Retrobulbar tumors in Indonesia

The field of medicine in Indonesia like the nation itself, is involved in the current process of development. Within the scope of the national health system, infectious diseases are still a major killer (1980) (Sistim Kesehatan Nasional, 1982). In comparison, the number of deaths due to cardiovascular diseases, cancer, degenerative diseases, and accidents is fairly low. Nevertheless, as a cause of death, the latter will play a prominent role in the decades to come. Among the eye and orbital diseases, several types of neoplasms may occur. Since visual ability is vital in man, ophthalmologists in Indonesia should not only be concerned about prevention of death in such cases, but more than that, they have to preserve vision as well. The total number of neoplasm patients treated in the Department of Ophthalmology of the University of Indonesia, at Dr. Cipto Mangunkusumo Hospital, Jakarta, reflects the above tendency. 0.59% of all the eye patients treated in 1982 were suffering from tumors (Moeloek et al., 1983), while in the Department of Ophthalmology at Dr. Sutomo Hospital in Surabaya Rajamin found a frequency of 0.50% for tumor cases in 1977 (Rajamin, 1978). Even though the incidence of tumor cases remains low as regards the frequency of blindness, the neoplasm must definitely be taken seriously as regards the incidence of mortality. From the analysis above it is clear that the problem of tumors should not just be passed over lightly. the specific issues discussed here are based on data over a period of five years (1979-1983) obtained in two of the major public service hospitals in Indonesia and it can be concluded that there are a variety of types of retrobulbar tumors. In addition to this variety of tumors, most patients came only for treatment after they had already become partially blind. the frequency of blindness in tumor cases is, therefore, unusually high and increases the problems involved in diagnosis and treatment.