Ear & Eye Conditions Flashcards
1
Q
Eye Anatomy Overview: Sclera, Cornea, and Conjunctiva
A
- Sclera - White outer layer of the eye.
- Cornea - Clear outer layer of the eye covering the iris and pupil.
- Conjunctiva - mucous membrane that lines the inner surfaces of the eyelids and folds back to cover the front surface of the eyeball, except for the cornea (protection)
2
Q
Eye Anatomy Overview: Iris and Pupil
A
- Iris - Colored contractile membrane between the lens and the cornea, separates the anterior and posterior chambers.
- Pupil - Opening at the center of the iris.
3
Q
Eye Anatomy Overview: Anterior Chamber, Posterior Chamber, Vitreous Chamber
A
- Anterior Chamber - Compartment between the cornea and iris.
- Posterior Chamber - Compartment between the iris and lens.
- Vitreous Compartment - Large compartment behind the posterior compartment, contains vitreous humor.
4
Q
Eye Anatomy Overview: Retina, Lens, and Optic Nerve
A
- Retina
~ Innermost covering of the vitreous
compartment.
~ Contains sensors for light. - Lens - Found behind the iris, focuses images on the retina.
- Optic Nerve - Transmits sensory visual
information to the brain.
5
Q
Glaucoma
A
- Condition that can damage the eye’s optic nerve and result in vision loss and blindness.
- Aqueous Humor
~ Fills the eye chambers.
~ Produced in the posterior chamber.
~ Aqueous humor flows continuously in
and out of the anterior chamber to
nourishes lens and cornea and
maintain eye shape
~ Humor leaves the anterior chamber
at the open angle where the cornea
and iris meet.
~ When the fluid reaches the angle, it
flows through a spongy meshwork,
like a drain, and leaves the eye via the
venous system.
6
Q
Glaucoma: Cause
A
- When humor reaches the angle it passes too slowly through the meshwork drain and the humor builds-up.
- Open Angle - Abnormalities in the meshwork
- Closed Angle - Angle is obstructed by the iris
- As the fluid builds up, the pressure inside the eye rises to a level that may damage the optic nerve
7
Q
Glaucoma: S&S
A
- At first no symptoms
~ It causes no pain
~ Vision stays the same - Lose their peripheral vision
- Condition can be painful in later stages
8
Q
Glaucoma: Management
A
- Medicines - Cause the eye to make less humor or lower pressure by helping fluid drain from the eye
- Laser Surgery - Evenly spaced burns that expand the drainage holes in the meshwork.
- Conventional Surgery - Small piece of tissue is removed to create a new channel for the fluid to drain from the eye
9
Q
Corneal Abrasion: Cause & Diagnosis
A
- Cause
~ Trauma
~ Removal of foreign object
> Pt thinks there’s something in eye
so they try to dig it out causing
abrasion - Diagnosis
~ Fluorescein dye introduced eye
~ Dye stains the abrasion a bright green
10
Q
Corneal Abrasion: S&S and Management
A
- S&S
~ Severe pain
~ Watering of the eye
~ Photophobia (light sensitivity) - Management
~ Patching/Contact Lens
> “Bandaid” : protects abrasion from
rubbing against the eyelid
~ Topical NSAIDs
~ Topical antibiotics
11
Q
Globe Rupture/Laceration: Cause
A
- Penetration of sharp objects
- Direct blow
- Results in the complete tear of sclera or cornea
12
Q
Globe Rupture/Laceration: S&S and Management
A
- S&S
~ Severe Pain
~ Impaired Vision
~ Irregular/Displaced Pupil
~ Orbital Leakage - Management
~ Activate EMS
~ Cover eye without pressure
> Round/cupped covering that won’t
press eye
~ Position supine or upright
13
Q
Hyphema: Cause and Major Complications
A
- Collection of blood in the anterior chamber
- Cause
~ Direct, contusive forces cause
mechanical tearing of the fragile blood
vessels of the iris. - Major Complications
~ Glaucoma
> Increased pressure
> Blood clogs draining system
~ Blood staining of the cornea
14
Q
Hyphema: S&S and Management
A
- S&S
~ Reddish tinge in the anterior chamber
changing to blood settling inferiorly.
