Psychosocial needs; changes in sensory Flashcards
Drusen
Yellow deposits under retina
Found in those 60+
Funduscopy
Examination of the fundus of the eye
- using opthalmoscope
Keratoconjunctivitis sicca
Decreased tear production with age
Dry eyes
Lipofuscin
Fatty brown pigment
Liver, retina, kidneys, adrenals etc
Prelingual Deafness
Deafness that occurs before the acquisition of spoken language
Tonomotry
Procedure used by eye care professionals to determine interocular pressure
Xerophthalmia
Itchy eyes
Schirmer’s test
Filter paper strips are placed under the lower eyelid to measure rate of tear production
Keratoconjunctivitis sicca: Interventions
- Artificial tears
- keeping the air in living environment moist with humidifiers
- Avoiding wind and the use of hairdryers
- Tear oitments
Blindness _______ mean full vision loss
Does not mean!!
Glaucoma
- Natural fluids of the eye are blocked by ciliary muscle rigidity
- Gradual buildup of intraocular pressure
- Optic nerve damage
Normal IOP
12mm Hg and 22 mm Hg
Risk factors: Glaucoma
- AGE!!
- diabetes
- Steroid use
- Past eye injuries
- Family history
Primary open-angle glaucoma
Accounts for 80%
Asymptomatic until late
Vision loss is irreversible, can be caught and treated early
Headaches, poor vision in dim lighting, increased sensitivity to glare, tired eyes, impaired peripheral, fixed and dilated pupil, frequent changes in prescriptions
Acute angle-closure glaucoma
Rapid rise in IOP
Redness and acute pain around eye
Severe headaches, nausea, vomiting, blurred vision
Caused by blocked path of aqueous humour
Blindness can occur in two days if untreated
Acute angle-closure Glaucoma: Treatment
Iridectomy
Surgical removal of part of the iris that relieves pressure
Acute angel-closure glaucoma: risk factors
Female, increased age, inuit or asian ethnicity, short anterior chamber, shorter axial length
Low-tension or normal-tension glaucoma
IOP is normal range
Damage to Optic nerve and narrowing of visual fields
Low/normal-tension glaucoma: risk factors
Family history, japanese ancestry, CVD
Assessment: Glaucoma
- Family history
- annual eye exams (65+)
- Those with med-controlled glaucoma every 6 months
-Dilated eye exam and tonometry
Cataracts
Caused by oxidative damage to lens protein by fatty deposits in the ocular lens (lipofuscin)
Can occur earlier in those “exposed to excessive sunlight or who have poor dietary habits, diabetes, hypertension, kidney disease, previous eye trauma, or a history of alcohol and tobacco use.”
can occur after eye surgery
Assessment: Cataracts
- Recognized by clouding of ocular lense
- Appearance of halos around objects
- Yellow tint to things
Interventions: Cataracts
- When visual acuity decreases to 20/50
- Surgical removal of the lense and placement of a plastic intraocular lense
- Done one eye at a time
Sign of a detached retina
Curtain coming down over the person’s line of vision
Macular Degeneration
- Affects the macula
- Causes a progressive loss of central vision
- Usually starts in one eye
- Caused by systemic changes in circulation, accumulation of cell waste, tissue atrophy etc.
Dry AMD
- More common
- Three stages
- Light-sensitive cells in macula slowly break down and cause blurring in the central vision of the affected eye
- Presence of drusen
Wet AMD
- Abnormal bv grow under the macula and leak fluid or blood, raising the macula from its normal place
- Light-sensing cells die
Assessment: AMD
- No cure
- screening, early detection, and prevention
- check eyes daily using Amsler grid
Amsler grid
Used to determine clarity of central vision
- Perception of wavy line
Interventions: AMD
- Photodynamic therapy
- Laser photocoagulation
- ## Medications that prevent vascular endothelial growth
Diabetic Retinopathy
- Effects of elevated blood sugar due to diabetes
- Disease of retinal
microvasculature - Increased vessel permeability
- Macular edema and hard exudate
Assessment: Diabetic Retinopathy
little to no evidence of retinopathy until 3 to 5 years or more after the onset of diabetes.
Early signs, which include microaneurysms, flame-shaped hemorrhages, cotton wool spots, hard exudates, and dilated capillaries, can be seen through funduscopy.
Interventions: Diabetic Retinopathy
- Continous, strict control of blood glucose, cholesterol, BP, laser photocoagulation
Tinnitus
- Perception of sound with no stimuli
- Ringing in the ear
- Worse at night/ in the quiet
- Generally increases over time
- Can be caused by noise damage, excessive cerumen, obstructions of the auditory canal, disorders of cervical vertebrae of TM joint, allergies, underactie thyroid
Assessment: Tinnitus
- May be subjective or objective
- Tinnitus handicap questionnare/tinnitus functional index
Interventions: Tinnitus
- Hearing aids
- Device that combines the features of a masker and a hearing aid
- lifestyle changes
Prelingual deafness
- Many older people with prelingual deafness will have had an entirely different childhood
- Those who depend on visual cues may have impaired communication with vision loss
- ## reading and writing may be impaired
