Lecture 3- Eyes and Ears Flashcards
what causes decreased color vision?
Decreased function of rods and cones
What causes decreased light and adaptation to light?
Decreased pupillary size and reflex
WHat happens to the cornea as you age?
Loss of endothelial integrity
Posterior surface pigmentation
What happens to the lens?
Increased size and density leading to cataracts
What leads to presbyopia?
lens sclerosis
How are tear secretion affected with age?
Decreased tearing (especially postmenopausal women) Decreased lacrimal gland function Decreased goblet cell (mucous) secretion
What direction do elderly have difficulty gazing ?
Upward and maintaing convergence
Optic neuropathy characterized by increased intraocular pressure (>21 mmHg) and destruction of retinal ganglion cells
Glaucoma
Type of glaucoma with Filtration angle remains open, but drainage of aqueous humor is impaired
open-angle
signs and symptoms of open angle glaucoma
Gradual loss of peripheral vision. Advances to tunnel vision
Fundoscopic changes, increased cup to disc ratio
type of glaucoma where Filtration angle narrows, blocking drainage of aqueous humor
Closed-angle glaucoma
Signs and symptoms of closed angle glaucoma
Blurred vision, halos around objects
Painful, red eye
Nonreactive pupil in mid-dilation
Cloudy cornea
Clouding and thickening of the lens resulting in visual impairment
Senile cataracts
Signs and symptoms of cataracts
Temporary shift toward nearsightedness
Decreased visual acuity, increased glare
Yellow-brown pigmentation
Absent red reflex
What causes the nearsightedness with cataracts
Nearsightedness is caused by increased refraction by lens. Known as index myopia.
Chronic eye disease that causes loss of central field of vision. Majority cause of vision loss in the elderly.
Age related macular degeneration
Type of MD caused by degeneration of retinal pigment epithelium preventing nutrient flow to macula. More benign clinical course and prognosis. Will have drusen
Dry Macular Degeneration
Exudative form of MD caused by neovascularization of choroidal capillaries, leaking blood and protein below the macula. More acute loss of vision
Wet macular degeneration
Walls of retinal vessels thicken
Vasospasms occur, causing focal narrowing
Hypertensive retinopathy
HTN retinopathy signs and symptoms
Copper wiring
AV nicking
Hemorrhages
Papilledema
Inward folding of eyelid, usually lower one
Eyelashes rub against and irritate cornea
Entropion
Outward turning of eyelid, usually lower one, with eyelid moving away from globe
Can lead to corneal exposure, tearing, keratinization of palpebral conjunctiva, and vision loss
Ectropion
Drooping upper eyelid with eye in primary gaze due to anatomical changes of levator palpebrae superioris
Signs and symptoms
Blepharoptosis
test for glaucoma (open vs. closed angle)
Gonioscopy
Measures intraocular pressure
Tonometry
Detects defects in central vision
Amsler Grid
An umbrella term used to include the psychological and physical challenges that visual impairment presents to the aging individual.
Highly correlated w/ depression and other comorbidities
Age-Related Psychoopthalmology (APO)
How can you treat glaucoma?
Surgical excision of a peripheral piece of iris Laser iridectomy Miotics Beta-blockers Carbonic anhydrase inhibitors
How do you treat macular degeneration?
Verteporfin photodynamic therapy (med eliminiated the extra blood vessels in the eye)
Vascular endothelial growth factor antagonism (stop the promotion of angiogenesis)
How do you treat diabetic retinopathy
Blood-glucose control
Blood pressure control
Laser photocoagulation
What is more common, dry or wet Macular degeneration?
Dry MD
Which progresses faster- dry or wet macular degeneration.
Wet MD
Why may you not get a good fundiscopic exam with closed angle glaucoma?
Cloudy cornea
3 main parts of the auditory system
Peripheral auditory system
Brainstem
Cortical areas
occurs when there is a problem conducting sound waves anywhere along the route through the outer ear, tympanic membrane (eardrum), or middle ear (ossicles).
Conductive hearing loss
type of hearing loss in which the root cause lies in the vestibulocochlear nerve (cranial nerve VIII), the inner ear, or central processing centers of the brain. Mainly caused by abnormalities in the hair cells of the organ of Corti in the cochlea
Sensorineural loss
what type hearing loss will you mainly see around age 65?
Sensorineural loss
3 main factors that enhance hearing loss
Previous middle-ear disease
Vascular disease
Exposure to noise
When does hearing loss start?
3rd decade of life
whispered voice test can detect hearing loss above what?
30 decibels
perception of a ringing, buzzing, hissing, or roaring sound in one or both ears.
tinnitus
what causes tinnitus ?
caused by damage to the tiny hairs on auditory cells within the inner ear.
Underlying conditions that may cause tinnitus
Removing impacted earwax
Treating a blood vessel condition
Changing medication (ex. aspirin)
Cochlear implant
What drugs can help with tinnitus
Tricyclic antidepressants, such as amitriptyline and nortriptyline
Alprazolam (Niravam, Xanax).
Symptoms of cerumen impaction
Diminished hearing (usually progressive as cerumen builds up)
Feeling of blocked/plugged ear
± Ear pain
± Tinnitus
Calcification of the tympanic membrane that results in stiffening of the drumhead
TYMPANOSCLEROSIS
what may a clicking sound heard as tinnitus indicate
nerve of muscular abnormality
Abnormal bone growth in middle ear causes fixation of the ossicular chain. almost exclusively in whites
association with pregnancy
OTOSCLEROSIS
Focal disorder of bone metabolism that occurs in the aging skeleton
characterized by an accelerated rate of bone remodeling, resulting in overgrowth of bone at a single or multiple sites and impaired integrity of affected bone
can lead to conduction and sensorineural loss if it affects the cochlea (similar to otosclerosis)
Paget Disease
Acquired cause of hearing loss producing cochlear damage (sensorineural loss)
ototoxic medication
What condition may have Reddish-blue TM (Schwartze’s sign) and nonmobile tympanic membrane.
otosclerosis
Hearing loss without any organic etiology
Usually related to psychological factors
PSEUDOHYPACUSIS
