s .

7 . P e n d e r i t a k e r a t i t i s t e r b a n y a k m e n g a l a m i p e r b a i k a n s e t e l a h d i t e r a p i .

5.2 Saran

1 . H a s i l p e n e l i t i a n i n i m e r u p a k a n d a t a a w a l a t a s p e n e l i t i a n p e n d a h u l u a n b a g i

p e n e l i t i a n s e l a n j u t n y a y a n g s e j e n i s a t a u t e r k a i t .

2 . P e l a y a n a n p r i m e r l e b i h b a n y a k m e l a k u k a n p e n y u l u h a n k e p a d a m a s y a r a k a t

t e n t a n g b a h a y a k e r a t i t i s .

3 . M a s y a r a k a t d a p a t m e n g e n a l i g e j a l a k e r a t i t i s l e b i h a w a l d a n m e n c a r i

p e n g o b a t a n s e g e r a .

4 . P e n g e l o l a a n r e k a m m e d i k a g a r l e b i h d i p e r b a i k i s e h i n g g a t i d a k a d a r e k a m

m e d i k y a n g r u s a k m a u p u n h i l a n g .

5 . P e r l u d i l a k u k a n p e n e l i t i a n l e b i h l a n j u t , t e r u t a m a h u b u n g a n t i n d a k a n b e d a h

p a d a m a t a d e n g a n k e j a d i a n k e r a t i t i s .

D A F T A R P U S T A K A

A l b a r , M . Y . 2 0 1 2 . K a r a k t e r i s t i k P e n d e r i t a K e r a t i t i s I n f e k t i f d i R S H . A d a m M a l i k M e d a n T a h u n 2 0 1 0 - 2 0 1 1 . T e s i s , J u r u s a n M a g i s t e r I l m u P e n y a k i t M a t a ( t i d a k d i p u b l i k a s i k a n ) .

A l - M u j a i n i , A . , A l - K h a r u s i , N . , T h a k r a l A . and W a l i , U K . 2 0 0 9 . Bacterial Keratitis: Perspective on Epidemiology Clinico-phatogenesis, Diagnosis and Treatment. ( h t t p : / / w w w . n c b i . n l m . n i h . g o v / p m c / a r t i c l e s / P M C 3 0 7 4 7 7 7 / , D i a k s e s 5 N o v e m b e r 2 0 1 3 ) .

A r f f a , R . C . 1 9 9 7 . Thygeson Superficial Punctate Keratitis. In: Grayson's Disease of The Cornea 4'^ Edition. ( h t t p : / / w e b e y e . o p h t h . u i o w a . e d u / d e p t / d i a g t r t / t h y g e s o n / t h y g e s o n . h t m , D i a k s e s 3 N o v e m b e r 2 0 1 3 ) .

A s o k a n , N . 2 0 0 7 . Asthma and Immunology Care. Diplomate of American Board of Allergy & Immunology and American Board of Pediatrics. ( h t t p : / / w w w . t r i n i t y a l l e r g y . c o m / m d - n a t a r a j a n - a s o k a n - t r i n i t y - a l l e r g y - a s t h m a -i m m u n o l o g y - k i n g m a n - a z . h t m , D i a k s e s t a n g g a l 1 0 N o v e m b e r 2 0 1 3 ) .

B a n g u n , C . Y . Y . 2 0 0 9 . P r e v a l e n s i K e b u t a a n A k i b a t K e l a i n a n K o m e a d i K a b u p a t e n L a n g k a t . T e s i s . D e p a r t e m e n I l m u K e s e h a t a n M a t a F a k u l t a s K e d o k t e r a n U n i v e r s i t a s S u m a t e r a U t a r a R S U P H . A d a m M a l i k . ( h t t p : / / r e p o s i t o r y . u s u . a c . i d / b i t s t r e a m / l 2 3 4 5 6 7 8 9 / 6 3 8 5 / l / l 0 E 0 0 l 7 6 . p d f , D i a k s e s t a n g g a l 1 0 N o v e m b e r 2 0 1 3 .

B i s w e l l , R . 2 0 1 0 . K o m e a . I n : V a u g h a n , A s b u r y . O f t a l m o l o g i U m u m E d i s i 1 7 . J a k a r t a : E G C

D a n d o n a , R . and D a n d o n a , L . 2 0 0 3 . Comal Blindness in a Southern Indian Population: Need For Health Promotion Strategies. ( h t t p : / / w w w . n c b i . n l m . n i h . g O v / p u b m e d / l 2 5 4 3 7 3 6 , D i a k s e s 5 N o v e m b e r 2 0 1 3 ) .

D o r l a n d , N e w m a n . 2 0 0 2 . K a m u s K e d o k t e r a n D o r l a n d E d i s i 2 9 . J a k a r t a : E G C

E r o s c h e n c k o , P . 2 0 0 3 . A t l a s H i s t o l o g i d i F i o r e . J a k a r t a : E G C

F o u l k s , G . N . and L a n g s t o n , D . D . . 1 9 8 8 . Cornea and External Disease. In: Manual of Ocular Diagnosis and Therapy. Edition. U n i t e d S t a t e s o f A m e r i c a : L i b r a r y o f C o n g r e s s C a t a l o g

F r o e t s c h e r , M . and B a e h r , M . 2 0 0 5 . D u u s Topical Diagnosis in Neurology. 4'^ Edition. N e w Y o r k : T h i e m e S t u t t g a r t

48

N g u y e n , Q . D . 2 0 1 2 . Mooren's Ulcer: Diagnosis and Management. ( h t t p : / / w w w . u v e i t i s . o r g / d o c u m e n t / d e t a i l / m o o r e n - s - u l c e r - d i a g n o s i s - a n d -m a n a g e m e n t - 2 , D i a k s e s 1 1 N o v e m b e r 2 0 1 3 ) .

