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Pengertian Refraksi :
adalah usaha dari mata agar bayangan yang
masuk ke mata oleh media refraktanya,
jatuh tepat diretina tanpa akomodasi atau
berakomodasi.
Accommodation Process
Capability of adding the refraction power of
the eye, by increasing the convexity of
the lens
normal : rays that come from > 5 m -
distance object regarded as parallel light;
the eyes are in relax position, the images
are focused right on the retina (fovea
centralis)
For object at less than 5
meters distance, the rays
do not come parallel but
divergent. If the eyes
are still in relax position,
the images will be
focused behind the
retina. So the object will
be seen blurred. These
images must be moved
forward so it will be
focused on the retina by
increasing the convexity
of the lens. This process
is called accommodation
process.
Emmetropia
Is the condition when
the parallel rays focused
exactly on the retina of
the eye in relax
condition ---> the
visual acuity is
maximum
Ametropia
Is the condition
when the parallel
rays are not focused
exactly on the retina
of the eye in relax
condition.
The focal point may
be behind or in front
of the retina
Myopia
Refractive condition
in which, with
accommodation
completely relaxed,
parallel rays are
brought to a focus in
front of the retina.
Myopic eye :
refractive state over
plus power
Factors that causing myopia :
Axial : The antero-posterior axis of the eye ball > normal
in this case, the refraction power of the cornea, lens and the lens position are
normal. The eye usually looks like proptosis
Curvature :
The size of the eye ball ---> normal, but there is a increasing of the cornea/lens
curvature
Myopia classification :
< 3.00 D = low myopia
3.00 - 6.00 D = moderate myopia
> 6.00 D = high myopia/gravis
Treatment :
Low and moderate myopia : full correction with weakest spherical lens that
give the best visual acuity
Example :
VOD = 5/60 S -2.50 D = 6/7
S -2.75 D = 6/6
S -3.00 D = 6/6
S -3.25 D = 6/7
The glasses are S - 2.75 D
Hypermetropia
Is a refraction
anomaly that
without
accommodation
parallel rays will be
focused behind the
retina
Etiology :
Axial ---> eye ball diameter < N
Deminished convexity of cornea/lens curvature
Decreasing Refractive index
Treatment :
If foria/tropia not present, apply strongest
positive spherical lens that give the best visual
acuity
astigmatism
Refractive condition
of the eye in which
there is a difference
in degree of
refraction in diferent
meridian, each will
focused parallel rays
at a different point.
The shape of the
images :
Etiology of astigmatism :
Corneal curvature disturbances ---> 90%
Lens curvature disturbances ---> 10%
Treatment : Cylindris lens
Contact lens : Hard ---> rigid lens
Soft
Indication :
High anisometropia
irregular astigmatism
Descemetocele
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PENGKAJIAN SISTEM PENGLIHATAN
Riwayat Kesehatan
Pemeriksaan Fisik
Data Psikososial
Prosedur Diagnostik
Riwayat Kesehatan
Data Demografi
Usia
Jenis Kelamin
Riwayat Kesehatan Klien
Insiden traumatik pada mata terutama faktor
waktu, riwayat tindakan operasi.
Penggunaan alat bantu (mulai, koreksi,
terakhir periksa)
Gejala penglihatan lain
Kebiasaan / perilaku
Intake vitamin A saat sekarang dan
periode waktu sebelumnya
Riwayat Kesehatan Keluarga
Tendensi gangguan yang bersifat familial
Status Sosial Ekonomi
Pekerjaan
Riwayat Kesehatan Saat Ini
Keluhan utama yang sering dialami
adalah :
Penglihatan berkurang, suram, tidak
bisa melihat
Sakit atau perasaan tidak nyaman
pada mata
Pemeriksaan Fisik
(Data Fokus Pemeriksaan Mata)
Visus
Bentuk bola mata
Palpebra superior
Palpebra inferior
Kornea
Iris
Conjungtiva bulbi
Conjungtiva tarsalis
Sekret
TIO
Pupil (refleks cahaya, ukuran, isokor)
Bilik mata depan (COA)
Lensa
Pengkajian Psikososial
Kecemasan akan kehilangan fungsi
penglihatan
Konsep Diri : Body image, harga