~ Partial or total vision block.
~ Painful - Management
~ Immediate Referral
~ Bed rest with head and shoulders
elevated
~ Medication to reduce pressure in the
anterior chamber.
~ Should resolve ≤ 5 Days
15
Q
Subconjunctival Hemorrhage: Cause and S&S
A
- Cause
~ Direct, contusive forces cause
mechanical tearing of the blood
vessels under the conjunctiva. - S&S
~ Red, bloody patch on the white of the
eye
~ Painless
~ No change in vision
16
Q
Retinal Detachment: S&S and Management
A
- Any separation of the retina from the underlying tissue
- S&S
~ Light Flashes
~ “Wavy,” or “Watery” Vision
~ Veil or Curtain Obstructing Vision
~ Shower of floaters that resemble
spots, bugs, or spider webs
~ Sudden decrease of vision
~ Very abnormal and obvious - Management
~ Immediate Rest/Eye Patch
~ Immediate Referral
17
Q
Types of Retinal Detachment: Tear
A
- Tear in the retina allows humor to seep underneath, causing retina to separate
- Usually due to traumatic injury
~ Boxing, MMA, martial arts, etc
18
Q
Types of Retinal Detachment: Strands of…
A
- Strands of scar tissue grow into retina and create traction, pulling it loose
- Complication of disease
~ Diabetes
~ Sickle cell anemia - Complication of Trauma
19
Q
Types of Retinal Detachment: Exudate
A
- Exudate collects underneath the layers of the retina, causing it to separate from the back of the wall of the eye
- Tumor growth
- Any eye disease that causes inflammation
20
Q
Conjunctivitis (Pink Eye): Causes and General Management
A
- Inflammation of the conjunctiva
- Causes
~ Viral infection
~ Bacterial infection
> Staph
> Strep
~ Allergic reaction - General Management
~ Disinfect surfaces such as doorknobs
and counters with diluted bleach
solution.
~ Don’t swim (some bacteria can be
spread in the water).
~ Avoid touching the face.
~ Wash hands frequently.
~ Don’t share towels or washcloths.
~ Avoid shaking hands.
21
Q
Viral Conjunctivitis: S&S
A
- Watery discharge (exudate)
- Irritation
- Red Eye
- Infection usually begins with one eye,
but may spread easily to the other eye. - Can be caused by herpes
22
Q
Viral Conjunctivitis: Management
A
- Cool compresses and artificial tears to soothe eye.
- Antivirals not typically used unless herpes infection is suspected
- Non-steroidal topical steroid drops may be prescribed to reduce the discomfort from inflammation.
~ Steroidal drops in more extreme
cases.
~ Sometimes combined with antibiotic
because viral infection increases
likelihood of secondary bacterial
infection. - Viral conjunctivitis usually resolves within 3 weeks.
23
Q
Bacterial Conjunctivitis: S&S
A
- Stringy discharge that may cause the lids to stick together, especially after sleeping
- Swelling of the conjunctiva
- Redness
- Tearing
- Irritation and/or a gritty feeling
- Usually affects only one eye, but may spread easily to the fellow eye.
24
Q
Bacterial Conjunctivitis: Management
A
- Cool compresses and artificial tears to soothe eye and clear debris.
- Treated with antibiotic eye drops or ointments
25
Q
Allergic Conjunctivitis: S&S
A
- Usually affects both eyes.
- Itching
- Tearing
- Swollen Eyelids
26
Q
Allergic Conjunctivitis: Management
A
- Cool compresses and artificial tears to soothe eye.
- Non-steroidal anti-inflammatory medications and antihistamines
- Chronic cases may require topical steroid drops.