O l a d i g b o l u , K . , R a f i n d a d i , A . , A b a h , E . and S a m a l i a , E . 2 0 1 3 . Corneal Ulcers in a Tertiary Hospital in Nothern Nigeria. ( h t t p : / / w w w . n c b i . n i m . n i h . g o v / p u b m e d / 2 4 0 0 5 5 8 9 , D i a k s e s 8 N o v e m b e r 2 0 1 3 ) .

P e r d a m i . 2 0 0 2 . I l m u P e n y a k i t M a t a U n t u k D o k t e r U m u m d a n M a h a s i s w a K e d o k t e r a n E d i s i K e d u a . J a k a r t a : C V . S a g u n g S e t o

R i o r d a n - E v a , P . 2 0 1 0 . A n a t o m i & E m b r i o l o g i M a t a . I n : V a u g h a n , A s b u r y . O f t a l m o l o g i U m u m E d i s i 1 7 . J a k a r t a : E G C

S e e l e y , R . R . , S t e p h e n s , T . D . and T a t e , P . 2 0 0 6 . Anatomy and Physiology. 1*^ Edition. N e w Y o r k : M c G r a w - H i l l

S n e l l , R i c h a r d . S . 2 0 0 6 . A n a t o m i K l i n i k U n t u k M a h a s i s w a K e d o k t e r a n . J a k a r t a : E G C

S u h a r d j o . 2 0 0 7 . I l m u K e s e h a t a n M a t a . Y o g y a k a r t a : B a l a i P e n e r b i t F K U G M

S u t p h i n . J . E . 2 0 0 8 . External Disease and Cornea (Basic and Clinical Science Course 2008-2009). S a n F r a n s i s c o : A m e r i c a n A c a d e m y o f O p h t h a l m o l o g y

T h y g e s o n , P . 1 9 5 0 . Superficial Punctate Keratitis. Journal of The American Medical Association. ( h t t p : / / w e b e y e . o p h t h . u i o w a . e d u / d e p t / d i a g t r t / t h y g e s o n . h t m , D i a k s e s 13 N o v e m b e r 2 0 1 3 ) .

T o r o n t o , O . 2 0 1 1 . Hudson Bay Centre, Concourse Level. 44 Bloor St. East. ( h t t p : / / w w w . d e e p d y v e . c o m / l p / i n f o r m a - h e a l t h - c a r e / f a c t o r s - a f f e c t i n g - t h e -e p i d e m i o i o g y - o f - a c a n t h a m o e b a - k e r a t i t i s - t o O P a l o h T O , D i a k s e s 15 N o v e m b e r 2 0 1 3 ) .

T o r t o r a , G . J . and D e r r i c k s o n , B . H . 2 0 0 9 . Principles of Anatomy and Physiology. 12'^ Edition. A s i a : J o h n W i l e y & S o n s

V a u g h a n , D . G . . A s b u r y , T . d a n E v a , P . R . 2 0 0 0 . O f t a l m o l o g i U m u m E d i s i 1 4 . J a k a r t a : W i d y a M e d i k a

V a u g h a n , D . G . 2 0 1 0 . O f t a l m o l o g i U m u m E d i s i 1 7 . J a k a r t a : E G C

49

W a g n e r , P . and L a n g , G . 2 0 0 6 . Lacrimal System. In: Lang, Gerhard (ed). Ophthalmology Edition: A Pocket Textbook Atlas. N e w Y o r k : T h i e m e S t u t t g a r t

W h i t c h e r , J . P . , S r i n i v a s a n , M . and U p a d h y a y , M . P . 2 0 0 1 . Corneal Blindness: A Global Perspective. S a n F r a n s i s c o . ( h t t p : / / w w w . n c b i . n l m . n i h . g O v / p u b m e d / 1 1 2 8 5 6 6 5 , D i a k s e s 5 N o v e m b e r 2 0 1 3 ) .

W i j a y a . C , T e r a b u n a n , J . d a n P e r w i r a , D . 2 0 1 2 . R e f e r a t K e r a t i t i s . B a g i a n I l m u P e n y a k i t M a t a F a k u l t a s K c d o k t e r a n U n i v e r s i t a s K r i s t e n M a r a n a t h a R S I m m a n u e l . B a n d u n g . ( h t t p : / / w w w . s c r i b d . c o m / d o c / 8 4 4 0 9 8 2 3 / k e r a t i t i s , D i a k s e s I N o v e m b e r 2 0 1 3 ) .

F A K U L T A S K E D O K T E R A N UNIVERSITAS MUHAMMADIYAH PALEMBANG

SK. DIRJEN DIKTI NO. 2130 / D / T.'' 2008 TGL. 11 JULl 2008 •. IZ!N PENYELENGGARA PROGRAM STUDI PENDIDIKAN DOKTER

K a m p u s B J l . K H . B h a l q i / T a l a n g B a n t e n 13 U l u Te lp 0 7 1 1 - 5 2 0 0 4 5 Fax . 0 7 1 1 5 1 6 8 3 9 P a l e m b a n g ( 3 0 2 6 3 )

Palembang. I 7 Desember 2013

Nomor : 7H-57i-K-UMP7XII/20l 3 Lampiran Perihal : Surat Izin Penelitian

Kepada : Ylh. Direktur RS. Muhammadiyah Palembang di

Tempat

Assalamu'alaikuni. W r , W b ,

Ba'da salam. semoga kita semua mendapatkan rahmat dan hiclayah dari Allah. SWT. Amin Ya robbai alainiti

Sehubungan dengan akan berakhirnya proses pendidikan Tahap Akademik mahasiswa angkatan 2010 Program Studi Pendidikan Dokler di Fakultas Kedokteran Universitas Muhammadiyah Palembang. Maka sebagai salah satu syarat kelulusan, diwajibkan kepada setiap mahasiswa untuk membuat Skripsi sebagai bentuk pengalaman belajar riset.

