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PHAR 1054 > Ears and eyes > Flashcards

Ears and eyes Flashcards

1
Q

Outline the role of the ear

A
  • Hearing organ and helps to regulate balance
  • Consists of three parts, outer
    ear middle ear and inner ear
  • The rigid parts of the inner
    ear called the bony labyrinth
    are involved in balance hence
    the balance/hearing
    condition labyrinthitis
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2
Q

Outline hardened ear wax as an ear condition

A
  • Earwax is a secretion in the auditory canal which protects the ears from dirt and infection and irritation from water.
  • Flakes or crusts of earwax break off and fall out of the ear from time to
    time.
  • Patients with excessive ear wax may find lumps of earwax on their pillow and affects hearing and becomes uncomfortable
  • Older people and people who use hearing aids or earplugs might
    experience worse problems in comparison to the rest of the
    populations
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3
Q

Outline what causes hardened ear wax

A
  • A number of possible causes:
  • Internal factors
  • Excessive ear wax secretion
  • Hairy or narrow auditory canal
  • Age
  • External factors
  • Hearing aid and earplugs
  • Cotton buds!!
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4
Q

Outline signs and symptoms of hardened ear wax

A
  • Earache
  • Reduced or difficulty hearing
  • Itchiness in the ear with temptation to use a cotton bud
  • Dizziness if severe
  • Increased risk of ear infection
  • Ringing or high pitched tone in the ear
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5
Q

Outline when to refer for heardened ear wax

A
  • If a proprietary ear wax softening product hasn’t cleared a blocked ear
    after 5 days
  • If the ear is painful
  • If the sufferer has difficulty hearing
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6
Q

Outline patients likely to be affected from hardened ear wax

A
  • Common in older adults (rare in children)
  • Older adults who may have impaired hearing often don’t notice build
    up of wax. Many cases of conductive hearing loss/impairment are
    caused by excessive wax build up
  • A child may show signs of excessive ear wax by sticking objects in
    their ears out of irritation
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7
Q

Outline 1 treatment option for hardened ear wax

A
  • Oil based wax softeners which claim to soften wax in the ear
  • Assists the natural shedding process
  • Can result in thinner wax that may be cleared from the outer ear by wiping away any residue
  • Not particularly effective and many patients will still require
    mechanical removal by a healthcare professional
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8
Q

Outline a 2nd treatment option for hardened ear wax

A

Chemical softeners
* Ingredients are alkaline and ear wax is slightly acidic
* Both products release gas to aid the break up of wax
* Sodium bicarbonate releases carbon dioxide
* Urea hydrogen peroxide releases oxygen
- Examples include: sodium bicarbonate and urea hydrogen peroxide (Otex express)

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9
Q

Outline a downside of chemical softeners

A
  • Can dry out and
    irritate the auditory canal
  • Some patients find the fizzing sensation upsetting or disorientating
  • Some manufacturers have added glycerine to their drops to aid the
    softening process and to reduce the sensation of dryness and
    irritation
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10
Q

Outline how to use ear drops

A
  • Warm the ear drops before insertion
  • Lay on your side or tilt your head
  • Pull on the outer ear gently to open the ear canal so that it is easier to
    insert the drops
  • Insert drops into the ear canal without the bottle touching the ear
  • Rub the tragus to ensure that the ear drops have reached all the way
    down the ear canal
  • Wait 2-3 minutes for the drops to be absorbed
  • Return to an upright position wiping away any residue that had
    formed at the opening of the ear
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11
Q

Outline lifestyle advice for heardened ear wax

A
  • Using olive oil drops may soften wax and ease its removal
  • Ear candles do not work so don’t waste money
  • Ear wax is natural so aggressive removal can worsen ear health
  • Cotton buds should NEVER be inserted into the ear
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12
Q

Outline otits media as an ear condition

A
  • Patients typically
    experience acute otitis
    media as a result of colds
    and flu, bacterial infections
    and inflammatory
    conditions such as mumps.
  • If the swelling in the middle
    ear becomes too great the
    fluid may escape by
    perforating the ear drum
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13
Q

Outline otitis externa as an ear condition

A
  • Patients who suffer from dermatitis or
    eczema are more likely to experience
    otitis externa
  • Patients who swim a lot are also
    susceptible as water and chemicals in
    swimming pools can strip away ear
    wax and irritate the skin
  • Secondary infection commonly occurs
    due to irritation and damage to the
    skin
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14
Q

