PEDIATRIK CLINIC 3

PRESENTATION

PRESENT BY :
DANANG KUSUMAH / 172020009
M. MA’SUM / 172020030
DIMAS MAULANA SYAFELI / 172020033
Pati ent ’s P r of i l e
 Name : R.A
 Age : 12 years old
 Gender : Male
 Race : Sunda/Indonesian
 Occupation : Student (grade 5)
 Hobbies: Football, Volly and Badminton
Case History

Ocular
• L : Both Eyes
• O : About 6 months
History • Very health now
• Has no history of systemic
• F : Sometimes Red Eyes disease, not currently
• T : Sometimes Red Eyes on Both • Never wear glasses
undergoing treatment
eyes • Never had an eye exam • Allergies (+) seafood
•S : • Playing HP more than 2 hours
•E : per day
•A : • Trauma (-)
• Infection (-)
• Operation (-)
Chief General
Complaint Health
Family History

Parent • Mom: Wearing Glasses

• Dad: doesn’t wear glasses

• No diabetes (-)
• No hypertension (-)
• No glaucoma (-)
• No cataract (-)
 Tentative
Diagnosis • Hypermetropia
• Preliminary Examination
Assessmnet • Refraction
Plan • Accommodation Test
• Management & Follow Up
Prelimenary Examination
Entrance Test

Examination Right Eye Left Eye

Hirshberg Test Center and Symmetrical
Pupil Equally Round Reactive to Light and Accommodation (PERRLA)
Pupil Reflex Test
No Relative Afferent Pupillary Defect (RAPD)
Smooth, Accurate, Full, Extensive Smooth, Accurate, Full, Extensive
Ocular Motility Test (SAFE) (SAFE)
Cover Test Normal, No Movement Detect (Orthophoria  distance and near)

Confrontation Test Full (can see finger in all direction) Full (can see finger in all direction)

Ishihara Test 10/10

Stereoacuity Titmus
Aided = 100 seconds of arc
Test
Worth 4 Dots Test No Suppression
Refraction
EXAMINATION RIGHT EYE LEFT EYE

Autorefractometer S +0.50/ -1.00 X65 S +1.00/ -0.75 X170

Visual Acuity (sc) Distant : 20/25 PH(+) 20/20 Distant : 20/25 PH(+) 20/20
Near : N6 @30cm Near : N6 @30cm

Subjective Refraction S +0.50/ -0.25 x 65 (20/20) S +0.50/ -0.75 x170 (20/20)

Near : N6 @30cm Near : N6 @30cm

Stereopsis 100 sec of arc

 Accommodation Test
EXAMINATION RIGHT EYE LEFT EYE BINOCULAR INTERPRETATION
NPA
NPC - -
Management & Follow Up

Diagnosis • Hypermetropia

• Stop or reduce the near activity of using HP

• Do 20-20-20 tehnic
• When watching TV or doing activities using gatget, adjust the
Management distance so that it isn’t too close
• More Outdoor Acrivities
• Consume Vegetable and Vit A and drink enough water

• Recommend minimum re-examination about 6 months

Follow Up • Regular examination every 1 year, or come whenever
there is a problem with the eyes
DOCUMENTATION