Eyes and Ears

Question 1

Conjunctivitis

Answer 1

can be allergic or bacterial

Question 2

Allergic Conjunctivitis drugs

Answer 2

Antihistamines:
❄ cromolyn (Crolom)
❄ azelastine (Optivar)
❄ olopatadine (Patanol)
 all of these are eyedrops
Uses:
☆ allergic conjunctivitis (“red eye”)
☆ Ok for pediatric use >2-4 yr.

Question 3

Bacterial Conjunctivitis Drugs

Answer 3

❄ 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

Question 4

Glaucoma

Answer 4

Increased IOP&raquo_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

Question 5

Open angle glaucoma

Answer 5

“silent thief of sight” gradual, painless, cloudy or blurry vision, decreased peripheral vision

Question 6

Closed angle glaucoma

Answer 6

“emergent” sudden, painful, blurred vision, headache, n/v, possible loss of peripheral vision

Question 7

Danger signs of glaucoma

Answer 7

Blurry vision
 Halos around lights
 Decreased peripheral vision
 Headache and/or eye pain
 most dangerous sign = sudden pain & vision
change

Question 8

Glaucoma evaluation

Answer 8

❄ Tonometer evaluation- patients >40 yr. should be
examined every 2 yr.
❄ If + family history – then every year

Question 9

Beta Blockers for Glaucoma

Answer 9

❄ Decreases IOP by blocking beta receptors&raquo_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

Question 10

Alpha adrenergic drugs for Glaucoma

Answer 10

❄ Used if beta blocker contraindicated or ineffective
❄ Decreases IOP&raquo_space;> decreases aqueous humor
production & constricts pupil
❄ brimonidine (Alphagan B)
❄ Adverse Effects: same as beta blockers
❄ Monitor: same as beta blocker drops
❄ “lifelong therapy”

Question 11

Cholinergic drugs for glaucoma

Answer 11

☆ Decreases IOP&raquo_space;> decreases aqueous
fluid
☆ “dryness”
☆ pilocarpine (Isopto)
☆ Adverse effects:
■ burning, watery eyes, myopia, decreased visual
acuity, HTN, tachycardia

Question 12

Carbonic anhydrase inhibitors for Glaucoma

Answer 12

Inhibits production of carbonic anhydrase&raquo_space;
decreased production of aqueous humor&raquo_space;
decreases IOP
☆ acetazolamide (Diamox)
■ oral medication
☆ brinzolamide (Azopt) & dorzolamide
(Trusopt)
■ eyedrops
☆ Adverse effects: similar to pilocarpine

Question 13

Cataracts risk factors

Answer 13

aging, diabetes, excessive intake of alcohol, excessive sunlight exposure, hereditary, hypertension, overweight

Question 14

Symptoms of cataracts

Answer 14

cloudy or blurred vision, discolored vision, impaired night vision, double vision

Question 15

Cataract treatment

Answer 15

glasses in early stages, surgery to remove

Question 16

Retinal detachment risk factors

Answer 16

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

Question 17

RD S&S

Answer 17

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

Question 18

RD Nursing Care

Answer 18

Bedrest, do not bend forward, avoid excessive movements, no hair washing for 1 week, avoid strenuous activity x3 months

Question 19

Macular degeneration

Answer 19

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

Question 20

dry amd

Answer 20

no bleeding

Question 21

wet amd

Answer 21

bleeding

Question 22

risk factors for amd

Answer 22

family hx, advancing age, lighter eye color, obesity, HTN, smoking, sun exposure, nutrient deficiency

Question 23

dry amd treatment

Answer 23

increased vitamin intake, surgery to implant a telescopic lens in 1 eye; not reversible

Question 24

wet amd treatment

Answer 24

meds to stop growth of abnormal blood vessels, photodynamic therapy, photocoagulation, not reversible

Question 25

diabetic retinopathy

Answer 25

most common cause of new blindness among adults 20-64 (working adults), affects over 5.3 million americans age >18 (2.5%)

Question 26

Risk factors for Diabetic retinopathy

Answer 26

HTN, obesity, renal failure, hyperlipidemia, smoking, anemia, pregnancy and poor glycemic control

Question 27

S&S of Diabetic retinopathy

Answer 27

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

Question 28

Treatment for diabetic retinopathy

Answer 28

laser surgery

Question 29

Conductive Hearing loss

Answer 29

disorder in auditory canal, TM or bones

Question 30

causes of conductive hl

Answer 30

infection, inflammation, foreign body, impacted cerumen, trauma

Question 31

conductive hl treatment

Answer 31

antibiotics, heat, irrigation, ear drops, hearing aid, surgery

Question 32

Sensorineural

Answer 32

disorder in organ of corti, cochlea or acoustic nerve, may lead to vertigo, tinnitus, vomiting

Question 33

sensorineural causes

Answer 33

drug tox, infection, trauma, labyrinth disease

Question 34

combined loss

Answer 34

includes both conductive and sensorineural hl

Question 35

Vertigo

Answer 35

dizziness and head movements, caused by changes in positioning, causes sense of spinning, dizziness, loss of coordination, headache, imbalance, fatigue

Question 36

causes of vertigo

Answer 36

Meniere’s disease, inner ear infection, head/ neck injury, stroke/ tumor, headache, medicines that cause ear damage

Question 37

treatment of vertigo

Answer 37

severe cases require treatment, involves PT, medicine (Meclizine) and surgery

Question 38

Meniere’s disease

Answer 38

caused by dilation of labyrinth membrane

Question 39

meniere’s symptoms

Answer 39

decreased hearing, tinnitus, headache, vertigo,
anxiety, nausea, vomiting
 nystagmus may be present
 can be debilitating & chronic

Question 40

treatment of meniere’s

Answer 40

salt restricted diet, fluid restriction, diuretics, meclizine