Week 5 Chapter 39 Flashcards
Ability to focus with both eyes simultaneously
Binocular Vision
Binocular vision by the age of ____ and ___
3-7 months
Visual acuity is completed by what age?
5 years of age
Newborn eye vision is
20/400
Eyeball occupies larger space in orbit and makes it more…
Susceptible to injury
Hearing is intact in birth
True
Short, wide, and horizontally placed eustachian tubes in young children and increase risk of middle ear infections
Factors associated with disorders of the eyes and ears of children
Congenital Disorders
- Cataracts and infantile glaucoma
- Prematurity
Genetic Disorders
Family History
Common Labs and Diagnostics Tests for Eye/ Ear disorders
Inspection and observation
Visual Acuity Test
Audiometry
Tympanometry
Inspection of tympanic membrane with otoscope
Tympanic FLuid Culture
Inspections in eyes looking for?
Eyes, eyeglasses, strabismus, nystagmus, squinting, edema, discharge and size/ shape of pupils
Inspection of ears looking for…
Hearing aids, size and shape of ears, position, skin tags, dimples, palpate for pain, enlarged cervical nodes.
Testing Eyes performed During Physical Examination
Extraocular movements
Pupillary light response and accommodation
Symmetry of corneal light reflex
Presence of red reflex with an ophthalmoscope
Age approximate visual acuity test
Tumbling E and picture chart appropriate for preschool age children who do not know the alphabet
True
May be transient or permanent
unilateral or bilateral
Hearing acuity or loss
Language development is dependent on ability to hear
Transmission of sound through middle of ear is disrupted
Conductive
Damage to the hair cells in the cochlea or long the auditory pathway
Sensorineural
Attributed to both the conductive and sensorineural problem
Mixed
Tests of ears performed during physical examination
Audiometry
Tympanometry
Whisper Test
Weber and Rinne Tests Culture of tympanic discharge
Hearing test
Audiometry
Measures tympanic membrane mobility and determines middle of ear pressure
Tympanometry
4 years or older
One ear occluded stand behind child and whisper
Whisper Test
6 years or older and uses tuning fork
Weber and Rinne tests
Vibrating tuning to the middle of top of head. Should be equally heard
Weber
Vibrating tuning fork on mastoid process, child signals when sound is gone
Rinne
Then vibrating tuning fork outside of ear to test air conduction, child signals when gone
Air conduction time should be twice as long as bone conduction time
Passing Test
Common Medical Treatments for Eyes
Warm Compress
Corrective Lens
Patching
Eye Muscle Surgery
Common Medical Treatments for Ears
Pressure Equalizing Tubes
Hearing Aids
Cochlear Implants
Adhesive Patch applied to healthier eye to strengthen the weaker eye
(strabismus, ambylopia)
Patching
Surgical alignment of the eye
(stabismus)
Eye Muscle Surgery
Inserted into the TM ( chronic otitis media with effusion)
PE Tubes
Surgically inserted electronic prosthetic device (sensoriurneal loss)
Cochlear Implants
Must be at least 12 months of age
Treatment of bacterial infections of the eyes and ears
Antibiotics
Block histamine reactions
Antihistamines
Pain relief
Analgesics
Inflamed conjunctiva, purulent discharge, mild pain, occasional eye lid edema
Bacterial Conjunctivitis
Inflamed conjunctiva, watery discharge, usually eyelid edema
Viral Conjunctiva
Inflamed conjunctivae, watery or stringy discharge, itching, eyelid edema usually present
Allergic conjunctivae
Stye infected eyelash follicle
Hordeolum
Chronic scaling and discharges along the eyelids
Blepharitis
Enlargement of oil gland
Chalazion
Common 90% resolve spontaneously
Nasolacrimal Duct Stenosis
Management of Disorders of the Eyelid and Management
Topical antibiotic Tx- Hordeolum, blepharitis
Resolve Spontaneously- Chalazion
Massage- Nasolacrimal Duct Stenosis
May resolve spontaneously, but if not requires surgery
Parent education- hot, moist compresses
Chalazion
Light that enters the lens does not bend to allow it fall directly on the retina
Refractive Errors
Farsighted- Hyperopia
Nearsighted- Myopia
Eyeglasses or contact lens
Misalignment of eyes
Strabismus
Patching, corrective lens
Poor visual development in normal eye, “lazy eye”
Amblyopia
Patching
Rapid and irregular eye movement
Nystagmus
Common cause is neurologic problem
Autosomal Recessive, obstruction of aqueous humor flow and increased intraocular pressure
Glaucoma
Surgical Intervention - goniotomy, laser
Opacity of the lens of eye
Cataract
Rapid growth of retinal blood vessels in the premature infant
ROP
Retinopathy of Prematurity
- Serial Eye Exams
ROP Risk Factors
Low Birth Weight
Early Gestational Age
Sepsis
High Light Intensity
Hypothermia
Hypoxia
Duration and concentration supplemental oxygen
Acuity between 20/60 and 20/200
Legal blindness < 20/200 or peripheral vision less than 20 degrees
Visual Impairment
Factors that increase visual impairment
Prematurity
Development Delay
Genetic Syndrome
Family Hx of Eye Disease
African American
Diabetes, HIV
Previous Serious Eye Injury
Chronic Corticosteroid Use
Signs and Symptoms of Visual Impairment
Dull Vacant Stare
Infants
Does not fix and follow or make eye contact
Unaffected by bright light
Does not imitate facial expression
Signs and Symptoms Visual Impairment in Toddlers and Older Children
Rubs, shunts and covers eyes
Squints and blinks frequently
Holds object close or sits close to television
Bumps into objects
Displays head tilt or forward thrust
AOM
Acute Infectious Process
Otitis Media with Effusion
Collection of fluid in the middle ear without s/s of infection
Otitis Externa
Infection and inflammation of the skin of the external ear canal
Risk factors of Otitis Media
Eustachian Tubes
Recurrent Upper Respiratory Infection
Daycare Attendance
Previous Episode
Smoking in Household
HPI Acute Otitis Media
Onset and progression
Fever
Nasal Congestion
Eye or ear pain
Eye rubbing
Ear pulling
Headache
Lethargy
Behavioral Changes