Outline what causes otitis media

A
  • Inflammation of the middle ear
  • Fluid can accumulate in the middle
    ear for a number of reasons
  • Sufferers experience throbbing pain in
    one or both ears and it can affect
    hearing
  • Can lead to glue ear which is chronic
    inflammation of the middle ear
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15
Q

Outline what causes otitis externa

A
  • Inflammation of the auditory
    canal
  • Irritation and swelling of the skin
    in the auditory canal which is
    susceptible to secondary
    infection
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16
Q

Outline signs and symptoms of otitis media

A

Pain in the ear which is
throbbing
* Pain may worse with movement
particularly the jaw
* Patients may experience a high
temperature and very young
children may experience
vomiting or diarhoea

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17
Q

Outline signs and symptoms of otitis externa

A
  • Ear canal is itchy and irritated
  • Patient has probably tried to
    releve symptoms by scratching
    or insertion of cotton bud so
    skin trauma possible
18
Q

Outline when to refer for these types of ear pain

A
  • Pain
  • Discharge
  • Impaired hearing
  • Vertigo
  • Tinnitus
  • Deafness
19
Q

Outline patients likely to be addected from ear pain

A
  • Children
  • Rates of otitis media are higher in unvaccinated children
  • Patients with eczema and dermatitis are at greater risk of otitis
    externa
20
Q

Outline how to treat innear ear infections vs outer ear infections

A

INNER
* Antibiotics are not normally
required and do not make much of
a difference to symptoms such as
pain
OUTER
* Effective treatments are available
on prescription:
* antibiotic ear drops – to treat a
bacterial infection
* steroid ear drops – to bring down
swelling
* antifungal ear drops – to treat a
fungal infection
* antibiotic tablets – if your bacterial
infection is severe

21
Q

Outline lifestyle advice for ear pain

A
  • do not stick cotton wool buds or your fingers in your ears
  • use ear plugs or a swimming hat over your ears when you swim
  • try to avoid water or shampoo getting into your ears when you have a
    shower or bath
  • make sure children are up to date with vaccinations
  • Analgesics such as paracetamol or ibuprofen may relieve pain
    symptoms, however patients experiencing pain should be referred to
    their GP
22
Q

Outline the role of the eyes

A
  • The sight organ of the body, is made
    up of two component parts separated
    by the lens
  • The iris is a muscle which control the
    amount of light entering the eye
  • The white of the eye (Sclera) is the
    thicker protective coat which
    maintains the shape of the eye.
  • Infections of the eye usually affect the
    conjunctiva or surrounding structures
23
Q

Outline conjuctivitis as an eye infection

A
  • The conjunctiva is a transparent layer that covers the cornea and sclera
  • Irritation usually occurs first followed by reddening and soreness which is
    exacerbated by rubbing the eye
  • Conjunctivitis can have multiple causes and symptoms may differ slightly
    depending on the cause.
  • The most commonly described symptom by patients is a gritty sensation in
    the eye
24
Q

Outline allergic causes for conjuctivitis

A
  • Irritation of the conjunctiva
    caused by an allergen or irritant
  • Common causes include
  • Cosmetics (eye make up)
  • Chemicals
  • Pollen (associated with hay
    fever)
  • Usually affects both eyes
25
Q

Outline infective causes for conjuctivitus

A
  • Most commonly bacterial infections
    which results in thicker secretions
    which are yellowish in colour
  • Viral conjunctivitis usually results in a
    more watery secretion
  • Eyelids often become stuck together
    during sleep
  • Usually affects one eye first
26
Q

Outline how to treat allergic conjuctivis

A

Allergic
* Avoid causative agents if
identifiable
* Sodium cromoglycate eye drops
are considered effective
* Most witch hazel products do
little more than lubricate
* Vasoconstrictor eye drops
improve appearance but do little
to improve symptoms

27
Q

Outline how to treat infective conjuctivitis

A
  • If bacterial chloramphenicol eye
    drops or ointment are the most
    effective
  • Older agents such as propamidine
    isethionate are less effective but
    still available
  • Viral conjunctivitis should not be
    treated OTC as prescription
    antivirals may be necessary
28
Q

Outline when to refer for conjuctivitis

A
  • pain in your eyes
  • sensitivity to light
  • changes in your vision, like wavy lines or flashing
  • intense redness in 1 eye or both eyes
  • your baby has red eyes – get an urgent appointment if your baby is
    less than 28 days old
  • you wear contact lenses and have conjunctivitis symptoms as well as
    spots on your eyelids – you might be allergic to the lenses
  • your symptoms have not cleared up after 2 weeks
29
Q

