LAPORAN KASUS : KERATOKONJUNGTIVITIS GONOKOKAL
DOI:
https://doi.org/10.31004/prepotif.v9i3.51290Keywords:
glaukoma sekunder, kegawatdaruratan oftalmologi, keratokonjungtivitis gonokokal, neisseria gonorrhoeaeAbstract
Keratokonjungtivitis gonokokal merupakan infeksi okular hiperakut yang disebabkan oleh Neisseria gonorrhoeae. Bakteri ini memiliki kemampuan menembus epitel kornea dan konjungtiva yang utuh, menimbulkan inflamasi berat dan destruksi jaringan dalam waktu singkat. Penyakit ini tergolong kegawatdaruratan oftalmologis karena dapat menyebabkan ulserasi, perforasi kornea, hingga kebutaan permanen bila tidak segera ditangani. Laporan ini bertujuan untuk memaparkan kasus keratokonjungtivitis gonokokal pada pasien dewasa dengan komplikasi glaukoma sekunder inflamasi, guna menekankan pentingnya diagnosis dini dan terapi agresif berbasis pedoman terkini. Seorang perempuan berusia 58 tahun datang dengan keluhan nyeri hebat, kemerahan, dan sekret purulen melimpah pada mata kiri sejak satu minggu. Pemeriksaan slit-lamp menunjukkan kornea keruh dengan fluoresens positif dan peningkatan tekanan intraokular sebesar 48 mmHg. Hasil apusan sekret memperlihatkan diplokokus gram negatif intraseluler dan ekstraseluler. Diagnosis ditegakkan sebagai keratokonjungtivitis ec. Neisseria gonorrhoeae disertai glaukoma sekunder inflamasi. Pasien diberikan terapi sistemik ceftriaxone 1 g intravena setiap 12 jam, antibiotik topikal levofloxacin tetes mata tiap dua jam, serta irigasi mata dengan campuran Ringer Laktat dan betadine (5:1). Timolol tetes mata setiap 12 jam diberikan untuk menurunkan tekanan intraokular. Setelah tiga hari terapi, pasien menunjukkan perbaikan signifikan berupa berkurangnya nyeri, sekret, dan penurunan tekanan intraokular menjadi 25 mmHg. Keratokonjungtivitis gonokokal merupakan infeksi destruktif yang membutuhkan diagnosis cepat dan terapi sistemik intensif untuk mencegah komplikasi ireversibel. Kombinasi antibiotik parenteral dosis tinggi, terapi topikal intensif, serta pengendalian tekanan intraokular secara ketat menjadi kunci keberhasilan penatalaksanaan.References
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