Eye/Ear- Unit 5 Flashcards
What happens with a refraction error?
The eyeball is shortened or elongated - it’s doing something wrong.
Hyperopia - def
farsightedness (can’t see near)
Myopia - def. What age?
nearsightedness (can’t see far) Up to age 30 is normal.
Presbyopia - def. What age?
bifocals (asymmetrical corneal surface) - typically after the age of 40. It’s basically farsightedness just for older people.
Refraction - def
how the light gets bent.
Cataracts - normal age ___ and up.
60.
Macular Degeneration - normal age ___ and up.
65
Astigmatism - def
asymmetrical infraction (light focused in different areas)
What are some eye changes associated with aging?
Arcus senilis (hazy white ring around the cornea), decreased corneal transparency, decreased ability to tolerate glare, decreased night vision and color vision, decreased eye muscle ton, and dry eye (might need eye drops!)
What are some assessment questions we ask for the eyes?
Onset, duration, cause, treatment of problem
What are two of the most common eye problems?
Visual changes and eye pain (ask questions about the kind of pain, etc.)
What are some eye history questions?
Family history, psychosocial history (drugs, chemicals, fumes, lifestyle), past medical history (diabeetus, HTN, asthma, CV problems), past eye history, etc.
What’s the ishihara chart?
Colorblindness, where there’s a bunch of dots and a different color in the middle and you say what that thing is.
Legal blindness - best acuity with correction is __/__ or less OR widest diameter of visual field no greater than __ degrees.
20/200 —- 20 degrees.
Totally blind vs. functionally blind - differences?
Totally = can’t see any light at all.
Functionally blind = can see some light.
Unilateral blindness - def
Blind in one eye.
Bi-temporal hemianopsia - def
Blind in the outer half of both eyes.
Right homonymous hemianopsia - def
Blind in the right halves of the eye.
Left homonymous hemianopsia - def
blind in the left halves of the eyes.
Diplopia - def
Double vision.
Photophobia - def
Discomfort with exposure to light.
Floaters - def
Small black dots seen against a light background.
Photopsias - def
flashing lights, halos around lights.
Dyschromatopsias - def
Abnormal color vision.
Nyctalopia - def
Night blindness.
Hemeralopia - def
day blindness.
Does diabetes put you at great risk for visual changes?
YES
should older patients with visual problems have adequate, non-glare lighting in their rooms?
YES
What is blepharitis?
Inflamed, itchy and red eyelid. Greasy scales on brows and lids. You have decreased tear formation with this!
Entropion - def
eyelid growing in.
Ectropion - def
eyelid growing out.
Hordeolum - def
stye! Puss filled and usually unilateral.
Chalazion - def
chronic stye - redness, swelling, painless- - - - antibiotics needed to clear up the infection.
What is conjunctivitis?
infection of the conjunctiva.
Bacterial conjunctiva =
pink eye!
What is a conjunctival hemorrhage?
Small defined area of bright red hemorrhage under conjunctiva, no pain, visual impairment - usually clears up within 14 days.
What is a trachoma?
Chronic bilateral scarring form of conjunctivitis - caused by chlamydia trachomatis, chief cause of preventable blindness - spread by mosquito bites in third world countries.
What are cataracts?
Complete or partial opacity of the lens/clumps of protein. Visual acuity is decreased.
What are some risk factors for cataracts?
Aging, congenital issues, trauma, toxins, excessive exposure to the sun, chronic steroid use.
What are some symptoms of a cataract - early vs. late.
Early - blurred vision and poor color vision.
Late - diplopia, decreased acuity progressing to blindness, milky white eye appearance.
How do we diagnose cataracts?
Absence of red reflex and slit lamp.
What is part of the surgical correction for cataracts?
They take the lens out and replace it.
Pre-op cataract surgery, what do we do?
Dilate pupils, decrease intraoptic pressure (Diamox - Acetazolamide), anitbiotic drops, etc.
Mydriotic drugs - ___ pupils.
Myotic drops - ___ pupils.
Mydriotic - dilate.
Myotic - constrict.
Post cataract surgery - what can’t they do?
No BBSF - bending, blowing, sucking, or fucking - of any kind, ;)
If there are complications post cataract surgery, what will they be?
Vision changes, redness, infection, etc.
What is glaucoma?
Group of disorders characterized by an increase in intraocular pressure and progressive loss of vision.
Glaucoma - is there increased pressure?
Yes, increased aqueous humor pressure. It damages the optic nerve!
What are the two types of primary glaucoma?
Acute (closed angle glaucoma - angle between the iris and sclera and decreased) - RAPID increased in IOP.
Chronic - open angle glaucoma (angle between the iris and sclera is normal) - gradual increase in IOP.
What are some risk factors for glaucoma?
Age, diabetes, HTN, family history, retinal detachment.
Pressure of eyeball - needs to be below 21,200. T/F?
NO, 21.2!
What are some symptoms of glaucoma?
Increased IOP, visual changes, eye pain, photophobia, seeing colored halos around lights, N/V
Is acute glaucoma a medical emergency?
Yes
What are some meds to decreased IOP?
Prostaglanding analogs (Xalatan, Lumigant), Opthalmic Beta-adrenergic blocking agents (betalol, ocupress, timoptic), carbonic anhydrase inhibitors (diamox, trusopt), parasympathomimetics (epi), IV mannitorl, ocular steroid
How do we treat chronic glaucoma?
GIve meds that decreased IOP, avoid anticholinergic meds, report eye pain, halos - a trabeculoplasty might help.
OS = left eye. OD = right eye. OU = bilateral. T/F?
True
What is a retinal detachment?
Separation of the retina from the choroid due to fluid or tumor.
Is nearsightedness a risk factor for retinal detachment?
YES
What are symptoms of retinal detachment?
Gradual or sudden flashes of lights, loss of portion of visual field, floaters, increase in blurred vision, “curtain being drawn down” (This is Amaurosis Fugax - also a sign of stroke!)
How do we treat retinal detachment?
Cryotherapy (cold therapy), heat therapy, drainage of fluid, scleral buckling (put a band around the eyeball), stuff to decrease the inflammation, basically.
What is AMD?
Age-related macular degeneration - most common cause of central vision loss in clients over age 40.
What are symptoms of AMD?
Blurred, darkened vision, presence of scotomas, distortion of vision, etc.
What is wet-exuate vs dry non-exudate (for glaucoma).
Wet - more severe and very abnormal blood vessels, so they leak.
Dry - more common - accumulation of yellow pigment/scar tissue.
What is otalgia?
Ear pain.
What is otorrhea?
Drainage.
What is tinnitus?
Ringing in ears.
Can aspirin cause hearing loss?
YES
Rinne test - goes on the __ bone.
Mastoid.
What is conductive hearing loss?
Sound does not travel through the inner ear - Weber test shows more volume in affected ear.
Sensorineural - sound distorted by defect in the inner ear. T/F?
True (weber - unaffected ear hears better).
What is meniere’s syndrome?
Dilation of the endolymphatic system by either overproduction or decreased reabsorption of endolymphatic fluid
Meniere’s S/S’s?
Dizziness, progressive hearing loss, etc, Vertigo, Nausea, ataxia, nustagmus, etc.
What are some treatment options for meniere’s?
Atropine, sedative, diuretics, mexlizine hydrochloride for motion sickness, niacin, SAFETY RISK SAFETY RISK!!!!
Older people have a risk for high frequency hearing loss. T/F?
True!
