Ophthalmologica Indonesiana (OI) is an Open Access, SINTA 3–accredited peer-reviewed scientific journal and the official publication of the Indonesian Ophthalmologist Association (Perhimpunan Dokter Spesialis Mata Indonesia; PERDAMI). This journal publishes high-quality scholarly work that advances clinical practice, research, and education in the field of ophthalmology. Published biannually in February and August, Ophthalmologica Indonesiana disseminates original research articles, review articles, case reports, and other scientific contributions relevant to ophthalmology and visual science. This journal serves as a platform for clinicians, researchers, and academicians to share evidence-based findings and clinical insights. Ophthalmologica Indonesiana is available in both print (ISSN 0126-1193) and online (e-ISSN 2460-545X) formats. As an open access publication, all articles are freely available to readers without subscription or access fees. As an official publication of PERDAMI, the journal upholds high standards of scientific integrity and publication ethics.
The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))
Restoring Sight, Transforming Vision: The Past, Present, and Future of Ophthalmology in Indonesia From institution-based services to an integrated, digital, and equitable national eye-care system
The evolution of ophthalmology in Indonesia reflects substantial clinical progress achieved within a complex and demanding service environment. Across this vast archipelago, diagnostic and therapeutic technologies—including microsurgery, imaging, laser therapy, and pharmacotherapy—have been introduced and widely adopted. Yet these advances have not translated into equitable population benefit. Geographic isolation, the maldistribution of human and financial resources, and fragmented referral pathways continue to restrict access to timely, effective, and high-quality eye care, particularly in underserved communities. The central question is therefore no longer whether Indonesia can acquire modern ophthalmic capabilities, but whether these capabilities can be organised systematically into an accessible, equitable, and accountable national eye-care system. In 2022, the World Health Organization (WHO) launched its framework for integrated people-centred eye care (IPEC), which places the needs of individuals and communities at the centre of service delivery and promotes a coordinated continuum encompassing health promotion, prevention, diagnosis, treatment, disease management, and rehabilitation across all levels of the health system. Viewed through this lens, the evolution of ophthalmology in Indonesia should be assessed not solely by the adoption of modern technologies and procedures, but by the extent to which it serves a broader public purpose: from hospital-centred treatment to population-centred prevention and integrated care; from episodic charitable outreach to sustainable and equitable coverage; and from expertise concentrated in major cities to connected service networks across provinces. This Perspective traces major milestones in Indonesian ophthalmology, identifies persistent gaps, and proposes priorities for translating clinical and technological progress into equitable and effective population eye care.
Copyright (c) 2026 Muhammad Bayu Sasongko https://creativecommons.org/licenses/by-nc-sa/4.0
Concurrent Graves’ Ophthalmopathy and Sjögren’s Syndrome: A Case Report
Graves’ ophthalmopathy (GO) is the most common extrathyroidal manifestation of Graves’ disease, while Sjögren’s syndrome (SS) is a systemic autoimmune disease characterized by exocrine gland dysfunction. Although both conditions share autoimmune mechanisms, their coexistence remains underrecognized. We report a case of a woman presenting with progressive bilateral proptosis, ocular discomfort, xerophthalmia, and xerostomia. Ophthalmologic examination revealed bilateral proptosis with preserved visual acuity and normal intraocular pressure. Thyroid function tests demonstrated suppressed thyroid-stimulating hormone (TSH) and elevated free thyroxine (FT4), while orbital imaging showed bilateral extraocular muscle enlargement and exophthalmos, supporting the diagnosis of Graves’ ophthalmopathy. In addition, severe dry eye symptoms, reduced Schirmer test values, and xerostomia raised suspicion of coexisting Sjögren’s syndrome overlap. The patient demonstrated gradual clinical improvement following multidisciplinary management and systemic therapy. This case highlights the diagnostic challenge posed by overlapping ocular manifestations, particularly dual-mechanism dry eye resulting from both exposure-related and aqueous-deficient mechanisms. Early recognition of autoimmune overlap conditions is essential to optimize diagnosis, multidisciplinary management, and long-term outcomes.
Copyright (c) 2026 Banu Aji Dibyasakti, Nikolaus Erik Darmawan, Safirah Khairuna https://creativecommons.org/licenses/by-nc-sa/4.0
Orbital Meningioma in Patients with Hormonal Contraceptive History: Investigating The Role of mTOR and PTEN
Introduction and Objective: Meningiomas are among the most common low-grade intracranial tumors that can spread to the orbital cavity. Long-term use of hormonal contraceptives has been suggested to play a role in the development of meningiomas. Increasing levels of the mammalian target of rapamycin (mTOR) are considered to promote cell proliferation and prevent apoptosis. Mutations in the phosphatase and tensin homolog (PTEN) gene may increase neoplasm severity. This study aims to determine the role of mTOR and PTEN in meningioma tissues. Method: This cross-sectional study included 21 patients with meningiomas confirmed by histopathological examination. Interviews were conducted to assess their background knowledge of obstetrics, gynecology, and contraceptive use. Expression of mTOR and PTEN was assessed by real-time PCR. Result: The average age in this study was 44.93 years (SD±6.69). We also found that the average age of first-time use of contraception was 24.00 years old (SD±5.01), while the average duration of contraceptive usage was 197.31 months (SD±73.55). Among 16 patients, all subjects showed an increased expression of mTOR and PTEN. Quantitatively, there was an increase in mTOR (27,9 + 16,5) and PTEN (5.9 + 3.2) expression in tumor tissue. Conclusion: There was a significant increase in mTOR and PTEN expression in tumor tissue. Thus, mTOR and PTEN may play an important role in meningioma development.
Copyright (c) 2026 Yunefesta Angka, Datu Respatika https://creativecommons.org/licenses/by-nc-sa/4.0
The Hidden Costs of Inpatient Glaucoma Treatment: Out-of-Pocket Burden at a Tertiary Care Hospital in Yogyakarta
Introduction and Objective: Glaucoma requires lifelong care, generating out-of-pocket (OOP) costs despite insurance coverage. This study assessed OOP expenditure among hospitalized glaucoma patients covered by Indonesia’s National Health Insurance (JKN). Methods: A hospital-based cross-sectional study included 40 purposively selected glaucoma inpatients from December 2024 to February 2025. Self-reported data were collected through structured interviews. Multiple linear regression examined associations between sociodemographic and cost-related factors and total OOP expenditure. Results: Participants’ mean age was 56 years, with a male-to-female ratio of 1:1.9; 52.5% were unemployed and received subsidized JKN contributions. Mean OOP expenditure per hospitalization was IDR 640,090, comprising direct non-medical expenses (92%) and indirect costs (8%). Transportation (mean IDR 352,670; 61% of direct non-medical costs), meals for accompanying relatives (mean IDR 184,125; 32%), and indirect costs (mean IDR 50,375) were significantly associated with total OOP expenditure (all p < 0.001). The model explained 84.3% of expenditure variance (R² = 0.843). Conclusion: Transportation and meals for accompanying relatives dominated direct non-medical OOP costs, highlighting the need to strengthen financial protection for patients and their households.
