Eyes and Ears Flashcards
Conjunctivitis
can be allergic or bacterial
Allergic Conjunctivitis drugs
Antihistamines:
❄ cromolyn (Crolom)
❄ azelastine (Optivar)
❄ olopatadine (Patanol)
all of these are eyedrops
Uses:
☆ allergic conjunctivitis (“red eye”)
☆ Ok for pediatric use >2-4 yr.
Bacterial Conjunctivitis Drugs
❄ ciprofloxacin (Ciloxan)
❄ levofloxacin (Quixin)
❄ ofloxacin (Ocuflox)
❄ tobramycin (Tobrex)
❄ tobramycin with dexamethasone (Tobradex)
☆ contains steroid - not recommended for kids <12
most of these are available as eyedrops &
ointment
Glaucoma
Increased IOP»_space;> Damage to Optic Nerve (CN II)
Leading cause of blindness
Normal IOP = 8-20 mmHg
Higher Risk = diabetics, HTN, African-Americans, > 40 yr.
Can be hereditary
Open angle glaucoma
“silent thief of sight” gradual, painless, cloudy or blurry vision, decreased peripheral vision
Closed angle glaucoma
“emergent” sudden, painful, blurred vision, headache, n/v, possible loss of peripheral vision
Danger signs of glaucoma
Blurry vision
Halos around lights
Decreased peripheral vision
Headache and/or eye pain
most dangerous sign = sudden pain & vision
change
Glaucoma evaluation
❄ Tonometer evaluation- patients >40 yr. should be
examined every 2 yr.
❄ If + family history – then every year
Beta Blockers for Glaucoma
❄ Decreases IOP by blocking beta receptors»_space;>
decreased production of aqueous humor &
increases drainage
❄ timolol maleate (Timoptic)
❄ betaxolol (Betoptic)
❄ Administer: BID “lifelong therapy”
❄ Adverse Effects: burning, stinging
❄ Monitor: for systemic effects that may affect HR, BP, etc
Alpha adrenergic drugs for Glaucoma
❄ Used if beta blocker contraindicated or ineffective
❄ Decreases IOP»_space;> decreases aqueous humor
production & constricts pupil
❄ brimonidine (Alphagan B)
❄ Adverse Effects: same as beta blockers
❄ Monitor: same as beta blocker drops
❄ “lifelong therapy”
Cholinergic drugs for glaucoma
☆ Decreases IOP»_space;> decreases aqueous
fluid
☆ “dryness”
☆ pilocarpine (Isopto)
☆ Adverse effects:
■ burning, watery eyes, myopia, decreased visual
acuity, HTN, tachycardia
Carbonic anhydrase inhibitors for Glaucoma
Inhibits production of carbonic anhydrase»_space;
decreased production of aqueous humor»_space;
decreases IOP
☆ acetazolamide (Diamox)
■ oral medication
☆ brinzolamide (Azopt) & dorzolamide
(Trusopt)
■ eyedrops
☆ Adverse effects: similar to pilocarpine
Cataracts risk factors
aging, diabetes, excessive intake of alcohol, excessive sunlight exposure, hereditary, hypertension, overweight
Symptoms of cataracts
cloudy or blurred vision, discolored vision, impaired night vision, double vision
Cataract treatment
glasses in early stages, surgery to remove
Retinal detachment risk factors
diabetes, eye trauma, aging, previous retinal detachment in 1 eye, family hx, myopia, previous eye surgery, previous severe eye injury, previous other eye disease or inflammation
RD S&S
flashes of light, sudden dramatic increase in the number of floaters, ring of floaters or hairs just to the temporal side of the central vision, dense shadow starting peripherally and slowly progressing centrally, veil or curtain over the field of vision, straight lines appear curved, central vision loss if full RD
RD Nursing Care
Bedrest, do not bend forward, avoid excessive movements, no hair washing for 1 week, avoid strenuous activity x3 months
Macular degeneration
loss of macular function from the degenerative changes of aging (macula is responsible for sharp central vision), two types: wet and dry AMD, root causes are unknown
dry amd
no bleeding
wet amd
bleeding
risk factors for amd
family hx, advancing age, lighter eye color, obesity, HTN, smoking, sun exposure, nutrient deficiency
dry amd treatment
increased vitamin intake, surgery to implant a telescopic lens in 1 eye; not reversible
wet amd treatment
meds to stop growth of abnormal blood vessels, photodynamic therapy, photocoagulation, not reversible
diabetic retinopathy
most common cause of new blindness among adults 20-64 (working adults), affects over 5.3 million americans age >18 (2.5%)
Risk factors for Diabetic retinopathy
HTN, obesity, renal failure, hyperlipidemia, smoking, anemia, pregnancy and poor glycemic control
S&S of Diabetic retinopathy
early stages often don’t have symptoms, late stage symptoms include- floaters, blurred vision, vision that changes periodically from blurry to clear, blank or dark areas in visual field, poor night vision, colors appear washed out or different, vision loss
Treatment for diabetic retinopathy
laser surgery
Conductive Hearing loss
disorder in auditory canal, TM or bones
causes of conductive hl
infection, inflammation, foreign body, impacted cerumen, trauma
conductive hl treatment
antibiotics, heat, irrigation, ear drops, hearing aid, surgery
Sensorineural
disorder in organ of corti, cochlea or acoustic nerve, may lead to vertigo, tinnitus, vomiting
sensorineural causes
drug tox, infection, trauma, labyrinth disease
combined loss
includes both conductive and sensorineural hl
Vertigo
dizziness and head movements, caused by changes in positioning, causes sense of spinning, dizziness, loss of coordination, headache, imbalance, fatigue
causes of vertigo
Meniere’s disease, inner ear infection, head/ neck injury, stroke/ tumor, headache, medicines that cause ear damage
treatment of vertigo
severe cases require treatment, involves PT, medicine (Meclizine) and surgery
Meniere’s disease
caused by dilation of labyrinth membrane
meniere’s symptoms
decreased hearing, tinnitus, headache, vertigo,
anxiety, nausea, vomiting
nystagmus may be present
can be debilitating & chronic
treatment of meniere’s
salt restricted diet, fluid restriction, diuretics, meclizine
