LBM 2 RED EYES

Step 1
1. Injection conjuctiva: melebarnya pembuluh darah arteri konjungtiva posterior
akibat pengaruh mekanis alergi ataupun mekanis dari jaringan konjungtiva
(the dilatation of arterial conjuctiva posterior cause by alergy or mechanism
defect)
Step 2
1. How the defense of eyes surface?
2. How the mechanism of ocular surface disease?
3. How the mechanism of injection conjuctiva?
4. How the mechanism of eyes severe oedem?
5. What is papil conjunctiva and why it can be happen?
6. What are the classification of red eyes?
7. Why his eyes produces a yellow discharge?
8. Why he difficult to open his eyes?
9. What is fibrovascular fiber?
10.Mention the kind of eyes discharged!
11.What is the etiology of the red eyes?
12.What is the differential diagnosis of the scenario?
13.What are physical and additional examination we must to do?
14.What is the therapy of red eyes?
Step 3
1. How the defense of eyes surface?
The defense of eyes surface:
a. Palpebra
b. Cilia
c. Supercilia
d. Lakrimal gland
e. Tear film
Intinya untuk lindungi dari paparan debu, bakteri, virus
2. How the mechanism of ocular surface disease?
Causes by Infection, Allergy, Trauma, Inflamation, Glaukoma, and etc

3. How the mechanism of injection conjuctiva?

The dilatation of a. conjuctiva posterior, there are many factor cause

conjuctiva injection, which one is cause by patogen.
If the patogen enter and attack our defense surface there is makrofag and
other leukocyte release sitokin Histamin too whil dilate the blood vessels so
the sign that we see is conjunctival injection.
4. How the mechanism of eyes severe oedem?
Like the number 2 the process began from patogen is entering the bulbus
oculi , the macrophage is fagosite the antigen and presenting it to Th2, and
the the Th2 cell release cytokine sel B transform into plasma cell and it can
produce antibody IgE, Ig E bind with mast cell then antigen is phagositosis by
 mast cell and then produce the inflamation mediator like histamin and
bradikinin, it make the blood vessels dilate, because the vasodilatation its
increase the blood flow and then vascular permeability is increase that cause
the extravatation fluid from the intra to ekstravasculer and its make oedem
(dicari lagi mekanisme IgEnya lagi)
5. What is papil conjunctiva and why it can be happen?
The palpebra, if the pathogen enter the follicle and the pores it fagocyte by
macrophage and other leukocyte and it makes oedem in that area (sarang), it
can be single or multiple, So the papil is caused by accumulation of
inflamation reaction in subconjuctiva and follicle

6. What are the classification of red eyes?

Red eyes base the vision divided to:
a. with blur vision (attack the media refracta) its like keratokonjuctivitis, uveitis,
Glaukoma
b. without blur vision (not attack the media refracta) its like konjuctivitis,
skleritis

-->Konjuctivitis divided to caused by bacterial and virus

Red Eyes base the vasodilatation of the artery its divided to:
a. Injection conjuctivae: a. conjuctiva posterios is dilate, the caracteristic of
injection conjuctivae is the color is fresh red, itchy and it causes by trauma,
allergy , location in lebih ke perifer atau daerah limbus. Terapi Epinefrin akan
vasokonstriksi
b. Injection Cilliar: a. siliar, the caracteristic of injection cilliar is the color is
violet, and its will be pain if we touch it , lebihn ke sentral atau kornea, Terapi
epinefrin tidak vasokonstriksi
c. Injection Episklera : a. siliar longus, the caracteristic of injection episklera is
dark red, decrease the visus, location in central or cornea, Terapi epinefrin
tidak vasokonstriksi
Sekret injeksi konjungtiva +, lainnya (-)

7. Why his eyes produces a yellow discharge?

Yellow discharged causes by cells of inflamation mediator, migrate from
stroma to conjuctiva and move into epitel (the surface of conjuctiva),
mediator inflamasi bergabung dengan fibrin dan mukus dari sel goblet hingga
terbentuk eksudat. Gara-gara ada eksudat jadi susah buka mata utamanya
pada pagi hari.
8. Why he difficult to open his eyes?
Same with number 7
When we close our eyes the tear film the temperature is same with our body,
but when the patogen enter our eyes and we close our eyes the bactery
proliferate makes more the production of mucuse
9. What is fibrovascular fiber?
10.Mention the kind of eyes discharged!
- Water: causes by virus and allergy
- Purulen: bactery
- Hiperpurulen: ginecoccuc/meningococcus (GO)
- Mucoid: allergy vernal
- serose: virus (adenovirus)
11.What is the etiology of the red eyes?
12.What is the differential diagnosis of the scenario?
13.What are physical and additional examination we must to do?
14.What is the therapy of red eyes?