Outline 1 treatment option for bacterial/infective conjuctivitis

A

E.g. chloramphenicol 0.5% eye drops or 1% ointment
- Apply one drop every 2 hours for the first 2 days then 4
hourly thereafter. Treatment should continue for five days
even if symptoms improve.
- Ointments should be used 3-4 times daily

30
Q

Outline a 2nd treament option for bacterial/infective conjuctivtis

A

E.g. propamidine isethionate 0.1% or dibromopropamide isetionate
* Apply one to two drops
up to four times a day
* Eye ointments should be
applied once or twice a day

31
Q

Outline 1 treatment option for allergic conjuctivits

A

E.g. sodium cromoglycate, lubricants/witch hazel, vasoconstrictors

32
Q

Outline lifestyle advice for conjuctvitis

A
  • Use clean cotton wool (1 piece for each eye). Boil water and then let it cool
    down before you:
  • gently rub your eyelashes to clean off crusts
  • hold a cold flannel on your eyes for a few minutes to cool them down
  • Do not wear contact lenses until your eyes are better. wash hands regularly with warm soapy water
  • wash pillows and face cloths in hot water and detergent
  • do not share towels and pillows
  • Do not rub your eyes
33
Q

Outline styes as an eye infection and its causes

A
  • A stye is a small, painful lump on or inside the eyelid or around the eye.
  • Surrounding skin is usually
    reddened, swollen and the stye
    may be filled with yellow pus.
    CAUSED BY BACTERIA INFECTING EYELASH FOLLICLE OR EYELID
    COMMON IN PATIENTS WITH BLEPHARITIS
34
Q

Outline signs and symptoms of styes

A
  • A red, hot, exquisitely tender swelling near the edge of the eyelid
  • Inflamed (red and swollen) eyelids
  • Burning or sore eyes
  • Crusty eyelashes
  • Itchy eyelids
35
Q

Outline when to refer for styes and who is likely to be affected

A
  • If the stye is very painful or swollen
  • If the stye does not get better within a few weeks
  • If the stye affects the patients vision
    ANYONE CAN HAVE
  • May develop into chalazion or prespetal cellulitis
36
Q

Outline treatment options for styes

A
  • Products such as dibropropamidine
    isethionate (see conjunctivitis) may be
    used but are of limited benefit.
  • Treatments usually are not
    recommended as they are self limiting
37
Q

Outline lifestyle advice for styes

A
  • Do not try to burst a stye
  • Do not try to remove an infected eyelash yourself.
  • Both actions can spread the infection.
  • wash your face and remove eye make-up before bed
  • replace your eye make-up every 6 months
  • keep your eyelids and eyelashes clean, especially if you have blepharitis
  • do not share towels or flannels with someone who has a stye
  • do not rub your eyes if you have not recently washed your hands
  • do not put contact lenses in before washing your hands
38
Q

Outline blepharitis as an eye condition

A
  • Blepharitis is not usually a
    serious condition, but can lead
    to other problems, such as dry
    eyes and conjunctivitis if it’s
    not treated.
  • It may be triggered by a
    bacterial infection or skin
    condition such as dermatitis
39
Q

Outline signs and symptoms of blepharitis

A
  • sore eyelids
  • itchy eyes
  • a gritty feeling in the eyes
  • flakes or crusts around the roots of the eyelashes
  • red eyes or eyelids
  • eyelids sticking together in the morning when you wake up
40
Q

Outline when to refer for blepharitis

A
  • No response to over-the-counter treatments
  • If there is any sign of ulceration
40
Q

Outline treamtent options for blepharitis

A

Antibacterial eye drops could be recommended if there are signs of an
infection otherwise treatment usually consists of good eye hygiene and
a cleaning regime.

41
Q

Outline lifestyle advice for blepharitis

A
  • Cleaning the eyelids effectively
  • Soak a clean flannel or cotton wool in warm water and place on your eye
    for 10 minutes.
  • Gently massage your eyelids for around 30 seconds.
  • Clean your eyelids using cotton wool or a cotton bud. It might help to use a
    small amount of baby shampoo in water.
  • Clean your eyes every day even if symptoms improve or go away
  • Don’t wear contact lenses whilst symptoms continue
  • Do not use any make up as it could worsen symptoms or could be
    contaminated
  • Don’t use milk, traditional remedy more likely to make the condition
    worse/cause infection

PHAR 1054 (20 decks)

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