Copyright (c) 2026 Sang Ayu Putu Udara Pradnyadewi, Krisna Dwi Purnomo Jati, Meta Rahma An Nazzila, Tatang Talka Gani https://creativecommons.org/licenses/by-nc-sa/4.0
Combined Scheimpflug-Derived Tomographic and Biomechanical Assessment Detection: A Systematic Review
Purpose: Keratoconus is the most common corneal ectatic disease, characterized by progressive and bilateral thinning of the cornea leading to visual loss. Early diagnosis is important, particularly in preoperative screening, and the utilization of another imaging modality remains crucial. This study aimed to explore the combination of corneal biomechanical tomographic assessment derived from Scheimpflug in diagnosing subclinical keratoconus. Methods: A systematic search was conducted in MEDLINE, Google Scholar, Clinical Key, and EBSCO. Two independent reviewers selected studies and extracted data. Risk of bias was assessed using the QUADAS-2 tool in RevMan 5.4. The primary outcome measures included the Belin-Ambrosio enhanced ectasia total deviation index (BAD-D), Stiffness Parameter at First Applanation (SPA-1), Tomographic & Biomechanical Index (TBI), and Corvis Biomechanical Index (CBI). Diagnostic accuracy was categorized based on the area under the curve (AUC) as low (AUC < 0.7), moderate (0.7 ≤ AUC < 0.9), or high (AUC ≥ 0.9). Results: Twelve studies involving 3483 eyes were included BAD-D and CBI demonstrated low to moderate AUC, while TBI demonstrated moderate to high AUC. According to the QUADAS-2, common methodological limitations included inappropriate reference standards, unclear patient selection, and inconsistent exclusion criteria. Limitations include numerous issues with methodological and findings reporting, thus a meta-analysis was not conducted. Conclusion: Scheimpflug-based corneal tomographic and biomechanical assessment shows promise as an adjunctive tool for detecting subclinical keratoconus. Among the indices, TBI appears to provide the highest diagnostic performance. However, further high-quality, longitudinal studies are required to validate these findings and to develop standardized diagnostic criteria.
Copyright (c) 2026 Yuniar Sarah Ningtiyas, Amalia Azrina, Farida Moenir, Sahata P.H. Napitupulu, Dini Dharmawidiarini https://creativecommons.org/licenses/by-nc-sa/4.0
Preseptal Cellulitis: A Multidisciplinary Perspective on Diagnosis and Treatment
Introduction: Preseptal cellulitis is a common pediatric infection involving the eyelid and anterior orbital tissues, characterized by eyelid erythema and edema. Although most cases respond well to oral antibiotics, delayed diagnosis or inadequate treatment may lead to complications requiring more intensive management. Case Presentation: A febrile 7 year-old boy presented with progressive swelling, erythema, and purulent discharge of the right upper eyelid for two weeks despite prior oral antibiotic therapy. Examination revealed marked palpebral edema, tenderness, and a superior eyelid mass without proptosis or limitation of ocular motility. Laboratory findings showed elevated C-reactive protein levels. Orbital CT imaging confirmed preseptal cellulitis without orbital involvement. The patient was hospitalized and treated with intravenous ampicillin-sulbactam. Discussion: Preseptal cellulitis most commonly affects children under 10 years old. While mild cases can be managed with oral antibiotics, severe or unresponsive cases require intravenous therapy. The absence of proptosis and preserved ocular motility were key features distinguishing this condition from orbital cellulitis. Conclusion: Prompt recognition and timely intravenous antibiotic therapy are crucial in severe preseptal cellulitis to ensure clinical improvement and prevent progression to orbital complications.
Copyright (c) 2026 Carennia Paramita, Erica Widodo, Made Susiyanti https://creativecommons.org/licenses/by-nc-sa/4.0
Editor's Introduction: Paradigm Shift in Optic Neuropathy: Early Insights into Precise Etiological Differentiation
Due of its heterogeneity in etiology, including inflammatory, vascular, and traumatic causes rather than as a singular condition and individual disease, the global prevalence of non-glaucomatous optic neuropathy (NGON) continues to be a challenging scientific difficulty.1,2,3 A retrospective study was performed at a tertiary eye‑care center in Yogyakarta, Indonesia, covering the period between January 2019 to December 2023 (4 years investigation period, including in the COVID-19 era). Read more >>>
Copyright (c) 2026 Indra Tri Mahayana, MD, PhD https://creativecommons.org/licenses/by-nc-sa/4.0
Clinicopathological Characteristics and Predictive Clinical Features of Lacrimal Gland Lesions
Introduction: Lacrimal gland tumors encompass a wide spectrum of benign, malignant and inflammatory conditions. Understanding the clinico-demographic profile and histopathological findings is crucial for early detection, determining appropriate treatment strategies and improving patient outcomes. Methods: This was a retrospective observational study of patient with lacrimal gland lesions diagnosed at the Reconstructive Oculoplastic and Oncology department at a tertiary care hospital in Central Java. Thirty-nine patients with biopsy-proven lesions between January 2021 and December 2024 were included. Clinical characteristics including age, sex, laterality, symptom duration, proptosis, lagophthalmos, and ocular motility restriction were evaluated. Histopathological diagnoses were categorized into benign, malignant, and inflammatory lesions. Statistical analyses were performed to assess associations between clinical variables, sex, and tumor classification. Results: A total 47 eyes of 39 patients were retrospectively reviewed. The mean age of patients was 46.15 ± 20.27 years (range 2–76), with 48.7% male and 51.3% female. Malignant tumors were more frequent in patients older than 60 years (69.2%), while benign tumors were more common in patients aged 40–59 years (60.0%). Histopathological analysis demonstrated that lymphoid and inflammatory disorders were the most common lesions. Inflammatory disorders consisted of dacryoadenitis and systemic inflammatory disease (sarcoidosis). Proptosis and shorter symptom duration were significantly associated with malignancy, whereas bilateral involvement was significantly associated with inflammatory disorders. No statistically significant difference in tumor classification was observed between male and female patients. Conclusion: Lymphoid and inflammatory disorders were the most prevalent lacrimal gland lesions. Identifying clinical markers such as proptosis, symptom duration, laterality can assist in early malignancy detection and guide management decisions effectively. This study is limited by its retrospective design, single-center setting, and small sample size, which may introduce selection bias and limit generaizability.
