Disorders of the Eyes/Ears Flashcards
Variations of Child’s Eye
- visual acuity develops through childhood
- eyeball occupies larger space; more prone to injury
- color discrimination is incomplete
- retinal vascularization incomplete
Variations of Ear
- hearing is intact at birth
- recurrent disorders may affect hearing
- placement of eustachian tubes and enlarged adenoids make ears prone to infection
Common Lab/Diagnostic Tests
- culture of eye/ear discharge
- tympanic fluid culture
- tympanometry
Tympanometry
determines the effusion of the middle ear
Physical Exam of the Eye
- extraocular movement
- pupillary light response and accommodation
- symmetry of corneal light reflex
- presence of red reflex
- age appropriate visual acuity
Common medical treatment for eyes and ears is?
- warm compress
- corrective lenses
- patching
- eye muscle surgery
- pressure-equalizing tubes
- hearing aids
- cochlear implants
Prescription eye glasses may be used for what?
- hyperopia
- myopia
- astigmatism
What can be done to help manage amblyopia?
Strengthening the weaker eye with eye patch or atropine drops in the better eye
What can be done for Strabismus?
- vision therapy
- eye muscle surgery
Types of Infectious Diseases of the Eye
- conjunctivitis
- nasolacrimal duct obstruction
- eyelid lesion
- periorbital cellulitis
Conjunctivitis
“Pink Eye”
- inflammation of the conjunctiva
- bacterial or viral
- allergic or chemical
Risk Factors for Retinopathy
- low birth weight
- early gestational age
- sepsis
- high light intensity
- hypothermia
What is the most common causes of conjunctivitis in the newborn?
Chlamydia or Gonorrhea
Factors Increasing the Risk for Visual Impairment
- prematurity
- developmental delay
- genetic syndrome
- family hx
- African American
- previous injury
- Diabetes, HIV
- Chronic corticosteroid use
S/S of Conjunctivitis
- redness
- edema
- tearing
- discharge
- eye pain
- itching of the eyes
The child can not return to school until when?
They have been on an antibiotic for 24 hours
What two virus are the common causes of viral conjunctivitis?
Adenovirus and influenza
What is the most common cause of bacterial conjunctivitis?
Staphylococcus aureus
What should the nurse teach the parents to do for a child with conjunctivitis?
- encourage not to touch or rub eyes
- rinse eyelids periodically w/ clean washcloth or cool water
- when child comes in from outside wash face and hands
- ensure child showers and shampoos before bed
Nasolacrimal Duct Obstruction
stenosis or simple obstruction of the nasolacrimal du0ct
- common disorder for newborn
- should resolve by 12 months
Periorbital Cellulitis
bacterial infection of the eyelids and tissue surrounding the eye
-via abrasion, laceration, insect bite, foreign body, or lesion
S/S of Periorbital Cellulitis
- hx of fever
- pain around eye/restricted movement
- eyelid edema
- purplish/red color of eyelid
Nursing Management of Periorbital Cellulitis
- warm soaks to eye for 20 mins q 2-4 hours
- antibiotics
- teach when to call physician
What is the most common cause of visual difficulties in children?
Refractive errors
Refractive Errors
when light enters the lens and does not bend appropriately to allow it to fall directly on the retina or when the light focuses in front of the retina
Hyperopia
farsightedness
-blurriness at close range
Myopia
nearsightedness
-may see well at close range but have difficulty focusing on distant objects
Astigmatism
Cornea’s curvature is uneven which results in an irregular quality of vision because light rays are refracted unevenly
Strabismus
misalignment of the eyes
What are the two most common causes of Strabismus?
Exotropia and Esotropia
Exotropia
eyes turn outward
Esotropia
eyes turn inward
Amblyopia
“Lazy Eye”
- poor visual development in otherwise structurally normal eye
- vision in one eye is reduced b/c eye and brain are not working properly together
- develops w/in the first decade of life
If left untreated what is the most common cause of vison loss in children and young adults?
Amblyopia
Nursing Management for Amblyopia
- patching the stronger eye
- atropine drops in stronger eye
- vision therapy
- eye muscle surgery if cause is strabismus
Nystagmus
very rapid, irregular eye movement
“bouncing” of the eyes
What is the most common cause of nystagmus?
neurologic problems
Infantile Glaucoma
autosomal recessive disorder
-obstruction of aqueous humor flow and increased intraocular pressure that results in large, prominent eyes
S/S of Infantile Glaucoma
- infant keeps eyes closed or rubs eyes a lot
- corneal enlargement and clouding
- enlarged appearance of eyes
- photophobia
- tearing or conjunctivitis
- eyelid squeezing or spasm
Nursing Postop Care for Infantile Glaucoma
- protect surgical site
- maintain bed rest
- distraction methods
- teach to avoid contact sports for 2 weeks
Congenital Cataract
opacity of the lens of the eye that is present at birth
S/S of Visual Impairment in Infant
- does not “fix and follow”
- does not make eye contact
- unaffected by bright light
- does not imitate facial expression
S/S of Visual Impairment of Toddler and Older Child
- rubs, shuts, and covers eyes
- squints and blinks frequently
- holds object close or sits close to TV
- bumps into objects
- displays head tilt or thrust forward
Otitis Media
illness in children resulting from infection of fluid in middle ear
What are common complications of Otitis Media
- hearing loss
- expressive speech delay
- tympanosclerosis
- tympanic membrane perforation
- chronic drainage
- acute mastoiditis
- intracranial infections
S/S of Otitis Media
- fever
- ear pain
- irritability
- crying inconsolably
- tugging at ear
- poor feeding
- lethargy
- difficulty sleeping
- drainage
Otitis Media w/ Effusion
presence of fluid w/in the middle ear w/o signs or symptoms of infection
Risk Factors for OME
- passive smoking
- absence of breastfeeding
- frequent viral URI
- allergy
- young age
- male
- eustachian tube dysfunction
- congenital tube disorders
What is the standard treatment for persistent or problematic OME?
Surgical insertion or pressure-equalizing tubes
Otitis Externa
an infection and inflammation of the skin of the external ear canal
“swimmers ear”
Normal Level of Hearing
0-20
Mild Hearing Loss
20-40
Moderate Hearing Loss
40-60
Severe Hearing Loss
60-80
Profound Hearing Loss
Greater than 80
Types of Delayed-Onset Hearing Loss
- Conductive hearing loss
- Sensorineural hearing loss
- Mixed hearing loss
Conductive Hearing Loss
results when transmission of sound through the middle ear is disrupted, as in OME
Sensorineural Hearing Loss
Caused by damage to the hair cells in the cochlea or along the auditory pathway
Mixed Hearing Loss
Occurs when the cause may be attributed to both conductive and sensorineural problem
Types of Eyelid Disorders
- Hordeolum
- Chalazion
- Blepharitis
