Paper astigmatisma revisi.doc

PAPER DEPARTEMEN ILMU KESEHATAN MATA FAKULTAS KEDOKTERAN USU/RSUP H. ADAM MALIK MEDAN

NAMA : RAUDHAH SARI NIM : 120100143

PAPER

ASTIGMATISMA

Disusun oleh : Raudhah Sari 120100143

Supervisor : dr. Arani A. A!ra" M.#ed$%ph&"Sp.M$#&

PR%GRAM PE'DIDI#A' PR%(ESI D%#TER DEPARTEME' I)M* #ESE+ATA' MATA (A#*)TAS #ED%#TERA' *'I,ERSITAS S*MATERA *TARA RS*P +. ADAM MA)I# MEDA' 201-

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#ATA PE'GA'TAR

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Tuuan Pe Penulisan















$a$%# ini %"a&i*u un+u" ,%,%nu(i $%#!a#a+an "%*ia+an P#*#a, P%ndidi"an P#6%i P#6%i D"+%# D"+%# P3D di D%$a#+%,%n D%$a#+%,%n I&,u K%%(a+an K%%(a+an Ma+a Fa"u&+a Fa"u&+a K%d"+%#an K%d"+%#an Uni7%#i+a Su,a+%#a U+a#a.

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1 E$i+ E$i+%& %&iu iu, , "#n "#n%a %a M%,i&i"i "%+%a&an %"i+a# 10 +%a& "#n%a ;0 C,. T%#di#i da#i ;-< &a$i %& !an* ,%&indun*i a*ian $%#,u"aan ,a+a da#i a#ai ,%"ani dan ,%,%n+u" ,%,%n+u" permeability barrier un+u" un+u" ,&%"u& "%'i& ai# dan in dan ,%n'%*a( $a+*%n ,au". S%& +%#da&a, ,%,i&i"i %n+u" "&u,na# d%n*an in+i in+i !an* !an* %a# %a# dan dan u&a u&a+. +. Di a*i a*ian an &ua# &ua# 2-3 2-3 &a$i &a$i %& %& $&i $&i(% (%d# d#a& a& %#%n+u" a!a$. Pada &a$ian !an* &%i( u$%#6iia& %& ,%njadi &%i( *%$%n*.< 2 M%, M%,#a #an n 95 95,a ,an n  Anterior Anterior limiting lamina lamina T%#&%+a" di%&a"an* &a$ian %$i+%&iu, !an* ,%n*andun* %#au+ "&a*%n !an* $ada+ ,i#i$ d%n*an u+ania $#$#ia d%n*an "%+%a&an 12 C,. &a$ian ini +ida" ,%n*andun* 6i#&a+. < 3 Su+a Su+ani niaa P#$ P#$#ia #ia +#,a +#,a La$ian ini ,%,i&i"i "%+%a&an ;00 C, dan ,%,%n+u" a*ian +%#%a# "#n%a. La$ian ini $ada+ dan +#an$a#an !an* +%#di#i da#i 200-2;0 &a,%&a !ai+u uunan "&a*%n !an* %jaja# a+u d%n*an &ainn!a u,u,n!a "&a*%n +i$% 1. Pada $%#,u"aan +%#&i(a+ an!a,an !an* +%#a+u# %dan*"an dia*ian $%#i6%# %#a+ "&a*%n ini %#'aan*. K%#a+i+ ,%#u$a"an %& +#,a "#n%a !an* ,%#u$a"an 6i#&a+ !an* +%#&%+a" di an+a#a %#a+ "&a*%n +#,a. < 4 M%, M%,#a #an n D%' D%'%, %,%n %n++  Posterior Posterior limiting lamina lamina M%#u$a M%#u$a"an "an ,%,#a ,%,#an n a%&u&% a%&u&%## dan ,%#u$a ,%#u$a"an "an a+a a+a %&a"a %&a"an* n* +#,a +#,a "#n%a di(ai&"an %& %nd+%& dan ,%#u$a"an ,%,#an aa&n!a. La$ian ini %#i6a+ %&a+i" dan %#"%,an* +%#u %u,u# (idu$ d%n*an +%a& 4 C, aa+ &a(i# dan ,%nin*"a+ ,%njadi 12 C, $ada d%"ad% "%-=. < ; End+% d+%&i &iu u, La$ian ini ,%nu+u$i a*ian $+%#i# "#n%a dan +%#di#i da#i %&a$i %&















