Hearing and Balance

Otitis Media (OM)

Inflammation of middle ear

Manifestations: cold like symptoms and/or upper respiratory problems

Acute OM

• Bulging TM, effusion, pain, temporary hearing loss.

  • Complications: rupture of T.M, temporary conductive hearing loss

Recurrent Acute OM

≥3 episodes/6 months or ≥4/12 months.

Risk factors: Male gender, smoke exposure, winter season.

Chronic OM

>6 weeks; persistent effusion in middle ear space; mild–moderate hearing loss.

Otosclerosis

• Definition: Abnormal bone growth in middle ear; bilateral; slowly progressive            

• Causes: Alternating bone resorption and formation, Genetic (autosomal dominant), viral, autoimmune

Presbycusis

• Definition: Age-related hearing loss (most common).

• Cause: Multifactorial (aging, environment, genetics).

Ménière Disease

Definition: Excess endolymph in membranous labyrinth of inner ear.

Manifestations: Vertigo, tinnitus (ringing), nausea/vomiting, ear fullness, fluctuating hearing loss.

Ototoxicity

Definition: Medication-induced inner ear sensory cell damage.

Factors affecting extent of ototoxic effects:  age, coexisting medical conditions,  genetic predisposition, drug use, drugs dosage, schedule

Cochleotoxic

Affects cochlea → sensorineural loss (bilateral).

Vestibulotoxic

Affects balance system → dizziness, unsteadiness (bilateral).

Nonsyndromic

 Only hearing loss.

Syndromic

With other abnormalities

Myopia

Nearsightedness

image focused in front of retina

Hyperopia

Farsightedness

image focused behind retina

Presbyopia

age-related farsightedness

loss of lens elasticity reduce accommodation, ciliary muscles weaklings, eye becomes less flexible

Astigmatism

Irregular cornea/lens

Blurred vision

Strabismus

One eye deviation

Double vision; risk of amblyopia, hypertonic muscle

Nystagmus

Rapid, Involuntary eye movement

Often neurologic/inner ear cause, inner ear or cerebral disturbance, drug toxicity

Diplopia

Double vision, loss of depth perception

Muscle paralysis or neurological cause (stroke)

Hordeolum

Tender red bump on eyelid

Bacterial infection in oil glands

Conjunctivitis

Redness, discharge, itching, burning of eyes

Increased tearing, blurred vision, light sensitivity

Viral conjunctivitis

Adrenoviruses, herpes simplex virus

Bacterial Conjunctivities

Chlamydia

Persist up to 3 weeks

Allergic Conjunctivitis

Not contagious

Pterygium

Benign conjunctival growth

UV light, wind, irritants

Keratitis

Corneal infection/inflammation, photophobia

Herpes, chemical damage, splashes, and fume; scar formation damage to cornea

Corneal Abrasion

Scratch on cornea

Foreign body, rubbing, chemical irritant, redness, tearing, eye pain, blurred vision, light sensitivity

Cataracts

Clouding of lens

Age, trauma, disease, congenital anomalies, systemic disease, pharmacologic triggers

Glaucoma

increase Intraocular pressure, painless/slow loss of vision

Chronic (open-angle): thickness of trabecular network, irreversible or acute

Chronic (narrow-angle): aging developmental abnormalities

Retinopathy

Retinal damage, Retinal detachment, Significant myopia

Diabetic (proliferative: angiogenesis)

(non-proliferative: no angiogenesis)

Retinal Detachment

Retina separates from support tissue

Myopia, trauma, surgery

Macular Degeneration

Macula deterioration, loss of central vision

Aging; “dry” is blurry or wavy central vision vs. “wet” is new blood vessels grow around macula, causes bleeding, scarring, photoreceptor atrophy 

semicircular canals

balance

vestibule

acceleration

Cochlea

hearing