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BDS3 Special Care Dentistry > Sensory Impairment > Flashcards

Sensory Impairment Flashcards

1
Q

What is sensory impairment?

A

when one or more of a person’s senses is no longer normal.

A person doesn’t not have to have full loss of a sense to be sensory impaired.

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2
Q

What key care needs can help an individual with a sensory disability with confidence, skills and mobility?

A
  • Communication
  • Access to services
  • Help with mobility
  • Accessibility and isolation
  • Rehabilitation
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3
Q

What is the leading cause of vision impairment and sight loss?

A
  • Uncorrected refractive errors

- Cateracts

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4
Q

The majority of people with vision impairment are over what age?

A

50

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5
Q

At least half of sight loss cases are avoidable. How can uncorrected refractive errors and cataracts be treated?

A
  • wearing the right prescription glasses
  • surgery

Note: If detected and treated early, some sight loss due to glaucoma, AMD and diabetic retinopathy could be avoided.

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6
Q

The prevalence of sight loss is associated with what? Explain this.

A

Associated with lower income

Difficulty in getting to an optometrist and concerns about the cost of glasses can result in people not going for eye tests as often as they want, to delaying visits until they experience symptoms.

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7
Q

Vision impairment is classed into what two groups?

A

Distance and near presenting vision impairment

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8
Q

Distance vision impairment can be classes into what?

A
  • Mild – presenting vidual acuity worse than 6/12
  • Moderate – presenting visual acuity worse than 6/18
  • Severe – presenting visual acuity worse than 6/60
  • Blindness -presenting visual acuity worse than 3/60
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9
Q

Describe near vision impairment.

A

presenting near visual acuity worse than N6 or M.08 with existing correction.

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10
Q

What are some symptoms of visual impairment?

A
  • Severe, sudden eye pain
  • Recurrent pain in or around they eye
  • Hazy, blurred, or double vision
  • Seeing flashes of light or sudden bright floating spots
  • Seeing rainbows or halos around lights
  • Seeing floating ‘spider webs’
  • Seeing a ‘curtain coming down’ over one eye
  • Sensing a ‘cup filling up with ink’ in one eye
  • Unusual, even painful, sensitivity to light or glare
  • Swollen, red eyes
  • Changes in colour of the iris
  • White areas in pupil of eye
  • Sudden development of persistent floaters
  • Itching, burning, or a heavy discharge in the eyes
  • Gritty feelings
  • Any sudden changes in vision
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11
Q

What are cataracts?

A

Clouding of the lens of the eye which prevents clear vision

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12
Q

What are some causes of cataracts?

A
  • majority just relates to ageing process but can be born with it
  • • May develop after eye injuries, inflammation, and some other eye diseases

NOTE: is the leading cause of blindness worldwide

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13
Q

Describe age-related macular degeneration.

A

• Affects older people
• Involves loss of persons central field of vision
• Occurs when macular (or central) retina develops degenerative lesions
-the photoreceptors (macula cells) become damaged and scarred
-reduction in blood flow also thought to play a part

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14
Q

What are the two types of macular degeneration you get?

A

Wet and dry

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15
Q

Describe wet AMD.

A
  • Severe sight loss in a matter of months
  • Can develop very rapidly, resulting in more sudden sight loss
  • Growth of new vessels under retina which then break and leak into the macula
  • Occurs when unhealthy new vessels begin to grow under the macula and leak blood and fluid (why its termed wet) which causes scarring to develop within the macula cells causing vision to go
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16
Q

Describe dry AMD.

A
  • Bilateral condition
  • More common type (90% of cases this)
  • Though to have hereditary element
  • Gradual loss of central vision
  • Person becomes unable to recognise people because they cannot see faces clearly
  • Layer of the macula become progressively thinner, causing it to function less effectively.
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17
Q

Describe what causes glaucoma.

A
  • Both structural change and functional deficit
  • Usually caused by fluid building up in the front part of the eye, which increases pressure inside the eye
  • Generally, a bilateral condition, affects one eye before the other
  • Can lead to loss of vision if not diagnosed and treated early (sight will never recover)
18
Q

In what age group is glaucoma more common?

A

70s and 80s

19
Q

What are the 2 most common forms of glaucoma?

A
  • Primary open angle glaucoma

- Angle closure glaucoma

20
Q

Describe primary open angle glaucoma.

A
  • Slow and insidious onset
  • Anterior chamber angle is open
  • Caused by the drainage channel in they eye becoming gradually clogged over time
21
Q

Describe angle closure glaucoma.

A
  • Less common
  • More acute
  • Caused by drainage in eye become suddenly blocked
  • Pressure in eye can raise very quickly
22
Q

What is diabetic retinopathy?

A

• Characteristic group of lesions found in retina of individuals who have had diabetes mellitus for several years

  • is the result of vascular changes in retinal circulation
  • Macular oedema can sig. decreases visual acuity
23
Q

What are the risk factors for diabetic retinopathy?