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Ga!5ar 2.2. A&i#an A?u%u Hu,# < 7. )ensa &%na &%na ,%#u$a ,%#u$a"an "an ua+u ua+u +#u"+u +#u"+u## i"n7 i"n7%" %" a7a"u a7a"u&a# &a# dan +#an$ +#an$a#an a#an..

T%a&n!a %"i+a# 4 ,, dan dia,%+%#n!a  ,,. &%na +%#*an+un* $ada nu&a di %&a"an* i#i nu&a ,%n*(uun*"ann!a ,%n*(uun*"ann!a d%n*an '#$u 'i&ia#%. Di %%&a( an+%#i an+%#i# # &%na &%na +%#da$ +%#da$a+ a+ a?u%u a?u%u (u,# (u,# dan di %%&a( %%&a( $+%#i $+%#i#n #n!a !a 7i+#%u 7i+#%u. . Ka$u& Ka$u& &%na &%na ada&a( ada&a( ua+u ua+u ,%,#a ,%,#an n %,i$% %,i$%#,% #,%a& a&%% %di"i %di"i++ &%i( &%i( $%#,%a $%#,%a&% &% da#i$ada dindin* "a$i&%# !an* a"an ,%,$%#&%("an ai# dan %&%"+#&i+ ,au". = Di %%&a( d%$an +%#da$a+ +%#da$a+ %&a$i %&a$i %$i+%& u"a$u&a# u"a$u&a#.. Nu"&%u Nu"&%u &%na &%i( "%#a da#i$ada "#+%"n!a. S%i#in* d%n*an %#+a,a(n!a uia %#a+-%#a+ &a,%&a# u$%$i+%& +%#u di$#du"i %(in**a &%na $%#&a(an-&a(an ,%njadi &%i( %a# dan "u#an* "u#an* %&a+i" %&a+i".. Nu"&%u Nu"&%u dan "#+%" "#+%" +%#%n +%#%n+u" +u" da#i da#i &a,%&& &a,%&&a% a% "n%n "n%n+#i +#i !an* !an* $anjan*. Main*-,ain* %#a+ &a,%&a# ,%n*andun* %ua( in+i *%$%n*. Pada