Dengan ini kami mohon kepada Saudara/i agar kiranya berkenan memberikan izin pengambilan data awal kepada :

NO. NAMA /NIM J U D U L S K R I P S I

1 Rizki Amalia

702010036 Karakteristik Penderita Keratitis di RS . Muhammadiyah Palembang Tahun 2011-2012

Untuk mengambil data yang dibutuhkan dalam penyusiman skripsi yang bersangkutan.

Demlkian, atas bantuan dan kerjasamanya diucapkan terima kasih .

Billahittaufiq Walhidayah. Wassalamu'alaikum Wr. Wb.

Dekan,

y

Prof. Dr. K H M . Arsyad, D A B K , Sp. And NBM/NIDN. 0603 4809 1052253/0002064803

Tcmbusan 1. m . Waled fJckan I IK LfMP. 2. Yth. Ka. UPK TK UMP. 3 Yth. Kasubag Akademik FK UMP 4 Yth. UP2M FK UMP

RIINAH SAKIT NIIHANNADMH PALEMBANG (RSMP) Jin. Jend. A. Yani 13 Ulu Telp. (0711) 511446 Fax. (0711) 519988

e-mail: rsmuh_plg@yahoo.co.id Palembang 30263

SURAT K E T E R A N G A N N o : / K E T / L - l / R S M P / 1 / 2 0 1 4

Y a n g b e r t a n d a t a n g a n d i b a w a h i n i m e n e r a n g k a n b a h w a :

N a m a : R i z k i A m a l i a N I M : 7 2 0 1 0 0 3 6 P r o g r a m S t u d i . F a k u l t a s K e d o k t e r a n P e r g u r u a n T i n g g i : U n i v e r s i t a s M u h a m m a d i y a h P a l e m b a n g

B e n a r t e l a h m e l a k u k a n p e n e l i t i a n d i R u m a h S a k i t M u h a m m a d i y a h P a l e m b a n g d a r i t a n g g a l 0 2 - 0 7 J a n u a r i 2 0 1 4 d e n g a n j u d u l p e n e l i t i a n " K a r a k t e r i s t i k P e n d e r i t a K e r a t i t i s d i R u m a h S a k i t M u h a m m a d i y a h P a l e m b a n g T a h u n 2 0 1 1 - 2 0 1 2 " .

D e m i k i a n l a h s u r a t k e t e r a n g a n i n i d i b u a t s e b e n a r - b e n a m y a , u n t u k d a p a t d i p e r g u n a k a n s e b a g a i m a n a m e s t i n y a .

P a l e m b a n g , 1 0 J a n u a r i 2 0 1 4

D i r e k t u r , . X ^

D r . Yud?»F8^h, S d . P D . . F I N A S I M . M A R S ^ N B P . 0 5 . 6 4 . 0 0 6 6 '

