CASE REPORT
PRIMARY OPEN ANGLE GLAUCOMA
Hely Purbasari
(I11106022)
Identity
Name : Ny. N
Age : 41 years-old
Sex : women
Job
: staf administration
Addres : sungai jawi, Pontianak
Religion : muslim
Examination date : december 29,
2009
Patient History
Main complaint : eye pain in the right eye
Present illnes:
Eye pain since 3 month ago, continue
Blurred vision
Headache
visual field to narrow
the right eye feeling full or heavy.
Sometimes, patient complain fotofobia and
halos around single sources of light.
DM (-), Hipertension (-)
Past history :
Patient never complaint like this before
Family history :
In the family, noting complaint like this
Opthalmologic Assesment
Visual Acuity
OD :6/30
OS :6/10
IOP
OD : 37 mmHg
OS : 20 mmHg
Opthalmologic Assesment
Eye ball position: ortho
Eye ball movement:
OD
OS
Opthalmologic Assesment
OD
movement (+), ptosis (-), lagoftalmos
OS
Palpebra
(-)
Hiperemis (+), secret (-), injeksi (-),
(+),
ptosis
(-),
lagoftalmos (-)
Conjunctiva
ulcus (-)
Edema (+),ulcus (-)
movement
Hiperemis (-), secret (-), injeksi
(-), ulcus (-)
Cornea
Edema (-),ulcus (-)
Clear , impression deep, hipopion (-), Anterior chamber Clear, hipopion (-), hifema (-)
hifema (-)
Iris brown, cripta (+), sinecia (-)
Iris/pupil
Iris brown, cripta (+), sinecia (-)
Pupil isokor (3 mm), refleks cahaya
Pupil isokor (3 mm), refleks
(+)
cahaya (+)
clear , subluksasi (-)
Papil blurred, CDR : 0,8
Lens
Fundus
clear , subluksasi (-)
Papil normal, CDR : 0,4
Status Oftalmologis5
Ichihara Test : (-)
Tes Konfrontasi:
OD
OS
Resume
Women, 41 th come in the hospital with
complain eye pain in the right eya and decrease
of the vision since 3 month ago. Visual field is
narrow, headache (+), in the right eye feeling
heavy and full, fotofobia (+), halo (+), trauma
(-).
Ophtalmologis examination OD : visual acuity
3/30; IOP 37 mmHg; conjunctiva hiperemis (+),
injeksi (-); edema cornea (+), deep anterior
chambers; refleks cahaya (+); papil blurred, CDR
0,8; narrow visual field in confrontation test.
Diagnosis
Working diagnosis :
Primary open angle glaucoma OD
Suplemental testing
Gonioscopy
Perimetry
Management
Medikamentosa:
Timol 0,5 % 2 x 1 gtt OS (timolol maleat )
Glaukon 3 x 250 mg (acetazolamide)
Prognosis
OS :
Ad vitam
: bonam
Ad functionam : dubia ad bonam
Ad sanationam : bonam
LITERATURE REVIEW
PRIMARY OPEN ANGLE
GLAUCOMA
(POAG)
Primary open angle glaucoma
(POAG)
most common type of glaucoma
POAG is a chronic, progressive
disease that most often presents
with characteristic optic nerve (ON)
damage, nerve fiber layer (NFL)
defects, and subsequent visual field
(VF) loss
It is characterized by slowly
increasing eye pressure and the
gradual loss of side vision
PATOFISIOLOGY
Clinical Manifestations
Visual field loss
Blurred vision
Eye pain
Headache
Rainbow haloes around lights
Examination
Fundus examination
Intraocular pressure : tonometry
Visual field testing: confrontation test
and perimeter
Gonioscopy
Fundus examination
Tonometry Goldman
Gonioscopy
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