%n+u" +%#"idai ,au$un +%#%du"i. +% #%du"i. Tida" ada %#a+ n!%#i $%,u&u( da#a( a+au a#a6 di &%na.= d. ,ireus i+%# i+%#u u ada& ada&a( a( ua+u ua+u ada adan n *%&a *%&a+i +in n !an* !an* j%#n j%#ni( i( dan dan a7a" a7a"u& u&a# a# !an* !an* ,%,%n+u" dua $%#+i*a 7&u,% dan %#a+ ,a+a. i+#%u ,%n*ii #uan*an !an* dia+ai &%( &%na #%+ina dan di"u $+i"u. P%#,u"aan &ua# 7i+#%u ,%,#an (!a&i (!a&id d n#,a& n#,a&n!a n!a %#"n %#"n+a" +a" d%n*an d%n*an +#u"+u +#u"+u#- #-+#u +#u"+u "+u## %#i"u %#i"u+: +: "a$u& "a$u& &%na &%na $+%#i# %#a+-%#a+ nu&a $a# $&ana &a$ian %$i+%& #%+ina dan 'a$u+ n%#7i $+i'i. 9ai 7i+#%u ,%,$%#+a(an"an $%n%,$%&an !an* "ua+ %u,u# (idu$ "% &a$ian %$i+%& $a# $&ana dan #%+ina +%$a+ di %&a"an* #a %##a+a.= i+#%u ,%n*andun* ai# %"i+a# . Sia 1 ,%&i$u+i dua ",$n%n "&a*%n dan aa, (ia&u#na+ !an* ,%,%#i %n+u" dan "ni+%ni ,i#i$ *%& $ada 7i+#%u "a#%na "%,a,$uann!a ,%n*i"a+ an!a" ai#.= 2.1.2. 2.1.2. (isiol (isioloi oi Penli Penliha haan an K%+i K%+i"a "a 'a(a! 'a(a!aa ,au ,au" " "% ,a+a ,a+a ,%&a ,%&a&u &uii "#n "#n%a %a 'a(a! 'a(a!aa +%#% +%#%u u++ a"an a"an diia" diia"an. an. R%6#a" R%6#a"ii $%,i $%,iaan aan 'a(a!a 'a(a!a ,%#u$a ,%#u$a"an "an $%,%& $%,%&"a "an n a#a( a#a( 'a(a!a 'a(a!a "a#%na "a#%na 'a(a!a ,%&a&ui dua ,%diu, ,%diu, !an* %#%da. %#%da. a(a!a a(a!a ,%#a,a+ ,%#a,a+ &%i( '%$a+ ,%&a&ui uda#a diandin*"an ,%dia +#an$a#an &ainn!a. P%,iaan ini da$a+ +%#jadi a$ai&a a#a( %#"a 'a(a!a ,%n*%nai $%#,u"aan ,%diu, a#u d%n*an udu+ !an* +ida" +%*a" &u#u. @i"a +%*a" &u#u 'a(a!a (an!a a"an ,%&a,a+ dan ,%n*a&a,i ,%n*a&a,i $%,%nd%"an

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. Compound !yopic Astigmatism Astigmatism  !a"ni ji"a "%dua *a#i 6"u %#ada di d%$an #%+ina. '. Simple "yperopic Astigmatism Astigmatism ji"a a+u *a#i 6"u %#ada di %&a"an* #%+ina dan !an* &ainn!a %#ada di #%+ina. d. Compound Compound "yperopic "yperopic Astigmatism Astigmatism ji"a ji"a "%du "%duaa *a#i *a#i 6"u 6"u %#ad %#adaa di %&a"an* #%+ina. %. !i#ed Astigmatism Astigmatism !a"ni ji"a a+u *a#i 6"u %#ada di d%$an #%+ina dan !an* &ainn!a %#ada di %&a"an* #%+ina.














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d%#aja+. L%i( %#in* di+%,u"an $ada $ai%n uia ,uda. Againts%the%rule astigmatism& ,%#idi ,%#idian an (#i (#in+a n+a&& ,%,i&i" ,%,i&i"ii "%"ua+ "%"ua+an an #%6#a"i &%i( %a# an+a#a 1<0 dan 20 d%#aja+. L%i( %#in* $ada #an*



+ua. 'bli(ue astigmatism: astigmatism: ,%#idian-,%#idian u+a,an!a +ida" +%#&%+a" da&a, 20 d%#aja+ d%#aja+ (#in+a& (#in+a& dan 7%#+i"a& 7%#+i"a& +%+a$i an+a#a 20 dan 80 d%#aja+ a+au an+a#a



110 dan 1<0 d%#aja+. )iobli(ue astigmatism: astigmatism: ji"a dua ,%#idian u+a,a +ida" +%#&%+a" $ada udu+ !an* a,a a+u a,a &ain ,ia&n!a a&a( a+u $ada 30 dan a+un!a &a*i 100 d%#aja+.

5.

