PENANGANAN TRAUMA MATA AKIBAT SEMBURAN BISA ULAR

Muhammad Abdurrauf

Abstract


Abstrak. Beberapa ular mengembangkan mekanisme pertahanan diri dengan menyemburkan bisa ular yang mengarah ke mata hewan atau manusia yang mengancamnya. Jika bisa ular terkena pada mata maka akan mengakibatkan kerusakan pada mata. Trauma mata akibat bisa ular ini merupakan kegawat daruratan mata yang membutuhkan pertolongan awal segera berupa irigasi selama 30 menit untuk mencegah komplikasi yang terjadi. Selain irigasi dapat pula ditambahkan dengan midriatikum, anastesi topikal, antibiotik topikal, sikloplegis topikal dan melakukan pemeriksaan flouresin dengan slitlamp. Pemberian serum anti bisa ular secara topkal maupun intravena dan kortikosteroid topikal merupakan kontraindikasi dalam kasus ini. Dilaporkan satu kasus laki laki 34 tahun tersembur bisa ular pada mata kanan datang ke UGD RSUD Sumberrejo Bojonegoro. Pada pasien dilakukan irigasi dengan RL selama setengah jam. Setelah dilakukan evaluasi post irigasi didapatkan  blepharospasme, hiperemi konjungtiva, tidak tampak kekeruhan kornea, bmd tampak dalam. Visus pasien > 3/60. Kemudian pasien diberi antibiotik topikal Chloramphenicol dan NSAID oral. Bebrapa dokter spesialis mata merekomendasikan untuk menutup mata dengan kasa setelah penanganan awal. (JKS 2016; 3: 181-184)

Kata Kunci : trauma mata akibat semburan bisa ular, pertolongan pertama, irigasi, kegawat daruratan mata

Abstract.Some types of snake develop defense mechanism by spitting the venom to the eye of animal or human that threatens them. If the venom hit the eye, it caused injury to the eye. This eye injury is one of the eye emergencies that require immediate first treatment which is irrigation of the eye for about 30 minutes to prevent further complications. Besides the irrigation we can add midriatics, topical anesthetics, topical antibiotics, topical cycloplegics, and perform flourecin staining with slitlamp. Topical or intravenous antivenom and topical corticosteroids administration are contraindicated in this case. Reported a 34 years old male got spitted by snake venom in the right eye, and then he came to Emergency Room in RSUD SumberejoBojonegoro. Then the patient is irrigated by RL for about 30 minutes. After evaluated post irrigation there was blepharospasm, hyperemicconjunctiva, corneal cloudiness isn’t available, anterior chamber seem deep. Visual Acuity of the patient is >3/60. Then the patient is administered topical antibiotics Chloramphenicol and oral NSAID. Some ophthalmologist suggest to use eyepatch after initial treatment. (JKS 2016; 3: 181-184)

Keyword : ophtalmic snake venom injury, first treatment, irrigation, ophthalmic emergency

Keywords


trauma mata akibat semburan bisa ular, pertolongan pertama, irigasi, kegawat daruratan mata; Keyword : ophtalmic snake venom injury, first treatment, irrigation, ophthalmic emergency

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References


Daftar Pustaka

Jackson, K., 2003. The Evolution of Venom Delivery System in Snakes. Zool. J. Linn. Soc 137, 337-354.

Kardong, K. V., 1996. Snake Toxin and Venoms; an Evolutionary Prespective. Herpetologica, 52 36-46.

Weinstein, S. A., Kardong, K. V., 1994. Properties of Duvernoy’s Secretions from Opisthoglyphous and Aglyphous Colubrid Snakes. Toxicon 32, 1161-1185.

Weinstein, S. A., Smith, T., Kardong, K. V., 2009 Reptile Venom Glands; Form, Function and Future. In: Mackessy, S. P. (Ed.), Handbook of Reptile Venoms and Toxins. CRC Press, Boca Ranton pp. 65-94.

Glikes, M. J., 1959. Snake Venom Conjunctivitis. Br. J. Ophtalmol. 43, 638-639.

Minton, S. A. 1974. Venom Diseases. Thomas, Springfield pp. 235.

Pugh, R. N., Theakston, R.D., Reid, H. A., 1980 Malumfashi Endemic Disease Research Project, XIII. Epidemology of Human Encounters with the Spitting Cobra, Naja nigricollis, in the Malumfashi area of northen Nigeria. Ann. Trop. Med. Parasitol. 74, 523-530.

Ridley, H., 1944. Snake Venom Ophtalmia Br. J. Ophthalmol. 28, 568-572.

Strover, H. M. 1955. Snake Bite and It’s Treatment. Trop. Dis. Bull. 52, 421-426.

Warrel, D. A., Ormerod, L. D., 1976. Snake venom Ophthalmia and Blindness Caused by the Spitting Cobra (Naja nigricollis). Q. J. Med. 45, 1-22.

Westhoff, G., Tzschätszch, K., Bleckmann, H., 2005. The Spitting Behavior of Two Species of Spitting Cobras. J. Comp. Physiol. A. Neurethol. Sens. Neural. Behav. Physiol. 191, 873-881.

Minton Jr., S. A., Minton, M. R., 1980. Venomous Reptiles. Charles Scribner’s Sons, New York, pp. 308.

Young B. A., Boetig, M., Westhoff, G., 2009. Functional Bases of The Spatial Dispersal Venom during Cobra “Spitting”. Physiol. Biochem. Zool. 82, 80-89.

Chu, E. R., Weinstein, S. A., White, J., Warrell, D., A., 2010. Venom Ophthalmia caused by Venoms of Spitting Elapid and Other Snakes: Report of Ten Cases with Review of Epidemiology, clinical features, Pathophysiology and Management. Toxicon 56, 259-272.

Harvey, A. L., 1991. Snake Toxins. Pergamon. New York.

Lee, Y., Chan, S. I., 1977. Effect of Lysolectin on The Structure and Permeability of Lecithin Bilayer Vesicles. Bhiochemistry 16, 1303-1309.

Mebs, D., 2002. Venomous and Poisonous Animals, Medpharm, Stuttgart, pp 339.

Bernheimer, A., W., Weinstein, S. A., Linder, R., 1986. Isoelectric Analysis of Some Australian Elapid Snake Venoms with Special Reference to Phospholipase B and Hemolysis. Toxicon 24, 841-849.

Kao, P. H., Wu, M. J., Chang, L. S., 2008. Membrane Bound Conformation of Naja nigricollis Toxin Gamma Affects Its Membrane Bound Damaging Activity. Toxicon. 53 342-348.

Wang, C.H., Liu, J. H., Lee, S. C., Hsiao, C. D., Wu, W. G., 2006. Glycosphingolipid-Facilitated Membrane Insertion and Internalization of Cobra Cardiotoxin. The Sulfatide Cardiotoxin Complex Structure in a Membrane Like Environment Suggest a Lipid-Dependent Cell-Penetrating Mechanism for Membrane Binding Polypeptides, J. Biol. Chem. 281,656-667.

Grüntzig, J., Lenz, W., Berkemeier, B., Mebs, D., 1985. Experimental Studies on The Spitting Cobra Ophthalmia (Naja nigricollis). Graefes. Arch. Clin. Exp. Ophthalmol. 223, 196-201.

Kanski, J. J., 2007. Clinical Ophthalmology; a Systemic Approach. 6th. Elsevier. New York.

Warrel, D. A., 2010. Guidelies for the Management of Snake-Bites. WHO.




DOI: https://doi.org/10.24815/jks.v16i3.6555

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