^

52

L A M P I R A N i l l

D A F T A R P E N D E R I T A K E R A T I T I S Di R U M A H S A K I T M U H A M M A D I Y A H P A L E M B A N G

TAHUN 2011-2012

No No.Reg Nama Pasien Sex Umur Status

1, 2099 NADILA SAFITRl P 11 JAMSOSKES

2 3809 NELLY MUNARSIH P 22 JAMSOSKES

3. 4085 NEN AYU BINTITAHRI P 66 JAMSOSKES

4. 7291 ERNAWATI P 53 JAMSOSKES

5. 8109 FEBRI RAMADHONI L 18 JAMSOSKES

6. 9363 CEK RONI P 67 JAMSOSKES

7. 10631 YUSMIATI P 35 JAMSOSKES

8 10956 SUGIRAN L 48 JAMSOSKES

9. 11791 ALAN HERSYAH L 18 JAMSOSKES

10 12676 RUSMALA DEW1 P 36 JAMSOSKES

11 12894 SAI NAM P 52 JAMSOSKES

12 13519 SOHAR L 66 JAMSOSKES

13 13928 AMIR HAMZAH L 39 JAMSOSKES

14 17290 RUSLI L 57 JAMSOSKES

15 19954 ILYAS L 43 JAMSOSKES

16 20614 ANJAISAPUTRA L 10 JAMSOSKES

17 20868 HANA P 64 JAMSOSKES

18 22070 ARIYANTO L 16 JAMSOSKES

19 23776 ROMSIDAH P 52 JAMSOSKES

20 24114 MASNAH P 53 JAMSOSKES

21 24777 DEN! DARMAWAN L 13 JAMSOSKES

22 26169 TRISNAWATI P 52 JAMSOSKES

23 26847 TOHIR L 54 JAMSOSKES

24 27951 MARDIANA P 30 JAMSOSKES

Nama Dokter Diagnosis

RATNA JUWITA, dr. Hj. Sp M Keratitis

IBRAHIM, dr, Sp M Keratitis

RATNA JLJWITA, dr, Hj, Sp.M Keratitis

RATNA JUWITA. dr. Hj. Sp.M Keratitis

RATNA JUWITA, dr, Hj, Sp.M Keratitis

RATNA JUWITA, dr. Hj. Sp.M Keratitis

HASMAINAH, dr, Hj, Sp.M Keratitis

RATNA JUWITA, dr, Hj, Sp.M Keratitis

RATNA JUWITA, dr, Hj, Sp.M Keratitis

HASMAINAH, dr, Hj, Sp.M Keratitis

RATNA JUWITA, dr, Hj, Sp.M Keratitis

IBRAHIM, dr, Sp.M Keratitis

IBRAHIM, dr. Sp.M Keratitis

RATNA JUWITA, dr. Hj, Sp.M Keratitis

IBRAHIM, dr, Sp.M Keratitis

IBRAHIM, dr, Sp M Keratitis

HASMAINAH, dr, Hj, Sp.M Keratitis

IBRAHIM, dr, Sp.M Ulkus Komea

IBRAHIM, dr. Sp.M Keratitis

IBRAHIM, dr, Sp.M Keratitis

IBRAHIM, dr, Sp.M Keratitis

IBRAHIM, dr, Sp.M Keratitis

IBRAHIM, dr, Sp.M Keratitis

IBRAHIM, dr, Sp.M Keratitis

Jenis

Flikten

Tidak ada data

Pungtata

Tidak ada data

Tidak ada data

Tidak ada data

Keratokonjunctivitis

Post-operatif

Tidak ada data

Tidak ada data

Tidak ada data

Post-operatif

Tidak ada data

Post-operatif

Post-operatif

Tidak ada data

Post-operatif

Tidak ada data

Tidak ada data

Tidak ada data

Tidak ada data

Tidak ada data

Tidak ada data

Tidak ada data

53

25 27989 NUR SAKBANI L 10

26 27994 MARWIYAH P 73

27 28900 LELA P 46

28 31332 YUSRIL MAHENDRA L 8

29 31389 NURAINI P 58

PRIYATI BINTI 30 31712 P 26

NOMEUK

31 31760 ANDRE L 10

32 32006 SUKARDI L 32

33 33062 HAFIT ABDULAH L 62

34 33065 HABSON L 65

35 33441 ABU NAIM L 58

36 35782 ITAHANI P 42

37 37180 MARTI P 55

38 39789 KUSAtRI L 74

39 40746 ARIFIN L 61

40 42206 SAKDIAH P 38

41 43094 MURSANI P 46

42 43988 ERNA BINTI MADERI P 46

43 44541 JAMALUDIN L 73

44 45129 SUJIAH P 68

45 45206 NYIMAINAH P 54

ZAINALIS BIN R ARIFIN 46 46492 L 77

TAMIN

47 47034 M SOBRI L 45

48 47189 HAYUMA L 72

49 49757 SYAMSIAH P 60

50 53253 EFENDI L 48

51 53621 MALI L 67

52 53929 ZIKRILLAH A ZUBER L 10

JAMSOSKES

JAMSOSKES

JAMSOSKES

JAMSOSKES

JAMSOSKES

JAMSOSKES

JAMSOSKES

JAMSOSKES

JAMSOSKES

JAMSOSKES

JAMSOSKES

JAMSOSKES