Asi!ais!a Ireuler )a"ni a$ai&a #i%n+ai ,%#idian u+a,a a+au ju,&a( a+i*,a+i,a %#ua(

da#i +i+i" "% +i+i" aa+ ,%&%5a+i $u$i&. M%"i$un ,%#idian u+a,an!a +%#$ia( 0 $ada %+ia$ +i+i" "adan*-"adan* $ada $%,%#i"aan #%+in"$i a+au "%#a+,%+#i %'a#a "%%&u#u(an ,%#idian u+a,a $ada "#n%a ini +ida" +%*a" &u#u a+u a,a &ain. S%%na#n!a %+ia$ ,a+a n#,a& ,%,i&i"i %+ida"n!a %di"i+ a+i*,a+i,a















Pada a+i*,a+i,a a+i*,a+i,a #%*u&a# #%*u&a# %+ia$ ,%#idian ,%#idian ,%,ia"an ,%,ia"an 'a(a!a %'a#a +%#a+u +%#a+u## dan a,a a,a a"an a"an +%+a$i +%+a$i $%,ia $%,iaan an ,%#idi ,%#idian an !an* !an* a+u %#%da %#%da d%n*an d%n*an ,%#idi ,%#idian an !an* !an* &ain. &ain. Sa+u Sa+u ,%#idi ,%#idian an ,%,ia ,%,ia"an "an 'a(a!a 'a(a!a %#&% %#&%i(a i(an n dan !an* !an* &ainn!a "u#an*. Dua j%ni ,%#idian ini di%u+ d%n*an ,%#idian u+a,a "%duan!a a&in* +%*a" &u#u. 12 Pada "%an!a"an "au a+u ,%#idian u+a,a +%#&%+a" %'a#a 7%#+i"a& dan a+un!a &a*i +%#&%+a" (#in+a& na,un ia +%#jadi &i" na,un udu+n!a ,ai( a&in* +%*a" &u#u 0 d%#aja+ a+u a,a &ain. 12 M%#idian 7%#+i"a& da&a, an!a" "au ,%,ia"an 'a(a!a &%i( "ua+ da#i$ada !an* (#in+a& (a& ini "%,un*"inan %a# di%a"an &%( +%"anan $a&$%#a& "% "#n%a. Ti$% a+i*,a+i,a ini di%u+ with%the%rule dan with%the%rule dan &%i( %#in* $ada ana"-ana". S%,%n+a#a i+u a$ai&a ,%#idian (#in+a& ,%,ia"an 'a(a!a &%i( "ua+ ini di%u+ d%n*an a+i*,a+i,a against%the%rule dan against%the%rule dan &%i( %#in* $ada #an #an*

d%5a %5aa. a.

P%# P%#%d %daa aan n

#%6# #%6#a" a"i i

an+a an+a#a #a

"%du %dua

,%#i ,%#idi dian an

u+a, u+a,aa

ini ini

,%n**a,a#"an %a#n!a a+i*,a+i,a dan di#%$#%%n+ai"an da&a, di$+#i D. 12 K%+i"a $%#%daann!a +ida" &%i( da#i 0.; a,$ai 0.8; D ,a"a di%u+ d%n*an a+i*,a+i,a 6ii&*i dan iaan!a +ida" $%#&u "#%"i "a#%na ,ai( ia di",$%nai dan +ida" ,%ni,u&"an "%&u(an uj%"+i6 $ada %%#an*.
















Ga!5ar 2.. Circle of least confusion4
















i#%*u&%#. A+i*,a+i,a i#%*u&%# +%#jadi a"ia+ in6%"i "#n%a +#au,a dan di+#6i a+au a"ia+ "%&ainan $%,iaan $ada ,%#idian &%na !an* %#%da. ;