27
Q
Ear Anatomy Overview: External Ear, Middle Ear, and Internal Ear
A
- External Ear
~ Auricle
~ Ear Canal
~ Outer Layer of Tympanic Membrane - Middle Ear
~ Tympanic Membrane
~ Ossicles
~ Tympanic Cavity - Internal Ear
~ Cochlea
~ Semicircular Ducts
28
Q
Auricular Hematoma: Cause and Management
A
- Formation of a hematoma between the cartilage of the ear and the Connective Tissue covering the cartilage
- Cause
~ Repeated shearing forces - Management
~ Ear Guard Use
~ Application of friction reducing agent.
(Skin lube or Vaseline)
~ Donut Pad
~ Prevention of scar tissue formation.
> Aspiration
> Pressure dressing
29
Q
Otitis Externa (Swimmer’s Ear): Cause
A
- Inflammation of the ear canal between the ear drum and the outside of the ear
- Cause
~ Bacterial or fungal infection.
~ Often occurs when water removes the
protective ear wax.
> Excessive ear wax can trap
organisms in the ear canal and
cause OE, as well
~ Can also develop in the ear canal if
injured by putting finger or some
other object in ear (causes abrasion)
30
Q
Otitis Externa (Swimmer’s Ear): S&S and Management
A
- S&S
~ Itching
~ Pain/pain with Movement
~ Ear Feels Plugged
~ Diminished Hearing
~ Discharge - Management
~ Referral to rule out more serious
problem.
~ Ear drops to make ear environment
more acidic to kill bacteria.
~ Antibiotics - if bacterial
31
Q
Otitis Externa (Swimmer’s Ear): Prevention
A
- Dry ears thoroughly.
- Avoid excess cleaning of ears.
- Avoid putting obiects in ears
- Use drops of solution containing boric acid and alcohol to kill bacteria and dry the ear
32
Q
Otitis Media (Middle Ear Infection): Cause
A
- Inflammation of the area behind the tympanic membrane in the middle ear, results in fluid accumulation
- Cause
~ Bacterial or viral infection
~ Organisms enter through the
eustachian tube
> Tube runs to the nasopharynx.
> Evens pressure behind tympanic
membrane.
> Tube becomes blocked and
pathogen is trapped
• Blockage many times associated
with URI - More serious than Swimmer’s Ear because it affects balance/proprioception and won’t be able to hear
33
Q
Otitis Media (Middle Ear Infection): S&S and Management
A
- S&S
~ Intense pain in the ear/no pain with
movement
~ Discharge due to possible membrane
rupture
~ Diminished hearing
~ Fever
~ Fatigue - Management
~ Treat symptoms
~ Anti-biotic if bacterial
~ Orally so it can reach it
34
Q
Rupture of Tympanic Membrane: Cause
A
- Otitis Media
~ When the infection causes a build up
of pus or fluid in middle ear
> Can cause eardrum to burst
~ Pathology or inflammatory response
can damage membrane - Injury and Sudden Pressure Changes
~ Cleaning Ears
~ Blow to the Ear
~ Severe Pressure or Suction
> Sudden Altitude or Air Pressure
Changes
> Swimming or Diving
> Nearby Explosion
35
Q
Rupture of Tympanic Membrane: S&S and Management
A
- S&S
~ Loud “Pop”
~ Hearing Loss
~ Pain - Management
~ Protection
~ Referral
~ Surgical Repair - If small enough can heal itself
36
Q
Otoscope Exam
A
- Best way to see/diagnose is to stick a camera in ear
- Normal
~ Canal clear, although some wax
normal. Wax should not occlude more
than 50% of membrane
~ Color of membrane should be pearly
grey and translucent - Abnormal
~ Otitis Media (air bubbles = fluid build
up)
~ Excessive Wax
~ Exostosis (abnormal bone growth)
~ Perforation (hole)
