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REFRACTIVE ERROR

dr. Nurfifi Arliani, SpM


Fakultas Kedokteran
Universitas Muhammadiyah Yogyakarta
INTRODUCTION

 Hazy, foggy, blurred vision at particular distance


 refractive error

 The causes :
 Diameter antero-posterior (axial length)
 Refractive index (power)
 The Lens

The most case of refractive error : Myopia.


Good vision :

 No refractive error

 Clear refraction medium

 Healthy fundus oculi

 Normal visual pathway

 Good visual center

 Good intelectual consciousness


Emmetropia
 The object could be seen : reflecting light

 The light from far distance : parallel  will be


focused by refraction system

 In emmetropia  focused in retina

 The parallel light  focused not in retina 


ametropia
 Near-sight needs accommodation

 Accommodative effort : lens

 In old patient : weak of accommodation  need


reading glasses  Presbyopia
Myopia

 The most common case

 The cause : diameter antero-posterior too long 


focus in front of the retina

 Normal: 24 mm (approx. add 1 mm miop equally


with add 3 Dioptri)
Myopia
MATA NORMAL MATA MIOPIA
Sign and symptom:

 Appearance of eyeball  bigger

 Far-sight (distance-vision): blurred

 Clear near-sight

 Children with high-myop : creep around &


examine things closely
 Myopia needs correction : spherical glass negative

 Degree of Myopia:
 <3 D : mild
 3-6 D : moderate
 >6 D : high

 The higher myop the blurrer vision the nearer


reading ( the nearer near-sight)

 Complication of high myop :


 Ablatio retina
 Glaucoma
Can lead to blindness
HYPEROPIA
 Diameter antero-posterior shorter than normal

 Light focused behind the retina

 Far-sight need acomodation, near-sight need


stronger acomodation

 Need positif spherical Lens/glasses


MATA NORMAL MATA HIPERMETROP
HYPEROPIA
Sign and symptom:
 Distance vision : blurred
 Near-sight need accomcodasion 
 Unconfinient in reading a book
 Fatigueness when reading a book

 Headache, stiffness of the neck,

vomiting
Complication:
 Strabismus (esotropi acomodativa)

 Amblyopia
ASTIGMATISM

 The light focused in two significantly different


meridians

 The cause : surface of the cornea


ASTIGMATISM
 Site of light focus:

 One at retina, other one in front of retina, 


astigmat myop simplex
 One at retina, other one behind the retina, 
astigmat hyperopia simplex
 Both focuses in front of retina but in different
distance from retina  astigmat myop
compositus
 Both focuses behind the retina but in different
distance from retina  astigmat hyperopia
compositus
 one in front of retina and other one behind
the retina, -> astigmat mixtus

 Astigmatism sight : the object seen shadowy


 Correction of astigmatism : combined glasses
spherical and cylinder.
Conclusion

 It need an awareness from the parents of the


condition of refractive error, since early detection
give more benefit result in correcting the
refractive error. It will prevent from the
occurance of further complication.

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