JAMSOSKES

JAMSOSKES

JAMSOSKES

JAMSOSKES

JAMSOSKES

JAMSOSKES

JAMSOSKES

JAMSOSKES

JAMSOSKES

JAMSOSKES

JAMSOSKES

JAMSOSKES

JAMSOSKES

JAMSOSKES

JAMSOSKES

JAMSOSKES

IBRAHIM, dr. Sp.M

IBRAHIM, dr. Sp.M

IBRAHIM, df. Sp M

IBRAHIM, dr. Sp M

IBRAHIM, dr. Sp.M

IBRAHIM, dr. Sp.M

IBRAHIM, dr. Sp M

RATNA JUWITA, dr, Hj. Sp.M

IBRAHIM, dr. Sp M

RATNA JUWITA, dr, Hj, Sp.M

IBRAHIM, dr, Sp M

IBRAHIM, dr. Sp.M

HASMAINAH. dr. Hj. Sp.M

RATNA JUWITA. dr. Hj. Sp.M

RATNA JUWITA. dr, Hj. Sp.M

HASMAINAH, dr, Hj, Sp M

RATNA JUWITA, df, Hj, Sp.M

IBRAHIM, dr. Sp.M

IBRAHIM, dr, Sp.M

HASMAINAH, dr. Hj, Sp M

HASMAINAH. dr, Hj. Sp.M

RATNA JUWITA. dr. Hj. Sp M

RATNA JUWITA, dr, Hj, Sp.M

RATNA JUWITA, dr, Hj. Sp.M

RATNA JUWITA. dr. Hj. Sp.M

HASMAINAH. dr. Hj, Sp M

IBRAHIM, dr, Sp.M

IBRAHIM, dr, Sp.M

Keratitis

Keratitis

Keratitis

Keratitis

Keratitis

Keratitis

Ulkus Komea

Keratitis

Keratitis

Keratitis

Keratitis

Keratitis

Keratitis

Ulkus Komea

Ulkus Komea

Keratitis

Keratitis

Keratitis

Ulkus Komea

Keratitis

Keratitis

Ulkus Komea

Ulkus Komea

Keratitis

Keratitis

Keratitis

Ulkus Komea

Ulkus Komea

Tidak ada data

Tidak ada data

Tidak ada data

Flikten

Tidak ada data

Tidak ada data

Tidak ada data

Tidak ada data

Tidak ada data

Post-operatif

Post-operatif

Tidak ada data

Tidak ada data

Tidak ada data

Tidak ada data

Tidak ada data

Tidak ada data

Tidak ada data

Tidak ada data

Post-operatif

Tidak ada data

Post-operatif

Tidak ada data

Post-operatif

Post-operatif

Post-operatif

Tidak ada data

Tidak ada data

54

53 54769

54 54772

55 55321

56 57623

57 57851

58 57968

59 58835

60 58965

61 59592

62 60419

63 61179

64 63346

65 64749

66 64772

67 67163

68 67390

69 67877

70 68464

71 68532

72 72255

73 75333

74 80646

75 82009

76 82090

77 85126

78 85166

79 85209

WIJI LESTARI BIN

SUMO

SANTI HASANUDDIN

NINGMAS BIN ZAINAL

SYAKRONI S

ROHMAN BIN VAN

SARMINAH BT ROHIM

HERMA SURYATI BT

UJANG SURI

SRI WISNU

WIDIAMOKO

EKA AGUSTINA

SAYUPI BIN MERIK

CITRA DEWI

AGUSTINA

MERI JUMIATI BIN

NURHASANAH

ORIS TRI CANIA PUTRI

SIT! FORI AISYAH

RODIAH BINTI DJAHRI

MARYANI BINTI

SAIMUN AGUS

M KERAMA JAVA

MEGA LEGARINA

SIREGAR

ASIA BINTI NANGYU

MASTIAH

SYAMSUDIN

YUNANI BINTI SURON

ARI SAPUTRA

SYAMSANI BINTI

DJARIN

MAULISA

NOVELIA CAHYANI

CIK NONA

P 44 JAMSOSKES HASMAINAH, dr, Hj, Sp M Keratitis

P 33 JAMSOSKES HASMAINAH, dr, Hj, Sp.M Keratitis

L 53 JAMSOSKES RATNA JUWITA. dr, Hj, Sp.M Keratitis

L 66 JAMSOSKES HASMAINAH, dr. Hj, Sp.M Keratitis

L 52 JAMSOSKES IBRAHIM, dr, Sp.M Ulkus Komea

P 50 JAMSOSKES HASMAINAH, dr, Hj, Sp.M Keratitis

P 30 JAMSOSKES IBRAHIM, dr, Sp.M Keratitis

P 34 JAMSOSKES HASMAINAH, dr, Hj. Sp.M Keratitis

P 17 JAMSOSKES HASMAINAH, dr, Hj, Sp M Keratitis

L 64 JAMSOSKES RATNA JUWITA, dr, Hj, Sp.M Keratitis

P 18 JAMSOSKES HASMAINAH, dr, Hj, Sp.M Keratitis

P 42 JAMSOSKES IBRAHIM, dr, Sp.M Keratitis

P 14 JAMSOSKES IBRAHIM, dr, Sp.M Keratitis

P 42 JAMSOSKES RATNA JUWITA, dr, Hj, Sp.M Keratitis

P 37 JAMSOSKES RATNA JUWITA, dr, Hj, Sp M Keratitis