&%( &%( "a#%na "a#%na $%#%d $%#%daan aan da&a, da&a, "ndi "ndiii $%n'a( $%n'a(a!a a!aan an dan +i$% +i$% "a#+u "a#+u ja#a" ja#a" dan "n+#a da$a+ ,%n!%a"an (ai& +ida" %uai d%n*an da+a. 1; 5. Re Reino inoso sopi Tin*"a+ #%6#a"i $ada %&u#u( ja&u# $+i dini&ai ,%n**una"an #%+in"$i. R%+in R%+in" "$i $i ,%#u$a ,%#u$a"an "an &an*"a &an*"a( ( a5a& a5a& $ada $ada #%6#a"+ #%6#a"+,% ,%+#i +#i.. P%,%#i" P%,%#i"aan aan ini di*una"an un+u" ,%ni&ai "%&ainan #%6#a"i dan ,%,$%#"i#a"an j%ni dan "%"ua+an &%na !an* di$%#&u"an un+u" ,%,$%#ai"i "%&ainan +%#%u+. R%+in"$i "adan* di%u+ di%u+ %a*ai %a*ai #%6#a"+#i #%6#a"+#i j%"+i6 j%"+i6 "a#%na +ida" ,%,u+u("a ,%,u+u("an n $a#+ii$ai $a#+ii$ai a+au #%$ #%$n n da#i da#i $ai% $ai%n. n. Pada Pada a+i* a+i*,a ,a+i +i, ,aa #%*u #%*u&%# &%# #%+in #%+in " "$i $i da$a da$a++ ,%ni ,%ni&a &aii $%#%daan "%"ua+an $ada dua ai !an* %#%da. %#%da. ;1;















u,u,n!a u,u,n!a di+%,u"an di+%,u"an $ada $%#ai $%#ai #%6#a"i #%6#a"i "%#a+'nu "%#a+'nu  dan "%&ainan "%&ainan "#n%a "#n%a &ain.;1< e. Topo opora ra8i 8i #or #orne nea a P%,% P%,%#i #i" "aa aan n ini ini ,%n* ,%n**u *una na"a "an n computer%a computer%assisted ssisted videokerato videokeratograph graphyy AK d%n*an +%"n&*i !an* &%i( ,aju da&a, ,%ni&ai a+i*,a+i,a "#n%a d%n*an d%n*an ,%n*u" ,%n*u"u# u# ni&ai ni&ai $ada $ada %%#a %%#a$a $a +i+i" +i+i" $ada $ada $%#,u" $%#,u"aan aan an+%#i an+%#i## "#n%a "#n%a.. P%,%#i" P%,%#i"aan aan ini %#i6a %#i6a++ j%"+ j%"+i6 i6 dan ,%,%# ,%,%#i"a i"an n in6#, in6#,ai ai %#*un %#*unaa +%#"ai+ +%#"ai+ "%+i "%+ida da"+ "+%# %#a+u a+u#a #an n

"#n "#n%a %a

dan dan

,%, ,%,an an+u +u

,%n* ,%n*an ana& a&i i

a+i a+i*, *,a+i a+i, ,aa

%'a#a %'a#a

"uan+i+a+i6 dan "ua&i+a+i6. AK ju*a da$a+ ,%n*(ai&"an ni&ai "u#7a+u#a #a+a-#a+a da#i %&u#u( "#n%a %#%da d%n*an "%#a+,%+#i. 1;