Copyright (c) 2026 Yossi Eriska, Raja Erinda, Trilaksana Nugroho https://creativecommons.org/licenses/by-nc-sa/4.0
Comparing Predictability of SRK/T, Barrett Universal II, and Kane Formulas on High Myopia Phacoemulsification
Introduction: The refractive outcomes of phacoemulsification surgery have improved significantly in recent years, but it is still challenging to obtain good outcomes in eyes with long axial lengths. This study compares the difference between the predicted and manifest refraction outcomes between Sanders Retzlaff Kraff theoretical (SRK/T), Barrett Universal II (BU-II), and Kane formula in high myopia patients undergoing uncomplicated phacoemulsification surgery. Methods: This cross-sectional design study includes eyes with high myopia (axial length ≥26.0 mm) that undergo uncomplicated phacoemulsification surgery with intraocular lens implantation between January 2024 and January 2025 at Semarang Tertiary Hospital. The one-month post-surgery mean absolute prediction errors (MAE) difference between SRK/T, BU-II, and Kane formula are calculated and analyzed using the Wilcoxon Sign Rank Test. Result: Thirty-seven eyes meeting the criteria were analyzed, with a mean axial length of 29.07±2.42 mm. The MAE and percentages of eyes within 0.50 diopters (D) refractive prediction errors of the three formulas are as follows: SRK/T (0.68 D, 60%), BU-II (0.41 D, 73%), and Kane (0.37 D, 76%). There is a statistically significant difference in MAE between SRK/T vs BU-II (p < 0.05) and SRK/T vs Kane (p < 0.05). Conclusion: The Kane and BU-II formula has better accuracy in predicting refractive outcome (lower MAE and higher percentages of eyes within 0.5 D refractive prediction errors) than the SRK/T formula in patients with high myopia who undergo uncomplicated phacoemulsification surgery.
Copyright (c) 2026 Rizal Ryamizard, Wisnu Sadasih, A. Rizal Fanany, Fatimah Dyah Nur Astuti https://creativecommons.org/licenses/by-nc-sa/4.0
Visual Acuity and Contrast Sensitivity Association Among Hemodialysis Patients
Introduction: This study aimed to assess the association between visual acuity (VA) and contrast sensitivity (CS) in patients with end-stage renal disease (ESRD) undergoing hemodialysis (HD), stratified by diabetes mellitus (DM) status. Methods: A cross-sectional study with a total of 100 HD patients was enrolled. Based on their HbA1c levels, they were categorized as having DM or as normal. They received a thorough eye examination, and those with corneal disease, cataracts, and macular disease were excluded. Best-corrected VA (BCVA) was evaluated using the Early Treatment Diabetic Retinopathy Study (ETDRS) chart, and CS was assessed using the MARS numeral CS chart. Fisher’s exact test was employed to compare VA and CS based on DM status. Results: We analyzed 100 patients (185 eyes), consisting of 51 (51%) males and 49 (49%) females. The mean age of the study group was 47±12.8 (15-76) years. The BCVA in DM and non-DM was mostly in the 0.50-0.00 LogMAR category. CS values in DM and non-DM were mostly in >1.52 LogCS category. VA and CS were significantly different in both DM and non-DM groups (p=0.03; p=0.00, respectively). A strong correlation between VA and CS was also observed in both groups (r=0.644; r=0.573, respectively). Conclusion: Visual acuity and CS in ESRD patients with DM undergoing HD had significant differences from those without DM. BCVA was strongly correlated with CS in both groups. Monitoring VA and CS in HD patients with DM provides early detection of vision-threatening changes, helps prevent severe visual impairment and improves patients’ quality of life.
Copyright (c) 2026 Muhammad Firmansjah, Togar Erkasan Sitorus, Wimbo Sasono, Sauli Ari Widjaja, Ima Yustiarini, Ady Dwi Prakosa, Widodo, Ria Sandy Deneska https://creativecommons.org/licenses/by-nc-sa/4.0
Affordable HLA-B27 Detection in Resource-Limited Settings: Evaluating Conventional PCR for Uveitis and Spondyloarthropathy in Indonesia
Introduction: HLA-B27 is a genetic marker strongly associated with spondyloarthropathy (SpA) and acute anterior uveitis (AAU). Detection of this allele can support earlier diagnosis and targeted management. However, commercially available HLA-B27 tests are costly and often inaccessible in low- and middle-income countries, including Indonesia. Methods: A cross-sectional study was conducted involving 42 subjects: 14 with SpA, 19 with AAU, and 9 healthy controls. DNA was extracted from peripheral blood samples and analyzed using both conventional PCR (targeting exon 3 of HLA-B27) and a commercial HLA-B27 strip assay. Sensitivity, specificity, and diagnostic accuracy of conventional PCR were calculated against the commercial kit as the reference standard. Results: Conventional PCR showed high sensitivity (100%) and accuracy (85.71%) in SpA patients, indicating its potential as a reliable screening tool in this group. However, its performance in AAU patients was suboptimal, with lower sensitivity (40%) and specificity (55.56%). False positives and false negatives were observed, likely due to limitations in allele coverage by conventional primers. Conclusion: Conventional PCR is a promising, affordable alternative for HLA-B27 detection in SpA patients, particularly in resource-limited settings. However, its lower reliability in AAU cases highlights the need for careful clinical application and further optimization. Larger studies and local allele mapping are recommended to enhance diagnostic precision in diverse populations.