P 39 JAMSOSKES HASMAINAH, dr. Hj, Sp.M Keratitis

L 19 JAMSOSKES RATNA JUWITA, dr, Hj, Sp M Keratitis

P 42 JAMSOSKES HASMAINAH, dr, Hj, Sp.M Keratitis

P 52 JAMSOSKES IBRAHIM, dr. Sp.M Keratitis

P 42 JAMSOSKES RATNA JUWITA, dr. Hj. Sp.M Keratitis

L 37 JAMSOSKES HASMAINAH, dr. Hj, Sp M Keratitis

P 35 JAMSOSKES RATNA JUWITA, dr, Hj, Sp M Keratitis

L 18 JAMSOSKES HASMAINAH, dr, Hj, Sp.M Ulkus Komea

P 61 JAMSOSKES IBRAHIM, dr, Sp.M Keratitis

P 12 JAMSOSKES RATNA JUWITA, dr, Hj, Sp.M Keratitis

P 30 JAMSOSKES HASMAINAH, dr, Hj. Sp.M Keratitis

P 55 JAMSOSKES HASMAINAH. dr. Hj, Sp.M Ulkus Komea

Tidak ada data

Tidak ada data

Traumatic

Post-operatif

Tidak ada data

Tidak ada data

Tidak ada data

Numularis

Tidak ada data

Post-operatif

Tidak ada data

Keratokonjunctivitis

Tidak ada data

Post-operatif

Flikten

Tidak ada data

Tidak ada data

Post-operatif

Post-operatif

Tidak ada data

Post-operatif

Tidak ada data

Tidak ada data

Post-operatif

Tidak ada data

Tidak ada data

Tidak ada data

5 5

80 85611 TEUKU AGUS L 9

81 68935 RITA FITRIANI P 43

82 98156 MMUFTAHVAREL L 12

83 98573 MULIS SUSANTl P 34

84 98605 NAILIA P 55

85 108817 SITIANI BINTI HAMIM P 58

86 133273 RUSMAH P 72

87 135280 RA NUR JANAH P 67

88 140443 SUNITA HUSNIATI P 43

ROM! AULY 89 148805 L 16

PURWAYANSAH

90 155496 SISKAANGGRAENI P 31

91 156705 WARDIAH P 62

92 165454 LENI SUMARNI P 35

93 166652 DAHLIA P 59

94 166890 MIRA MUSRIANTI P 62

95 178679 IDRIS MONAS L 72

96 180282 PURTINEM P 36

97 186796 MAINI BINTI MAKMUN P 57

98 191649 AZIZA P 50

99 191708 TUNGIN L 76

10 191795 ISNAINI P 36

JAMSOSKES RATNA JUWITA, dr. Hj, Sp.M Keratitis

JAMSOSKES RATNA JUWITA. dr, Hj. Sp.M Keratitis

JAMSOSKES IRNA SAR! NASUTION, dr Keratitis

JAMSOSKES RATNA JUWITA, dr. Hj, Sp M Keratitis

JAMSOSKES HASMAINAH. dr, Hj. Sp M Keratitis

JAMSOSKES RSMP. dr Keratitis

JAMSOSKES RATNA JUWITA, dr. Hj. Sp.M Keratitis

JAMSOSKES IBRAHIM, dr, Sp M Keratitis

JAMSOSKES RATNA JUWITA. dr. Hj, Sp M KeratittS

JAMSOSKES IBRAHIM, dr. Sp.M Keratitis

JAMSOSKES IBRAHIM, dr. Sp.M Keratitis

JAMSOSKES RATNA JUWITA, dr. Hj, Sp.M Keratitis

JAMSOSKES IBRAHIM, dr. Sp.M Keratitis

JAMSOSKES HASMAINAH. dr. Hj, Sp.M Keratitis

JAMSOSKES HASMAINAH, dr, Hj. Sp M Keratitis

JAMSOSKES RATNA JUWITA, dr, Hj. Sp.M Keratitis

JAMSOSKES HASMAINAH, dr. Hj, Sp.M Keratitis

JAMSOSKES IBRAHIM, dr. Sp.M Keratitis

JAMSOSKES HASMAINAH. dr. Hj. Sp M Ulkus Komea

JAMSOSKES RATNA JUWITA. dr. Hj, Sp.M Keratitis

JAMSOSKES IBRAHIM, dr, Sp.M Keratitis

Flikten

Tidak ada data

Flikten

Post-operatif

Post-operatif

Post-operatif

Tidak ada data

Tidak ada data

Flikten

Tidak ada data

Post-operatif

Tidak ada data

Tidak ada data

Tidak ada data

Post-operatif

Flikten

Tidak ada data

Tidak ada data

Tidak ada data

Tidak ada data

Tidak ada data

56

L A M P I R A N IV

T a b e l H a s i l P e m e r i k s a a n V i s u s P a d a P e n d e r i t a K e r a t i t i s S e b e l u m D i t e r a p i d i

R u m a h S a k i t M u h a m m a d i y a h P a l e m b a n g T a h u n 2 0 1 1 - 2 0 1 2