,un*"in +ida" ,%n%#i,a "#%"i i&ind%# !an* $%nu( $ada %$aan* "a'a,a+an!a a+au "a'a,a+a !an* %&anju+n!a ji"a a+i*,a+i,an!a (an!a %a*ian di"#%"i. ; L%na i&ind#i ,u#ni a+au i&ind%# ,%#u$a"an &%na !an* ,%,$un!ai dua ,%#idian !an* a&in* +%*a" &u#u a+u a,a &ain d%n*an "%"ua+an #%6#a"i (an!a $ada a+u ,%#idian. M%#idian !an* +ida" ,%,$un!ai "%"ua+an di%u+ ai. Pii i&i i&ind nd%# %# ,%nu ,%nunj nju" u""a "an n ai ai d%n* d%n*an an #%n+ #%n+an an* * da#i da#i 0  (#i (#in+a n+a& & (in**a (in**a 0 7%#+i"a& dan "%,a&i "% 1=0  a,a %$%#+i 0. %#%da d%n*an &%na 6%#i i&ind%# ,%,6"u"an ina# 'a(a!a ,%njadi *a#i 6"u da#i$ada %ua( +i+i". K%"ua+an ,%#idian %&a&u 0 d%#aja+ ,%njau( da#i ai. O&%( "a#%na i+u ji"a ai 4; d%#aja+ ,a"a "%"ua+an ,%#idian $ada 13; d%#aja+. K%"ua+an i&ind%# $ada ,%#idian ai ada&a( n&. K%"ua+an ,a"i,u, ada&a( 0 d%#aja+ da#i ai. Ha& ini

















'a(a!a $ada a+u +i+i" +%+a$i ,%,ia"an 'a(a!a $ada %$anjan* "%dua ,%#idian ,%njadi dua *a#i 6"u. >a,a#an +%#j%#ni( +%#%n+u" $ada +i+i" an+a#a dua *a#i 6"u !an* ,%,%n+u" i+i&a( *%,%+#i circle  circle of least confusion. confusion . K%,a,$uan &%na 6%#i&ind%# un+u" ,%,ia"an 'a(a!a di%$anjan* "%dua ,%#idian da$a+ ,%n*#%"i a+i*,a+i,a dan ,i$ia a+au (i$%#$ia. ;





























"%&ainan #%6#a"i a+i*,a+i,a %'a#a $%#,an%n. K%u&i+an-"%u&i+an a5a& %#u$a +%#%n+u"n!a $%#"au+an u$%#6iia& di "#n%a +a,$a"n!a +%&a( %#(ai& dia+ai. PRK ,%n*(i&an*"an ,%,#an 95,an &a$ian +%,$a+ %$i+%& "#n%a ,%&%"a+ "adan*-"adan* (a& ini ,%n!%a"an "%"%#u(an "#n%a. Un+u" ,%,$%#+a(an"an ,%,#an ini di&a"u"an ua+u $#%du# a&+%#na+i6 !an* an!a" di"%na& %a*ai















*%n%+i" &in*"un*an &%i $ada "#n%a +#au,a in6%"i dan ",$&i"ai $%#ai ,a+a. A+i*,a+i,a da$a+ ,%ni,u&"an "%&u(an %#u$a $%#ua(an %n+u" %nda dan dan $and $andan an*a *an n "au "au## %#+ %#+aa *%ja *%ja&a &a-* -*%j %ja& a&aa asthenopic. asthenopic. K%&ai %&ain nan ini ini da$a da$a++ didi didia* a*n ni i d%n* d%n*an an $%,% $%,%#i #i" "aan aan +aja, +aja, $%n* $%n*&i &i(a (a+a +an n "%#a+ "%#a+ " "$i $i manifest refraction refraction #%+in"$i wavefront aberrometry aberrometry "%#a+,%+#i dan +$*#a6i "#n%a.















;. Kai, Kai, DKJ. DKJ. A+i*,a+i, A+i*,a+i,  D%6ini+in D%6ini+in E+i&*! E+i&*! &ai6i'a+in &ai6i'a+in Dia*ni Dia*ni and

Nn-Su#*i'a&

T#%a+,%n+.

2012;-84.

A7ai&a&%

(++$://'dn.in+%'($%n.',/$d6/2=; a''%%d n 30 O'+%# 2018. (++$://'dn.in+%'($%n.',/$d6/2=; <. S+and#in* S+and#in* S. >#a! >#a! Ana+,! Ana+,!.. 41+ %d. Lndn: Lndn: E&%7i%#. E&%7i%#. 201< <=8-<0. <=8-<0.

6#,

















Paper astigmatisma revisi.doc

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