Copyright (c) 2026 Rina La Distia Nora, Lukman Edwar, Made Susiyanti, Yulia Aziza, Ikhwanuliman Putera, Ulifna Alfiya Sifyana, Mei Riasanti, M Zakiy Waliyuddin, Maria Valentina Wibawa, Rachel Ethelind, Erica Widodo, Ratna Sitompul https://creativecommons.org/licenses/by-nc-sa/4.0
Correlation of Preoperative Keratometry and Corneal Astigmatism on Visual Outcomes in Cataract Patients Receiving Non-Toric IOLs
Introduction: Preoperative biometry plays a pivotal role in predicting visual outcomes after cataract surgery. Corneal astigmatism can significantly influence uncorrected visual acuity (UCVA). In clinical settings where only non-toric intraocular lenses (IOLs) are available, understanding the impact of astigmatism becomes even more crucial. This study investigates biometric profiles and visual outcomes in relation to corneal astigmatism severity in patients who received non-toric IOLs. Methods: A retrospective cohort analysis was conducted on 30 eyes from 28 patients undergoing phacoemulsification with non-toric IOL implantation at Nyi Ageng Serang Hospital between September 2021 and February 2022. Biometric parameters including axial length (AL), anterior chamber depth (ACD), and lens thickness (LT) were recorded. Patients were grouped based on corneal astigmatism values (>–1.0 D and ≤–1.0 D), and outcomes were analyzed in terms of postoperative UCVA and best corrected visual acuity (BCVA). Results: The mean age of patients was 66 ± 10.3 years, with 63.3% male. Nearly half (46.7%) of eyes presented with corneal astigmatism greater than –1.0 D. A significant age-related variation in astigmatism was observed (p=0.001), particularly in patients aged 61–70. There was no statistically significant difference in postoperative UCVA or BCVA between astigmatism groups (p=0.438 and p=0.524, respectively). Conclusion: In the absence of toric IOL options, corneal astigmatism showed a weak positive correlation with postoperative UCVA and moderate positive correlation with postoperative BCVA although these results did not lead to significantly different visual outcomes postoperatively. This underscores the importance of individualized preoperative planning and suggests future access to toric IOLs could further enhance postoperative UCVA, particularly in patients with corneal astigmatism >–1.0 D.
Copyright (c) 2026 Milzan Murtadha, Sagung Gede Indrawati, Amanda Nur Shinta Pertiwi https://creativecommons.org/licenses/by-nc-sa/4.0
Identifying the Burden of Digital Eye Strain: Prevalence, Clinical Manifestations, and Risk Factors in Indonesian Medical Students
Introduction: The increasing use of digital devices among university students, particularly in medical education, has raised concerns regarding Digital Eye Strain (DES). This study aimed to assess the prevalence, symptom profile, and risk factors of DES among Indonesian medical students. Methods: A cross-sectional study was conducted among 356 medical students using the validated Computer Vision Syndrome Questionnaire (CVS-Q). Data on demographic characteristics, ocular history, digital device usage habits, and DES symptoms were collected. Bivariate and multivariate logistic regression analyses were performed to identify factors associated with DES, with a significance level set at p < 0.05. Results: The prevalence of DES was 62.9%. Common symptoms included itchy eyes (76.8%), blurred vision (70.1%), and headaches (76.33%). Bivariate analysis revealed associations between DES and refractive errors (OR 1.889, p = 0.004), poor posture (OR 0.467, p = 0.001), and the use of more than two digital devices daily (OR 1.610, p = 0.030). Multivariate analysis identified refractive errors (OR 2.049, 95% CI: 1.300–3.227, p = 0.002), poor posture (OR 0.413, 95% CI: 0.258–0.663, p < 0.001), and the use of more than two devices (OR 1.879, 95% CI: 1.171–3.015, p = 0.009) as independent risk factors for DES. Conclusion: DES is highly prevalent among Indonesian medical students. Refractive errors, poor posture, and the concurrent use of multiple digital devices were significant risk factors. Vision screening, ergonomic education, and digital health awareness are recommended to reduce DES and support ocular health.
Copyright (c) 2026 Elwande Hagasaro Zega, Selly Azmeila, Yetty Machrina, Kamal Basri Siregar https://creativecommons.org/licenses/by-nc-sa/4.0
Characteristics of Conjunctival Melanocytic Tumor Patients in a Tertiary Hospital: A 4-Year Study
Introduction: Conjunctival neoplasms includes melanocytic and nonmelanocytic tumors, and most are benign. Due to their rarity in the general population, it is important to consider the demographic, clinical signs, symptoms, and histopathological features to make the correct diagnosis. This study aims to describe the demographic, clinical, and histopathology of Conjunctival Melanocytic Tumors patients in a Tertiary Hospital. Methods: A retrospective study held from the medical record of patients with diagnosis conjunctival melanocytic tumor from January 2019 - September 2023 in a Tertiary Hospital. Age, sex, laterality, clinical signs, symptoms, procedure, and histopathology result were recorded. Results: Thirteen patients were identified (n=13). The distribution was nearly equal between genders (54% male, 46% female), with a mean age of 39 years (range: 4–69 years). All cases were unilateral. The most frequent clinical presentation was a painless lump (69%), primarily localized in the temporal region (77%). Surgical interventions included simple excision (69.2%) and wide excision (30.8%). Histopathological analysis revealed that 61.5% of lesions were malignant melanoma, while 38.5% were compound nevi. Conclusion: In this study, it was found that conjunctival melanocytic tumor was found equal in both genders, majority in adult age, mostly presenting with painless lumps on the temporal region of bulbar conjunctiva. Most patient in this study were diagnosed with melanoma maligna, because usually patient with nevi were not referred to tertiary hospital. Majority of the patient underwent excision while the others underwent wide excision.
Copyright (c) 2026 Fadhila Khairunnisa Poerwoko, Raja Erinda, Faiza Rizky A.S https://creativecommons.org/licenses/by-nc-sa/4.0
The Profile of Optic Neuritis at RSUP Dr. M. Djamil Padang From January 2022 to June 2024
Introduction: Optic neuritis is an inflammatory condition of the optic nerve characterized by subacute vision loss, visual field defects, and color vision deficiency. It is commonly associated with demyelinating diseases and autoimmune disorders. No epidemiological data are available for Indonesia. This study aimed to examine the profile of optic neuritis patients at RSUP Dr. M. Djamil Padang from January 2022 to June 2024. Methods: A study on 42 patients with optic neuritis at RSUP Dr. M. Djamil Padang from 2022-2024 showed a higher prevalence in females (71.42%) and the 20-39 age group (50%). Unilateral optic neuritis (61.90%) was more common, and typical cases (57.15%) outnumbered atypical cases (42.85%). Discussion: The study revealed that optic neuritis was more common in females and the 20-39 age group. Most cases were unilateral, with typical optic neuritis being more prevalent. Visual acuity improved significantly after treatment, particularly in those receiving intravenous corticosteroids. Imaging showed optic nerve abnormalities in some cases, but most were normal. The study also found common visual field defects, such as central scotoma, and highlighted the role of neuroprotective therapy alongside corticosteroids in improving visual outcomes. Conclusion: This study found that optic neuritis was most common in females and the 20-39 age group. Most patients experienced significant improvement in visual acuity with intravenous corticosteroid therapy. Imaging showed abnormalities in some cases, though most had normal findings, offering valuable insights into diagnosis and treatment.