N o P e m e r i k s a a n V i s u s S e b e l u m D i t e r a p i

V O D V O S

1 2 0 / 3 0 2 0 / 2 5

2 2 0 / 3 0 2 0 / 2 0

3 2 0 / 4 0 0 2 0 / 4 0

4 2 0 / 6 0 2 0 / 5 0

5 2 0 / 2 0 2 0 / 2 5

6 2 0 / 3 0 2 0 / 4 0

7 2 0 / 8 0 2 0 / 4 0

8 2 0 / 4 0 l / o o

9 2 0 / 2 5 2 0 / 2 5

1 0 2 0 / 2 0 2 0 / 2 0

u 2 0 / 2 5 2 0 / 2 0

1 2 2 0 / 1 0 0 1 / 3 0 0

1 3 2 0 / 5 0 2 0 / 2 0

1 4 1 / 3 0 0 1 / 6 0

1 5 1 / 6 0 2 0 / 2 0 0

1 6 2 0 / 3 0 2 0 / 2 0

1 7 1 / 3 0 0 2 0 / 4 0 0

1 8 2 0 / 4 0 2 0 / 5 0

1 9 2 0 / 1 0 0 2 0 / 3 0

2 0 2 0 / 6 0 2 0 / 4 0

2 1 2 0 / 2 5 2 0 / 2 0

2 2 2 0 / 2 0 0 2 0 / 1 0 0

2 3 2 0 / 2 0 0

2 4 2 0 / 2 0 2 0 / 4 0

2 5 2 0 / 2 0 2 0 / 2 0

57

2 6 1 / 6 0 1 / 6 0

2 7 2 0 / 1 0 0 2 0 / 4 0 0

2 8 2 0 / 2 5 2 0 / 2 5

2 9 3 / 6 0 l/oo

3 0 2 0 / 2 0 2 0 / 2 0

3 1 2 0 / 2 0 2 0 / 2 0

3 2 2 0 / 2 0 4 / 6 0

3 3 0 2 0 / 7 0

3 4 I/QO l/oo

3 5 1/QO l/oo

3 6 I/QO 2 0 / 2 0

3 7 2 0 / 4 0 0 2 0 / 2 0 0

3 8 l/oo 2 0 / 2 0 0

3 9 2 0 / 6 0 2 0 / 6 0

4 0 2 0 / 2 0 2 0 / 2 5

4 1 2 0 / 4 0 2 0 / 4 0

4 2 2 0 / 5 0 2 0 / 4 0

4 3 0 4 / 6 0

4 4 1 / 3 0 0 2 0 / 2 5

4 5 T i d a k a d a d a t a T i d a k a d a d a t a

4 6 2 0 / 4 0 0 1 / 3 0 0

4 7 2 0 / 2 0 2 0 / 2 0

4 8 2 0 / 4 0 0 T i d a k a d a d a t a

4 9 2 0 / 8 0 2 0 / 1 0 0

5 0 2 0 / 4 0 0 2 0 / 4 0 0

5 1 5 / 6 0 1 / 6 0

5 2 2 0 / 1 0 0 2 0 / 1 0 0

5 3 2 0 / 4 0 2 0 / 1 0 0

5 4 2 0 / 8 0 2 0 / 1 0 0

5 5 2 0 / 4 0 2 0 / 4 0

58

56 T i d a k a d a d a t a T i d a k a d a d a t a

57 T i d a k a d a d a t a 2 0 / 7 0

58 2 0 / 4 0 0 1/60

59 T i d a k a d a d a t a T i d a k a d a d a t a

60 1 / 6 0 2 0 / 4 0

61 2 0 / 1 0 0 2 0 / 8 0

62 2 0 / 4 0 0 2 0 / 8 0

63 2 0 / 2 0 2 0 / 5 0

64 2 0 / 4 0 2 0 / 2 0

65 T i d a k a d a d a t a T i d a k a d a d a t a

66 2 0 / 7 0 2 0 / 2 5

67 2 0 / 2 0 2 0 / 2 0

68 T i d a k a d a d a t a T i d a k a d a d a t a

69 2 0 / 7 0 2 0 / 3 0

70 2 0 / 2 0 2 0 / 2 0

71 2 0 / 5 0 2 0 / 3 0

72 2 0 / 7 0 2 0 / 2 0

73 2 0 / 3 0 0

74 2 0 / 2 5 2 0 / 3 0

75 T i d a k a d a d a t a T i d a k a d a d a t a

76 2 0 / 4 0 0 2 0 / 6 0

77 2 0 / 2 0 0 2 0 / 4 0

78 2 0 / 3 0 2 0 / 2 5

79 1 / 3 0 0 2 0 / 2 0 0

80 T i d a k a d a d a t a T i d a k a d a d a t a

81 2 0 / 4 0 2 0 / 4 0

82 2 0 / 2 0 2 0 / 2 0

83 2 0 / 3 0 2 0 / 3 0

84 2 0 / 4 0 0 2 0 / 4 0 0

85 2 0 / 7 0 2 0 / 7 0

59

8 6 2 0 / 4 0 0 2 0 / 5 0

87 4 / 6 0 2 0 / 2 0 0

88 2 0 / 2 0 2 0 / 2 0

89 2 0 / 2 0 2 0 / 2 0

90 T i d a k a d a d a t a T i d a k a d a d a t a

91 2 0 / 8 0 2 0 / 8 0

9 2 2 0 / 7 0 2 0 / 4 0

93 2 0 / 3 0 2 0 / 4 0 0

9 4 T i d a k a d a d a t a T i d a k a d a d a t a

9 5 2 0 / 1 0 0 2 0 / 4 0

9 6 2 0 / 2 0 2 0 / 2 5

9 7 2 0 / 3 0 2 0 / 4 0

98 2 0 / 4 0 0 2 0 / 4 0 0

9 9 4 / 6 0 4 / 6 0

I C Q T i d a k a d a d a t a 2 / 6 0

•

60

LAMPIRAN V

T a b e l H a s i l P e m e r i k s a a n V i s u s P a d a P e n d e r i t a K e r a t i t i s S e t e l a h D i t e r a p i d i

R u m a h S a k i t M u h a m m a d i y a h P a l e m b a n g T a h u n 2 0 1 ! - 2 0 1 2

