Exemplars for CHs 43 &44, Eyes and Ears

Glaucoma

known as “silent thief of sight” because progression is gradual; caused by increased intraocular pressure (IOP) on the retina and junction of optic nerve due to inability of ocular fluid to drain

risk factors for glaucoma

• Age (over 40)

• Ethnicity

• History of migraines 

• Cardiovascular disease

• Use of contact lenses

• Family history

• Anticholinergic meds

S&S of glaucoma

• Eye pain

• Redness

• Halos around lights

• Vision loss 

Diagnostic test for glaucoma

fundoscopic exam

Treatment for glaucoma

Eyedrops to help reduce pressure in the eye and surgery

Diabetic retinopathy

Caused by high glucose level from diabetes damaging vessels of the retina

S&S of diabetic retinopathy

May initially be asymptomatic

• Blurred vision

• Poor eye sight at night

Diagnostics for diabetic retinopathy

slit lamp and fundoscopic exams

treatment for diabetic retinopathy

glycemic control

Cataracts

caused by excessive growth of epithelial layer of the lens

2 types

• senile

• congenital

senile cataracts

Caused by old age, diabetes, obesity, exposure to UV light, and smoking

congenital cataracts

present from birth, often caused by infections like rubella, syphillis, or cytelomegalovirus

S&S of cataracts

• Gradual vision loss 

• Seeing halos at night

• Opacity covering of the eye

Treatment of cataracts

surgery, one eye at a time, to replace cataract lens with an artificial lens

Otitis externa

a mild-severe inflammation of external ear, (AKA swimmers ear) that can be caused by infection or allergies, but usually by water in the ears; they would have pain when pulling on the pinna

patient teaching for otitis externa

encourage the patient to wear ear plugs while swimming

Otitis media

an infection of the middle ear that’s related to upper respiratory infection; it’s most common in kids because they have a shorter, wider, and more horizontal eustachian tubes 

• When they shoot the puff of air towards the ear drum, it demonstrates decreased movement

manifestations of otitis media

• fever

• earache (children pull on their ears)

•  irritability

• poor eating 

• fussy kids

• reddened tympanic membrane

Tympanic membrane perforation

a hole or tear in tympanic membrane that usually heals within 4ish weeks if it’s small

manifestations of tympanic membrane perforation

• Buzzing in the ears 

• Reports of earache 

• Hearing loss 

treatment for tympanic membrane perforation

systemic antibiotics or cauterization of the tear; NOT ear drops because they will get somewhere they shouldn’t

Ménière's Disease

a disease, with unknown etiology, that effects 40-50 yr olds, and presents with progressive hearing loss, tinnitus, and nausea

• treat with low salt, diuretics, steroids, and antiemetics for nausea

presbycusis

hearing loss in older adults that begins around age 50, and is caused by gradual loss of hair cells in the cochlea; high pitched sounds are lost first

• treat with hearing aids