Copyright (c) 2026 Atika Syafendra, M Hidayat https://creativecommons.org/licenses/by-nc-sa/4.0
Treatment Strategies of an Iris Implantation Cyst: A Case Report
Introduction: Iris cyst can be divided into primary and secondary, both originating from epithelial cells. Although rare, the entity has a high recurrence rate. This clinical case report highlights the treatment strategies to treat and prevent the recurrency of iris cyst. Case Report: We report a rare presentation of a secondary iris cyst in a 20-year-old male with a history of cataract surgery 17 years prior. The patient underwent fine-needle aspiration and intracystic alcohol injection. However, the iris cyst recurred eight months after the procedure. Afterward, the invasive strategy of iris cyst excision was conducted. Eight months after the secondary iris cyst surgery, the patient showed no signs of recurrence. Discussion: Iris cyst is known to have a high recurrence rate, however, a minimally invasive treatment is still preferred, supported by previous studies showing no recurrence in treatment with fine-needle aspiration and intracystic alcohol injection. In our case, the iris cyst relapsed eight months after this procedure, warranting for surgical excision. Eight months after the excision, the patient showed no signs of recurrence. Conclusion: Although the recurrency of iris cyst is high, the authors suggest starting with non-invasive treatment with follow-up ensuring no recurrence before opting for a more invasive treatment.
Copyright (c) 2025 Jessica Zarwan, Ayang Rashelda Maulidinia, Astrid Mariam Khairani Siregar, Syska Widyawati, Faraby Martha, Rio Rhendy https://creativecommons.org/licenses/by-nc-sa/4.0
3-Snip Punctoplasty with Silicone Tube Implantation: A Simple Procedure For Punctal Disorders
Introduction: Punctal or canalicular atresia is a rare disorder in which an intact epithelial layer covers the punctum, impairing tear drainage and causing epiphora, especially in lower punctal atresia. Less frequently, canalicular atresia occurs. Standard management involves probing, irrigation, and silicone tube insertion. Case Report: In two cases, an 8-year-old and a 30-year-old female presented with lifelong tearing and discharge from the left eye. Ophthalmic examination revealed imperforate superior and inferior lacrimal puncta, and the Dye Disappearance Test (DDT) confirmed reduced tear drainage, leading to a diagnosis of punctal atresia. In a third case, a 40-year-old female experienced a painful, red lump on the right medial lower eyelid over a three-month period. Palpation produced yellowish discharge, and examination revealed a hyperemic mass with granulomas around the punctum, consistent with chronic canaliculitis. All three patients underwent a 3-snip punctoplasty with silicone tube implantation using a round-tip pigtail probe. Discussion: The 3-snip procedure is a minimally invasive and effective treatment for punctal disorders. It involves one basal cut and two vertical incisions along the canaliculus. Although canaliculotomy with curettage can lead to fistula formation, the use of a silicone tube helps prevent this complication. At the three-month follow-up, all patients demonstrated functional tear drainage and normal DDT results. Conclusion: The 3-snip procedure with silicone tube implantation offers favorable functional and cosmetic outcomes. It is a simple and viable option for ophthalmologists in resource-limited settings, ensuring improvement in tear drainage without symptom recurrence.
3-Snip Procedure, Punctoplasty, Punctal Disorder, Punctal Atresia, Canaliculitis
Copyright (c) 2026 Aisyah Amelia Zulkarnaen R Wattimena, Andi Pratiwi, Halimah Pagarra, Suliati P Amir, Syukriah Sofyan https://creativecommons.org/licenses/by-nc-sa/4.0
UNUSUAL CASE OF A METAL FOREIGN OBJECT IN ORBITOCRANIAL INJURY: UNLOCKING THE MACCARTY KEYHOLE
Introduction. Penetrating orbitocranial injuries are quite rare but very fatal if left untreated. Various metal objects have been reported as foreign bodies that have penetrated the orbit. However, unusual objects such as motorcycle locks have never been reported before. Case Illustration. A 14-year-old boy was brought to the emergency room with a motorcycle lock embedded in his left temporal region. Examination of the left eye showed decreased vision, clear serous ciliary secretions, conjunctival hyperemia, chemosis, and relative afferent pupillary defect. Investigations using a 3D Head MSCT Scan revealed the presence of a metal object that penetrates the left optic nerve, the rectus lateralis muscle, and the frontal process of the left zygoma bone in the left temporal region, which is located around the MacCarty keyhole. The operation in the form of exploration and foreign object removal was then carried out in collaboration with the neurosurgeon. No postoperative complications were reported, but the patient had restricted movement of the left eye. Discussion. Penetrating orbitocranial injury should be treated as an emergency. Diagnosis should include comprehensive ophthalmological and neurological examinations. CT Scan continues to be the best cranial imaging technique. In this case, the motorcycle lock penetration was around the MacCarty keyhole, a structure that is frequently used to enter both the orbit and the frontal fossa, which located 7 mm superior and 5 mm posterior to the frontozygomatic suture. An appropriate surgical strategy is mandatory for removing the object because it may lead to serious consequences, including cerebral, infectious, vascular complications, and even death. Conclusion. Metal foreign objects such as motorcycle lock was considered unusual, particulary when it unlock an important landmark such as MacCarty keyhole. This case emphasizes the significance of a surgical strategy based on accurate anatomical tracking.
Copyright (c) 2025 Fadiah Gazzani Rahman, Andi Pratiwi, Halimah Pagarra, Suliati P. Amir https://creativecommons.org/licenses/by-nc-sa/4.0
COMBINATION OF DEXAMETHASONE IMPLANT AND ANTI-VEGF IN THE MANAGEMENT OF DIABETIC MACULAR EDEMA: A SYSTEMATIC REVIEW
Background: Anti Vascular Endothelial Growth Factor (anti-VEGF) and dexamethasone implant (DEX) are suggested as the first and second-line therapy for Diabetic Macular Edema (DME). However, persistent DME were found after six months of routine anti-VEGF injection. Intravitreal steroids have the advantage to control the inflammatory component of DME. Combining intravitreal anti-VEGF and DEX may reduce macular edema more effectively and more quickly theoretically. Hence, we aim to review the efficacy of adding DEX to anti-VEGF in treating DME. Methods: Literatures were obtained using comprehensive searching on PubMed and Proquest using the keywords “Dexamethasone implant”, “anti-VEGF therapy”, and “Diabetic Macular Edema” including their synonyms between 2018 to 2023. Non-English studies, animal studies, review articles, case studies, and editorial letters were excluded. This result was presented following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guidelines. Results: A total of 3 studies with 265 eyes were included. All of the studies had Central Foveal Thickness (CFT) and Best Corrected Visual Acuity (BCVA) as the main outcomes. Improved CFT was seen in all of the studies (all p<0.05) with ∆CFT (200,40 μm in 6 months and 413 μm in 12 months). Most studies showed improved visual acuity after 8 months of injections which were shown by ∆BCVA (8,84 letters in 6 months and 21,6 letters in 12 months) and increased intraocular pressure as an adverse effect of steroids. Conclusion: Combination of DEX and anti-VEGF showed improvement in CFT and BCVA. Further studies are required due to the controversial intravitreal steroids’ ocular adverse effect.
