Hearing & Vision

Question 1

Age-related changes to hearing

Answer 1

• Degenerative changes in inner ear
• Narrowing of auditory meatus from bone apposition (everything is collapsing)
• Diminished blood supply
• CNS changes

Question 2

Effects on communication

Answer 2

High frequency tones decline in early adulthood making it harder to hear words rich in sibilants (whistling quality like ch, f, g, s, sh, t, th, z). Vowels become easier to discern than consonants

Question 3

Risk Factors that Affect Hearing

Answer 3

• male gender
• aging
• exposure to noise (NIHL: noise induced hearing loss)
• impacted cerumen
• smoking
• ototoxic medications

Question 4

3 categories of hearing loss

Answer 4

Prelingual (happens before a child can speak)
Postlingual (happens after a child can speak around age 6)
Presbycusis (age-related degeneration of auditory structures)

Question 5

Age-related changes to Vision

Answer 5

• the eye looks different in appearance due to arcus senilis (circle of fat around cornea), loss of orbital fat and diminished elasticity of eyelid muscle
• diminished tear production
• degenerative changes of all eye structures, neural pathways, and visual cortex of the brain

Question 6

Health Promotion activities for Vision

Answer 6

Nursing assessment with vision screening tests, risk factors that affect vision, influence of vision changes on ADLs, attitudes about exams, low-vision aids, and preventative measures

Illumination, Glare Control and Dark/Light Adaptation
- position a soft white light bulb close to the head of an OA
- use clear plastic shower curtains to let all the light in
- use light coloured window curtains to eliminate glare
- nightlights
- illuminated light switches
- good lighting in stairways

Colour Contrast
- coloured tape on stair edges
- light and dark coloured cutting boards and choose to contrast with foods
- pens with black instead of blue ink

General Adaptive Measures and Environmental Modifications
- Do not rearrange furniture without informing or showing the OA
- Taking pauses in doorways when lighting changes so eyes can adjust
- Probe curbs, steps, edges with hands and feet

Question 7

Effects of age-related changes on vision

Answer 7

• Diminished depth perception and loss of accommodation/presbyopia
• Diminished acuity
• Delayed dark and light adaptation
• Increased glare sensitivity
• Reduced visual field
• Altered colour vision
• Diminished ability to perceive flashing lights
• Slower visual information processing

Question 8

Pathologic Conditions Affecting Vision

Answer 8

• Cataracts - (treatable)
• Age-related macular degeneration (AMD) - leading cause of severe vision loss, blurry middle section of vision (untreatable)
• Glaucoma: loss of peripheral vision leading to blindness if untreated

Question 9

3 kinds of glaucoma

Answer 9

Chronic (open-angle) - most common form (90%)
- starts early as poor vision in dim lighting and progresses to headaches, poor peripheral vision, halos around light
- treatable with meds or laser surgery

Normal Pressure Glaucoma
- optic nerve is damaged to an unknown cause
- treatable with meds or laser surgery

Acute Angle-Closure Glaucoma
- less common
- drainage blocked from high pressure build up
- emergency
- severe eye pain, blurred vision, headache
- must be treated quickly with meds or laser surgery