Conjunctivitis: inflammation of the conjunctiva (mucous membrane covering the eyeball)

- caused by bacteria, viruses, allergies, chemical irritants

- sx: photophobia, foreign body sensation, scratching/burning

• acute bacterial conjunctivitis: caused by gram+ organisms

  • sx: yellow-green drainage, tearing, burning

  • tx: antibiotics

• viral conjunctivitis (pink eye)

  • sx: clear discharge, tearing

  • tx: rest, avoid transmitting it!!

• allergic conjunctivitis

  • sx: swelling, runny nose, etc.

  • tx: antihistamines

• trachoma: caused by Chlamydial conjunctivitis

  • sx: inflammation + scarring of conjunctiva & eyelids → distorted lashes

Glaucoma: disruption of structural/functional integrity of the optic nerve

- primary risk factors: race & age

- pathophysiology: IOP builds up → damage to optic nerve

- diagnosis: use tonometry (determines IOP)

- tx: topical drugs, surgery to increase aqueous flow

primary: no evidence of preexisting ocular disease

secondary: result of previous/ongoing inflammatory process

• open-angle glaucoma: drainage of aqueous humor is impaired → increased IOP gradually

  • sx: halo around lights, mild-severe IOP, gradual reduction in visual field, impaired adaptation to dark

  • risk factors: race (latino & African Americans), sex (M), age

• angle-closure glaucoma: trabecular meshwork is blocked → increased IOP rapidly

  • sx: N/V, cloudy cornea, fixed pupils, reddened conjunctiva

  • risk factors: race (inuit & Asians), sex (F)

related exemplars: otitis media (hearing difficulty, ear pain, loss of damage), PD (impaired balance, hand tremors), cataracts (cloudy lens), macular degeneration (loss of central vision)

Cataracts: clouding of the ocular lens, interfering with transmission of light to the retina → loss of peripheral vision

- risk factors: age (most common age-related visual loss), genetics, environmental & metabolic influences, smoking

- thought to be disorder of carbohydrate metabolism

- sx: → glare, decreased visual acuity

- diagnosis: eye exam, Snellen eye chart

- tx: surgery

Macular degeneration: degeneration of the central portion of the retina → loss of central vision

- risk factors: age (50+), sex (F), comorbidities, smoking

- causes: aging of the eye, low perfusion, inflammatory process

- diagnosis: Amsler grid, ophthalmoscopic appearance

- tx: prevent progression (diet/lifestyle changes, visual aids, etc.)

• atrophic (dry): Drusen deposition, macular thinning, slow

  • sx: night vision changes, difficulty reading

• neovascular (wet): leaking of serous fluid & blood under retina → retinal tissue death, scar tissue formation, rapid & severe

  • sx: sudden vision changes

Otitis media: ear infection of the middle ear (common btwn 3 months & 3 yrs)

- causes: bacteria, virus

- diagnosis: pneumatic otoscopy, tympanometry, acoustic reflectometry

- sx (must have 2+): decreased/absent motility of tympanic membrane, white/yellow/amber tympanic membrane

- tx: antibiotics (amoxicillin), heat/cold, myringotomy

• acute otitis media (AOM): usually caused by existing bacterial or viral infection → eustachian tubes becoming swollen or blocked → inability to drain into nasopharynx

  • risk factors: unimmunized, bottle-feeding

  • sx: fever (>102.2/39) hearing loss, otorrhea, irritability

• otitis media with effusion (OME):

related exemplars: otitis externa (outer ear infection, “swimmers’ ear”), barotrauma (caused by rapid pressure change btwn middle ear & environment), otosclerosis (new bone formation → hearing loss)

Osteoporosis: decrease in bone density & mass

- risk factors: post-menopausal women, Caucasian & Asian women, heavy smoking & drinking, poor diet, low levels of physical activity, advancing age

- pathophysiology: imbalance of bone breakdown & restoration

- sx: back pain, increase in fx, postural changes

• idiopathic juvenile osteoporosis: occurs in children w/o known cause (rare)

Parkinson disease (PD): progressive nervous system disorder

- sx: tremors, stiffness, bradykinesia, shuffling gait

- risk factors: male sex, family history, 60+ yrs old, exposure to toxins

5 stages

1. mild- sx affect only one side of body

2. mild- sx affect both sides of body

3. getting severe- gait changes

4. severe-

5. severe-

Hearing Loss

- tx: hearing aids, cochlear implants, reconstructive surgery (for tympanic membrane), depends on prelingual or post lingual

- associated issues: isolation, depression, & decreased safety

• conductive hearing loss: disruption in transmission of sound

• sensorineural hearing loss: impairment of organ of Corti or its central connections