Copyright (c) 2024 Ursula Natasya Pradnya Paramita, Tania Tania, Clarissa Clarissa, Salma Salsabila https://creativecommons.org/licenses/by-nc-sa/4.0
Determining The Etiology of Uveitis in Indonesia: The Role of Clinical Manifestation and Serological Test in Infectious Uveitis
Introduction: Uveitis is a heterogeneous group of intraocular diseases that significantly causes vision disabilities in patients worldwide. Establishing an etiological diagnosis can be challenging because of the extensive and varied clinical patterns and differential diagnoses across regions. Knowledge of these patterns is crucial in aiding physicians with diagnosis, reducing the need for costly ancillary tests, and facilitating timely management. Methods: We conducted a retrospective descriptive study using medical records data from a tertiary referral hospital in Indonesia over two years (2016-2017), involving 299 patients with uveitis. Discussion: Among the 299 patients, 152 were men (152/299, 50.8%) with a median age of 36. Panuveitis was the most frequent anatomical entity (152/199, 53.2%). Infectious etiology, primarily toxoplasmosis and tuberculosis, remained prevalent. Despite various final diagnoses, serological tests for IgG Toxoplasma and CMV were predominantly reactive in 192/251 (76.5%) and 228/236 (96.6%) of tested patients. At presentation, 106/299 (35%) of patients were categorized as blind, and 64/106 (60%) were without improvement. Complications were observed in 167/299 (55%) of patients, including cataracts (133/299, 44%) and glaucoma (32/299, 10%), contributing to 70/106 (66%) of blindness in our series. Conclusion: Panuveitis and infectious etiology, particularly toxoplasmosis and tuberculosis, were the most common causes of uveitis. Clinical patterns were better able to distinguish them than laboratory results. Understanding these uveitis patterns can guide physicians in diagnosing before performing expensive ancillary tests. Ocular complications were related to severe visual function; thus, timely referral in severe cases is essential. Keywords: Uveitis, Indonesia, epidemiology
Copyright (c) 2025 Gisela Haza Anissa, Rina La Distia Nora https://creativecommons.org/licenses/by-nc-sa/4.0
THE MULTIPLE OCULAR MANIFESTATIONS OF A NEGLECTED NEWLY DIAGNOSED MULTIBACILLARY LEPROSY WITH GRADE II DISABILITY
Introduction: Leprosy is a chronic granulomatous infection cause by Mycobacterium leprae that could involving the eye with prevalence within 51,6% to 85%. Despite the high prevalence of leprosy and ocular manifestation, ophthalmologist consultation is not routinely performed, thus leads to unrecognized ocular complications. This case report aims to portrays the ocular manifestation of multibacillary leprosy with grade II disability. Case report: A 71-year-old woman presented with severe corneal ulcer with perforation leading to the iris-lens prolapse resulted in total blindness of the left eye; peripheral ulcerative keratitis and neurotropic ulcer of the right eye; lagophthalmos, corneal hypoesthesia, and madarosis of both eye. The Dermatovenereology Department consultation revealed claw hand, ulnar nerve thickening on both upper extremity, and hypoesthesia on both upper and lower limb. The acid fast bacteria were identified from auricula skin scraping specimens with +3 bacterial index (BI) and 75% morphological index (MI). The patient was diagnosed with LE severe corneal ulcer with iris-lens prolapse, RE peripheral ulcerative keratitis (PUK) and neurotropic ulcer, RLE lagophthalmos, and multibacillary leprosy with grade II disability newly diagnosed. Left eye evisceration was performed after initiated the multidrug therapy (MDT) regiment. Conclusion: The ocular manifestation found in this case are corneal hypoesthesia, madarosis, corneal ulcer with perforation, iris-lens prolapse, peripheral ulcerative keratitis, and neurotropic ulcer. The management is directed to pathogen eradication and specific management on ocular manifestation. The collaboration with Dermatovenereology Department is required for comprehensive screening and management.
Copyright (c) 2025 Suci Purnamasari, Ovi Sofia https://creativecommons.org/licenses/by-nc-sa/4.0
Copyright (c) 2024 Widya Artini Wiyogo https://creativecommons.org/licenses/by-nc-sa/4.0
Refractive and Visual Outcomes of Pediatric Cataract Surgery in Indonesian Tertiary Eye Center
Introduction: Cataract remains as a leading cause of visual impairment in children. Surgical intervention and post-operative refractive correction remain fundamental. This study aims to describe the refractive and visual outcome of pediatric cataract surgery in a tertiary eye center in Indonesia. Methods: This retrospective study was conducted utilizing medical records of all congenital and developmental cataracts patients undergoing cataract extraction procedures with or without primary IOL implantation between January and December 2022. Exclusion criteria included patients who did not undergo visual acuity and objective refraction examination 1-month post-cataract surgery and those with incomplete medical records data. Results: A total of 118 eyes from 65 patients was included in this study. Most patients had bilateral cataracts (93.80%) and operated at the median age of 18 (0.96-212.64) months. Post-operatively, there were 71 (60.19%) aphakic and 47 (39.81%) pseudophakic patients with a respective refractive status of +18.00 (12.00 – 21.13) D and +0.60 (±2.37) D. Prediction error (PE) and absolute prediction error (APE) were obtained within 1.00 D. Most aphakic patients had unquantifiable visual acuity both before (91.50%) and after (83%) surgery. Among pseudophakic patients, nine (19.16%) had visual acuity of ≥ 6/12 and seven (14.89%) had visual acuity of <6/12 - 6/18 post-operatively. No patients had visual acuity ≥ 6/12 and <6/12 - 6/18 before surgery. Conclusion: Post-operative refractive status of both aphakic and pseudophakic patients were well within correctable range. There was an improvement of vision after surgery. Limited visual potential may be attributed to the presence of amblyopia.