A
  • Duration of diabetes
  • Level of glycemia
  • Presence of high blood pressure
  • Dependence on insulin
  • Pregnancy
  • Levels of selected serum lipids
  • Nutritional
  • Genetic factors
24
Q

What is hemianopia?

A

Blindness in one half of visual field

25
Q

What is the most common cause of hemianopia

A

Stroke

26
Q

What can be done to prevent visual impairments?

A
  • Regular eye exams
  • Protect eyes from sun
  • Protective eye gear at work
  • Know family Hx
  • Seek treatment quickly
  • Stop smoking
  • Eating healthy and managing obesity
27
Q

What are some common misconceptions about the visually impaired?

A
  • They’re totally blind
  • They must wear dark glasses
  • Need to use a white cane or guide dog to get around
  • Have sensitive hearing and special sense of touch
  • Use Braille to read
  • Certain activities too difficult to try
  • Don’t look at you when talking to them
28
Q

What are some difficulties experienced by the visually impaired?

A
  • Not being able to access printed material
  • Difficulty in accessing the internet/electronic devices
  • Difficulty in getting to destinations and around the built environment
  • Accessing unfamiliar buildings and environments
  • Lack of awareness of other as to how to help
29
Q

How can we maximised communication with patients with visual impairments?

A

• Always identify yourself even in known surroundings
• Always use names to identify people – especially in a group situation
• Keep the visually impaired person informed of people moving around and/or leaving the room
• Tell them what you do before you do it – putting the chair back/LA/slow speed
• Do not use non-verbal communication e.g. pointing in the direction of something, shrugging shoulder, pulling faces
• Provide info in alternative formats:
o CD, email, extra large print, audio tapes, electronic formats, braille, moon, allow extra time
• Prepare surgery appropriately
• Arrange for the alternative formats to be provided
• Take time to get the environment right

30
Q

What is hearing impairment defined as?

A

a person who is not able to hear as well as someone with normal hearing – hearing thresholds of 25dN or better in both ears – is said to have hearing loss.

31
Q

What are some causes of hearing loss?

A

genetic causes, complications at birth, certain infectious diseases, chronic ear infections, the use of particular drugs, exposure to excessive noise, and ageing

32
Q

What % of childhood hearing loss is preventable?

A

60%

33
Q

What are some of the functional impacts of hearing loss/impairments

A
  • The ability to communicate with others
  • Spoken language development delayed in children
  • Adverse effect on the academic performance of children
  • Increased rates of grade failure and greater need for educational assistance
  • Access to suitable accommodations is important for optimal learning experiences but are not always available
34
Q

What are the social emotional impact of hearing impairments?

A
  • Loneliness
  • Isolation
  • Frustration
  • Higher unemployment rates
  • In lower grades of employment generally
35
Q

What are some congenital causes of hearing loss?

A

o Maternal rubella, syphilis or certain other infections during pregnancy
o Low birth weight
o Birth asphyxia
o Inappropriate use of particular drugs during pregnancy, such as aminoglycosides, cytotoxic drugs, antimalarial drugs, and diuretics
o Severe jaundice in the neonatal period

36
Q

What are some acquired causes of hearing loss?

A

o Infectious diseases including meningitis measles and mumps
o Chronic ear infections
o Collection of fluid in the ear (otitis media)
o Medicines
o Injury to head or ear
o Excessive noise (including occupational noise)
o Recreational exposure to loud sounds
o Ageing
o Wax or foreign bodies blocking the ear canal

37
Q

What are some signs and clues that someone may have a hearing problem/impairment?

A 
•	Inactivity 
•	Reduced development of speech and language skulls 
•	Deterioration of speech 
•	Reduced social and emotional development 
•	Irritability 
•	Autistic like behaviour
o	Don’t respond to name ect.
•	Confusion 
•	Unawareness of surroundings 
•	Failure to respond to sound 
•	Asking for sentences to be repeated 
•	Speaking in unusually loud voice 
•	Change in tone 
•	Withdrawing from life 
•	Spending time alone
38
Q

What is the treatment and prevention for hearing loss?

A
  • Early detection
  • Early management
  • Rehabilitation
  • Immunisation
  • Avoidance of some drugs
  • Reducing occupational exposure
39
Q

What kinds of hearing aids are available?

A
  • Behind the ear hearing aid
  • In the ear aid
  • In-the0canal aid
  • Completely-in-the-canal aid
40
Q

How can you maximise communication with a patient that has a heating impairment?

A
  • Ask if they want to use a loop system
  • Try to establish the person’s preferred communication method
  • If necessary, book BSL interpreters, lip readers, not taker well in advance. Should be recorded in patient notes
  • Face the person, don’t turn away
  • Use clear speech, normal lip pattern, don’t shout
  • Use finger spelling
  • Speak at ear level
  • Repeat, rephrase
  • Write things down
  • Ensure there is no echo – room with soft furnishings
  • Ask people to repeat important information back to you
  • Make sure hearing aids are switched on and functioning
  • Reduce background noise
  • Allow extra time
  • Prepare an appropriate room
  • Book the necessary communication support

BDS3 Special Care Dentistry (9 decks)

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