N o P e m e r i k s a a n V i s u s S e t e l a h D i t e r a p i

V O D V O S

1 2 0 / 2 0 2 0 / 2 0

2 2 0 / 2 0 2 0 / 2 0

3 2 0 / 4 0 0 2 0 / 4 0

4 2 0 / 4 0 2 0 / 4 0

5 2 0 / 2 0 2 0 / 2 0

6 2 0 / 2 5 2 0 / 3 0

7 T i d a k a d a d a t a T i d a k a d a d a t a

8 2 0 / 3 0 l/oo

9 2 0 / 2 0 2 0 / 2 5

1 0 2 0 / 2 0 2 0 / 2 0

1 1 2 0 / 6 0 2 0 / 2 0

1 2 2 0 / 1 0 0 1 / 3 0 0

13 T i d a k a d a d a t a T i d a k a d a d a t a

1 4 1 / 3 0 0 2 0 / 4 0 0

15 T i d a k a d a d a t a T i d a k a d a d a t a

1 6 T i d a k a d a d a t a T i d a k a d a d a t a

1 7 2 0 / 7 0 2 / 6 0

1 8 T i d a k a d a d a t a T i d a k a d a d a t a

1 9 2 0 / 3 0 2 0 / 2 0

2 0 2 0 / 5 0 2 0 / 4 0

2 1 2 0 / 2 5 2 0 / 2 0

2 2 2 0 / 1 0 0 2 0 / 1 0 0

2 3 T i d a k a d a d a t a T i d a k a d a d a t a

2 4 2 0 / 2 0 2 0 / 3 0

2 5 2 0 / 2 0 2 0 / 2 0

61

2 6 T i d a k a d a d a t a T i d a k a d a d a t a

2 7 2 0 / 7 0 2 0 / 8 0

2 8 2 0 / 2 0 2 0 / 2 0

2 9 2 0 / 1 0 0 l / o o

3 0 2 0 / 2 0 2 0 / 2 0

31 T i d a k a d a d a t a T i d a k a d a d a t a

3 2 T i d a k a d a d a t a T i d a k a d a d a t a

3 3 0 2 0 / 7 0

3 4 2 0 / 2 0 0 2 0 / 8 0

3 5 T i d a k a d a d a t a T i d a k a d a d a t a

3 6 T i d a k a d a d a t a T i d a k a d a d a t a

3 7 2 0 / 4 0 0 2 0 / 8 0

3 8 2 0 / 6 0 2 0 / 1 0 0

3 9 2 0 / 5 0 2 0 / 6 0

4 0 2 0 / 2 0 2 0 / 2 5

4 1 2 0 / 4 0 2 0 / 4 0

4 2 T i d a k a d a d a t a T i d a k a d a d a t a

4 3 T i d a k a d a d a t a I ' i d a k a d a d a t a

4 4 1 / 3 0 0 2 0 / 2 0

4 5 T i d a k a d a d a t a T i d a k a d a d a t a

4 6 4 / 6 0 1 / 3 0 0

4 7 T i d a k a d a d a t a T i d a k a d a d a t a

4 8 T i d a k a d a d a t a T i d a k a d a d a t a

4 9 1 / 6 0 1 / 6 0

5 0 2 0 / 4 0 0 2 0 / 4 0 0

5 1 T i d a k a d a d a t a T i d a k a d a d a t a

5 2 2 0 / 1 0 0 2 0 / 1 0 0

5 3 2 0 / 3 0 2 0 / 1 0 0

5 4 2 0 / 7 0 2 0 / 8 0

5 5 2 0 / 4 0 2 0 / 3 0

62

5 6 T i d a k a d a d a t a T i d a k a d a d a t a

5 7 T i d a k a d a d a t a T i d a k a d a d a t a

5 8 2 0 / 4 0 0 2 0 / 8 0

5 9 T i d a k a d a d a t a T i d a k a d a d a t a

6 0 1 / 6 0 2 0 / 3 0

6 1 2 0 / 1 0 0 2 0 / 7 0

6 2 2 0 / 2 0 0 2 0 / 4 0

6 3 2 0 / 2 0 2 0 / 5 0

6 4 2 0 / 2 5 2 0 / 2 0

6 5 T i d a k a d a d a t a T i d a k a d a d a t a

6 6 2 0 / 7 0 2 0 / 2 5

6 7 2 0 / 2 0 2 0 / 2 0

6 8 2 0 / 2 5 2 0 / 4 0

6 9 2 0 / 5 0 2 0 / 2 5

7 0 2 0 / 2 0 2 0 / 2 0

7 1 2 0 / 2 5 2 0 / 2 0

7 2 T i d a k a d a d a t a T i d a k a d a d a t a

7 3 2 0 / 3 0 0

7 4 2 0 / 2 0 2 0 / 2 5

7 5 T i d a k a d a d a t a T i d a k a d a d a t a

7 6 T i d a k a d a d a t a T i d a k a d a d a t a

7 7 2 0 / 6 0 2 0 / 4 0

7 8 T i d a k a d a d a t a T i d a k a d a d a t a

7 9 T i d a k a d a d a t a T i d a k a d a d a t a

8 0 T i d a k a d a d a t a T i d a k a d a d a t a

8 1 T i d a k a d a d a t a T i d a k a d a d a t a

8 2 2 0 / 2 0 2 0 / 2 0

8 3 2 0 / 3 0 2 0 / 3 0

8 4 2 0 / 4 0 0 2 0 / 2 0 0

8 5 2 0 / 5 0 2 0 / 7 0

63

8 6 2 0 / 8 0 2 0 / 5 0

8 7 2 0 / 4 0 0 2 0 / 1 0 0

8 8 2 0 / 2 0 2 0 / 2 0

8 9 T i d a k a d a d a t a T i d a k a d a d a t a

9 0 T i d a k a d a d a t a T i d a k a d a d a t a

9 1 T i d a k a d a d a t a T i d a k a d a d a t a

9 2 2 0 / 4 0 5 / 5

9 3 2 0 / 4 0 1 / 6 0

9 4 T i d a k a d a d a t a T i d a k a d a d a t a

9 5 2 0 / 8 0 2 0 / 4 0

9 6 2 0 / 2 0 2 0 / 2 5

9 7 2 0 / 3 0 2 0 / 3 0

9 8 2 0 / 4 0 0 2 0 / 4 0 0

9 9 2 0 / 6 0 2 0 / 8 0

1 0 0 2 0 / 2 0 2 / 6 0

KARTU AKTIVITAS BIMBINGAN SKRIPSI NAMA MAHASISWA : p J 2 K l /\^AUA

NIM : 7 0 2 ^ ( 0 0 3 6

PEMBIMBING! : P f t IBMHH , Sip-M

PEMBIMBING

JUDULSKRIPSI : KAU /^^JTlfUSTm p t N J O E f a / l I c e g ^ T l T I S P i ^ M A H S A M T

M U P A M N W D i y / H P ^ l t M B A N Q T P F W 2 o P - 2 0 ( 2

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L A M P I R A N V I I

BIODATA

N a m a : R i z k i A m a l i a

T e m p a t T a n g g a l L a h i r : P a l e m b a n g , 3 1 O k t o b e r 1 9 9 2

A l a m a t : J l . D . l P a n j a i t a n N o . 7 G P l a j u , P a l e m b a n g 3 0 2 6 6

H p : 0 8 9 7 4 8 1 4 4 5 1

E m a i l : k i k k y a m a l i a @ g m a i l . c o m

A g a m a : I s l a m

N a m a O r a n g T u a

A y a h : H . S y a i f t i l A n w a r . S E

I b u : D r a . H j . L e I i U s m a r

J u m l a h S a u d a r a : I O r a n g

A n a k k e : 2

R i w a y a t P e n d i d i k a n :

• T K B u s t a n u l A t f a l T a h u n 1 9 9 7 - 1 9 9 8

• S D M u h a m m a d i y a h 3 P l a j u T a h u n 1 9 9 8 - 2 0 0 4

• S M P Y K P P 1 P l a j u T a h u n 2 0 0 4 - 2 0 0 7

• S M A P a t r a M a n d i r i 1 P l a j u T a h u n 2 0 0 7 - 2 0 1 0

• F a k u l t a s K e d o k t e r a n U n i v e r s i t a s M u h a m m a d i y a h P a l e m b a n g T a h u n 2 0 1 0 -

s e k a r a n g

P a l e m b a n g , F e b r u a r i 2 0 1 4

R i z k i A m a l i a