Pediatric cataract, axial length, corneal curvature, BCVA, Biometric
Copyright (c) 2025 Feti Karfiati Memed, Rizki Adi Santosa, Irawati Irfani, Sesy Caesarya, Primawita Oktarima Amiruddin, Mayasari Wahyu Kuntorini https://creativecommons.org/licenses/by-nc-sa/4.0
COMPARISON OF VISUAL ACUITY RESULTS AFTER FEMTOSECOND LASER-ASSISTED IN SITU KERATOMILEUSIS (FS-LASIK) AND SMALL INCISION LENTICULE EXTRACTION (SMILE)
Introduction: Two of the most popular refractive surgery methods currently used are Femtosecond Laser-Assisted In Situ Keratomileusis (FS-LASIK) which creates a flap using femtosecond laser and stromal ablation using excimer laser, and Small Incision Lenticule Extraction (SMILE), a flapless procedure in which a lenticule is extracted through a small incision. The aim of this study is to compare the visual acuity results of FS-LASIK and SMILE. Methods: This is a descriptive cross-sectional study. Data were collected from the medical record of patients who underwent FS-LASIK or SMILE procedure at Cicendo Eye Hospital, the national eye centre, in 2022. Patients were followed up at 1 day, 1 week, and 1 month postoperatively and visual acuity outcomes between the two procedures were compared. Results: A slightly higher percentage of eyes in FS-LASIK (46.6%) achieved a UCVA of 1.0 at 1 day postoperatively compared to SMILE (45.5%). At 1 week and 1 month, SMILE showed superior results with 83% and 94.6% of eyes achieving a UCVA of 1.0, meanwhile FS-LASIK had 72.2% and 86.2%. Residual refractive error at 1 month had a median of -0.6146 and -0.3125 in the FS-LASIK and SMILE groups. Conclusion: This study found better UCVA results in the FS-LASIK group compared to the SMILE group at 1 day postoperatively. Meanwhile, UCVA at 1 week and 1 month postoperatively, showed superior results in the SMILE group. Residual refractive error at 1 month postoperatively also showed better results in SMILE than FS-LASIK.
Copyright (c) 2024 Nafisa Mardhiyya, Andrew M. H. Knoch, Emmy D. Sugiarti, Ludwig M. Tjokrovonco, Budiman https://creativecommons.org/licenses/by-nc-sa/4.0
INTERNUCLEAR OPHTHALMOPLEGIA IN MULTIPLE SCLEROSIS PATIENT
Introduction: Internuclear ophthalmoplegia (INO) characterized by impaired adduction of the affected eye caused by a lesion in the medial longitudinal fasciculus (MLF). The common cause of INO is demyelinating disease including multiple sclerosis. INO arguably the most discrete localizing sign in medicine, has considerable value in predicting multiple sclerosis. Due to its high spatial resolution, MRI has allowed us to depict in vivo the anatomic organization of the human oculomotor nerve complex, the MLF, and related structures in the brainstem. Case Report: A 48-year-old female presented with blurred vision of both eyes for 2 weeks, but then slowly resolved. Best corrected visual acuity presentation on both eyes were 20/20 with normal intraocular pressure (IOP). Adduction deficit observed on the left eye with no nystagmus. Convergence are not impaired in both eyes. Anterior segments was normal except minimal lens cloudiness in both eyes. Funduscopic examination result also within normal limit. Patient had undergone Computerised Tomography (CT-Scan) and the result was normal, no ischemic area or Space occupied lesion (SOL) or intracranial bleeding were found. Brain MRI showed bilateral optic perineuritis and multiple lesion in bilateral frontoparietalis and in the left side of the pons suggested multiple sclerosis. Discussion: Impairment of adduction movement on the patient’s left eye caused by demyelinating plaque related multiple sclerosis on the left side of the pons as shown MRI imaging. Management in this patient is based on the underlying condition. Conclusion: Internuclear ophthalmoplegia in this cases maybe caused by lesion in the medial longitudinal fasciculus could be related with multiple sclerosis.
Copyright (c) 2024 Fahrian Tirkal, Yunita Mansyur, Batari Todja Umar, Junus Baan, Yudy Goysal, Junus Baan https://creativecommons.org/licenses/by-nc-sa/4.0
Defeating Mooren Ulcer: Timely Diagnosis and Strategic Interventions for Swift Recovery
Introduction: Mooren ulcer is a unique and rare manifestation of peripheral ulcerative keratitis of idiopathic origin, triggered by immunological abnormalities, genetic predispositions, and environmental factors. Case Report: We report the successful treatment of a rare case involving a 43-year-old man who presented with a significant worsening of white tissue covering cornea, severe pain, redness, and blurred vision in the left eye. An examination revealed a peripheral ulcer extending centrally with scleral sparing. Ancillary examinations yielded unremarkable findings. The patient was diagnosed with Mooren ulcer and initially treated with topical steroid, which showed no improvement. Therefore, a simultaneous conjunctival resection combined with immunosuppressive therapy was performed. At 1-year follow-up, no pain was reported, vision improved (6/21 to 6/12), and resolved ocular surface inflammation. Discussion: Mooren ulcer is often prone to misdiagnosis due to clinical signs that resemble other differential diagnoses. A meticulous examination is essential to carefully exclude autoimmune and corneal infection. The treatment goals are to arrest the destructive process and facilitate re-epithelization. A stepwise aggressive approach is crucial, starting with topical steroids to control inflammation. However, this single treatment modality may not prevent rapid progression, making conjunctival resection imperative to eliminate the source of collagenase production by cutting off the perilimbal blood vessels’ access to ulcer cites. Combining this with an immunosuppressant effectively maintains a stable condition. Conclusion: This case underscores the importance of timely diagnosis and aggressive treatment in preventing the swift progression of Mooren ulcer.
Mooren Ulcer, Steroid, Conjunctival Resection, Immunosuppressant Therapy
Copyright (c) 2026 Florentina Priscilia, Dewa Ayu Anggi Paramitha, Yulia Aziza https://creativecommons.org/licenses/by-nc-sa/4.0
Development and Application of Targeted Multi-plex Polymerase Chain Reaction to Help Diagnose Infectious Uveitis
Introduction: Clinical pattern recognition is paramount in uveitis diagnosis. Pathogen detection from ocular fluid samples is often necessary to support infectious uveitis diagnosis, particularly in cases presenting with atypical clinical appearance. This study aims to present the process of developing targeted multiplex PCR and evaluate its application in infectious uveitis diagnosis. Methods: This was a cross-sectional study to evaluate the diagnostic performance of targeted multiplex PCR in infectious uveitis. We obtained ocular fluid samples and reviewed medical records of uveitis patients who underwent ocular fluid analysis at Cipto Mangunkusumo Hospital from February 2022 to March 2023. PCR detection threshold values (DNA copies/mL) were 10.9 for Mycobacterium tuberculosis (Mtb), 672 for Epstein-Barr virus (EBV), 4.77 for Cytomegalovirus (CMV), 6.37 for Toxoplasma gondii (T. gondii), and 5.53 for Herpes simplex virus (HSV). With multiple pathogen selection, this method requires a lower volume of samples than single-plex PCR, as the latter will increase the sample volume linearly with each additional pathogen tested. Discussion: Forty-seven aqueous or vitreous samples were analyzed. The positivity rate was 23.4% (11/47) with Mtb yielding the highest positivity (7/41; 17.1%). With final diagnosis as a reference, targeted multiplex PCR resulted in 32.3% (95% CI: 16.7 – 51.4%) sensitivity, 93.8% (95% CI: 69.8 – 99.8%) specificity, 90.9% (95% CI: 58.4 – 98.6%) positive predictive value, and 41.7% (95% CI: 35.2 – 48.4%) negative predictive value. Conclusion: With its high specificity, targeted multiplex PCR is useful as a confirmatory but not screening tool in uveitis diagnosis. Ocular fluid analysis is an important part of the stepwise diagnostic approach in uveitis.
Copyright (c) 2025 Rachel Ethelind, Rina La Distia Nora https://creativecommons.org/licenses/by-nc-sa/4.0
Refractive Status Characteristic in School-Aged Children: Cicendo National Eye Hospital Vision Screening Program
Introduction: Refractive error is a major cause of visual impairment in school-age children and can be detected early through vision screening programs. This study aimed to describe the characteristics of refractive errors among school-age children participating in a vision screening program at the Community Ophthalmology Unit, National Eye Center Cicendo Eye Hospital. Methods: A retrospective cross-sectional study was conducted using vision screening data from January–December 2023. Visual acuity and non-cycloplegic refraction were examined by trained personnel. Data were analyzed descriptively using Microsoft® Excel. Results: A total of 1,411 children were included, with 488 (17%) experiencing visual impairment. Myopia was the most common refractive error, mainly mild myopia and moderate astigmatism. Severe visual impairment (1.02%) was still found despite best corrected visual acuity. Refractive errors were most frequent among 11-year-old students (26%). Conclusion: The prevalence of refractive errors in school-age children remains high, with myopia as the most common type. Routine vision screening programs are still necessary for early detection and management.
Copyright (c) 2026 Nathasya Maharani Susilo, Nina Ratnaningsih, Mayang Rini https://creativecommons.org/licenses/by-nc-sa/4.0
The Relationship Between Tumor Necrosis Factor-Alpha (TNF-α) with Retinal Nerve Fiber Layer (RNFL) Thickness in Diabetic Retinopathy Patients at Prof. CPL Universitas Sumatera Utara General Hospital and Affiliated Hospital
Introduction: Retinal neurodegeneration may be an early indicator of diabetic retinopathy, the second most common complication after nephropathy. Tumor Necrosis Factor-Alpha (TNF-α) plays a role in the pathogenesis of inflammatory and neovascular eye disorders and is associated with intraocular inflammatory diseases like macular edema and proliferative diabetic retinopathy. This study aims to find the relationship between TNF-α levels and Retinal Nerve Fiber Layer (RNFL) thickness in diabetic retinopathy patients at Prof. CPL Universitas Sumatera Utara General Hospital and affiliated hospital. Methods: This cross-sectional study included 45 patients with type 2 DM and diabetic retinopathy at Prof. CPL Universitas Sumatera Utara General Hospital and affiliated hospital from March to June 2024. RNFL and posterior segment examinations were conducted. TNF-α levels were measured from blood samples.Blood sugar data were taken from medical records. Results: Of the 45 participants, 24 were men (53.3%) and 21 women (46.7%). 32 (71.1%) had DM for >5 years, and 27 (60%) experienced PDR. Highest location for RNFL thickness examination was superior (19, 42.2%). Average TNF-α with thin RNFL was 65.67 ng/L, and with thick RNFL was 64.78 ng/L. Mean TNF-α with thin superior RNFL was 65.74 ng/L, and thick was 63.70 ng/L. Mean TNF-α with thin inferior RNFL was 65.73 ng/L, and thick was 63.9 ng/L. Mean TNF-α with thin temporal RNFL was 68.73 ng/L, and thick was 67.19 ng/L. Mean TNF-α with thick nasal RNFL was 67.06 ng/L. Conclusion: There was no statistically significant relationship between TNF-α and RNFL thickness in diabetic retinopathy patients.
Diabetes mellitus, diabetic retinopathy, TNF-α, RNFL layer
Copyright (c) 2025 Wahyu Medsa Yeltas Putra, Delfi, Taufik Ashar https://creativecommons.org/licenses/by-nc-sa/4.0
Scleral Buckling for Retinopathy of Prematurity: A Case Report
Introduction The selection of management for advanced retinopathy of prematurity (ROP) requires careful consideration. The purpose of this study is to report the effectiveness of scleral buckling in patient with retinopathy of prematurity stage 4B of both eyes within 3 months. Case Description A 4-month-old female baby came to the Pediatric Ophthalmology Unit in Cipto Mangunkusumo General Hospital (RSCM) Kirana with chief complain did not make eye contact of both eyes. Her eyes were moving on their own since she was 3.5 months old, and sometimes squint. The patient came to the pediatrician and was referred to pediatric ophthalmology for further treatment. There was a history of premature delivery at 30 weeks with oxygen therapy for 3 weeks. The Pediatric ophthalmology division performed ultrasonography and retcam, and the diagnosis of retinopathy of prematurity stage 4B of both eyes was made. Scleral buckling was performed in the right and left eyes at the postmenstrual age of 49 weeks, and 52 weeks respectively by vitreoretinal division. Conclusion The management of ROP depends on the type ROP. For advanced ROP, surgery is indicated. The scleral buckle is a treatment option for advanced retinopathy of prematurity patients with retinal detachment if it is assumed that intraocular surgery presents a greater risk. In short-term period, for the right eye, the scleral buckling is effective. Further time to follow up is needed to show the long-term period effectiveness of scleral buckling in patients with advanced ROP.
Copyright (c) 2025 Gustiandari Fidhya Permanik, Julie Dewi Barliana, Anggun Rama Yudantha https://creativecommons.org/licenses/by-nc-sa/4.0