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Eye,Ear Procedure
Eye and Ear Procedures
| Question | Answer |
|---|---|
| Ophthalmology and otolaryngology are specialties that require | a variety of skills including screening examination and minor procedures such as eye and ear irrigation and visual acuity testing |
| MA can use a variety of visual screening chart to complete the distance visual acuity process. USE | Snellen eye chart for pt that can read English alphabet , Big E chart for pt unfamiliar with English alphabet , symbol chart for pediatric pts |
| Eye irrigation is performed to relieve | inflammation , remove drainage , dilute chemicals or was away foreign bodies |
| Sterile technique is used to | prevent contamination to eye |
| Ear irrigation is performed to remove | excessive or impacted earwax ( cerumen) or a foreign body |
| All irrigation eye or ear is set to | body temp, solution too hot or cold can cause pain or dizziness |
| The most common screen tool for distance visual acuity testing is | the Snellen eye chart |
| The provider may do a more in dept test or | refer patient for more detailed exam |
| The use eye irrigation is a | delicate process and is uncomfortable for patient |
| Precautions should be taken when to avoid | infecting the opposite eye and avoid injury to the eye |
| Ear irrigation can be uncomfortable for the patient . Always allow the ear to | drain completely after irrigation to decrease sensitivity and congestion |
| With bot eye and ear irrigation is it important | to manage pt safety and comfort |
| Common screening tests performed by the medical assistant include | visual acuity testing, both near and distance, as well as color vision assessment. A hearing screening may also be performed as part of the physical exam with the use of an audiometer (an instrument that measures hearing. |
| The provider will use the ophthalmoscope, | an instrument used to examine the internal structures of the eye, |
| The provider will use the the otoscope, | an instrument used to examine the ear during the physical examination. |
| Some patients may require installation or irrigation procedures of the eye and ear. | medical assistant is often responsible for performing these procedures in the office and providing patients with proper instruction for performing the steps at home. |
| Visual acuity testing is a screening procedure used | .to detect possible errors of refraction |
| Visual Acuity testing This type of testing may also be performed on | patients following an eye injury to determine if vision has been affected as a result of the injury. |
| Visual acuity testing . An error of refraction | As light enters the pupil, the light rays are bent so they can be focused on the retina. An error causes improper bending of the light rays, preventing proper focusing on the retina. refractive errors are caused by a defect in the shape of the eyeball. |
| Refractive errors include -Myopia (nearsightedness): | The ability to see only objects that are close up |
| Refractive errors include - Hyperopia (farsightedness): | The ability to see only objects that are far away |
| Refractive errors include - Presbyopia: | Farsightedness due to the aging process, caused by loss of elasticity of the lens |
| Refractive errors include - Astigmatism: | Abnormal curvature of the cornea, which causes blurry vision |
| The Snellen chart | is used to test distance visual acuity. This chart is used for adults and school-aged children and consists of different letters in the English alphabet, displayed in decreasing sizes. |
| Visual acuity testing should be conducted in a | quiet, well-lit area. Adult patients and children aged six and above are placed 20 feet away from the chart during testing, while pediatric patients aged five and below are placed 10 feet away from the chart. |
| Acuity is measured in | each eye separately, usually beginning with the right eye, then the left eye, and then both eyes simultaneously |
| The results may be recorded in the patient’s chart in the following manner | “R. eye: 20/40, L. eye: 20/50,” and “both eyes: 20/40.” |
| When patients wear corrective lenses, it will be up to the provider to determine | whether or not the testing will be performed with or without corrective lenses. When testing is performed with corrective lenses, it should be noted as such in the chart. |
| Visual Acuity testing Start with the | 20/70 |
| Eye installation is performed for a variety of reasons. Medications are instilled | to treat infections and to relieve inflammation, dilate or constrict the pupil, anesthetize the eye for examination, and to stimulate circulation in the eye. |
| Medications to be dispensed in the eye come in two forms: | sterile drops or sterile ointment. Before instilling drops or ointment in the eye, it is important to make sure the medication is for ophthalmic use only. |
| Important note: Medical assistants should never perform any procedure unless | directed to do so by the provider; however, they can set up various equipment and supplies to help save time in the event that testing or procedures are ordered. |
| Ask the patient: "Are You Experiencing Any.." | Hearing deficits, ringing in the ear, pain, or discharge, build-up of earwax, or a possible foreign body in the ear? Do you have a history of ear disorders? |
| Vital Signs | Blood pressure, temperature |
| Equipment | Otoscope, ear tray, ear medication, irrigating equipment, and solution |
| Possible Procedures | Ear irrigation, ear installation |
| A hearing loss or defect can be classified as a | conduction loss or a nerve loss. Conduction loss occurs when sound waves cannot reach the middle ear due to impacted cerumen, obstruction of the ear canal due to the presence of foreign bodies or polyps, or swelling due to otitis media. |
| A scarred tympanic membrane may also cause | conduction deafness. This type of deafness is often treatable. |
| Impacted Cerumen: | Wax can build up and block the ear canal. Wax blockage is one of the most common causes of hearing loss. |
| Nerve deafness occurs as a result of | damage to the inner ear or the auditory nerve, which blocks the transmission of sound waves to the auditory centers in the brain |
| Heredity | damage from infectious diseases such as measles or mumps, prolonged exposure to loud noise, tumors, and degeneration due to aging are causes of nerve deafness |
| Some patients may have hearing loss from both conductive and nerve defects. This is referred to | as mixed hearing loss |
| Hearing acuity may be performed by an | audiologist or a medical assistant. |
| Several methods may be employed to measure hearing acuity. Some are | simple gross screenings that use a tuning fork, while others involve the use of a specialized unit known as an audiometer |
| During any hearing acuity evaluation, | ears are tested one at a time and the ear not being tested should be covered to drown out extraneous sounds. |
| A gross screening is usually performed by the provider during the physical exam | The provider stands 1 to 2 feet away from the patient and whispers a series of words or numbers. The patient is asked to repeat the words or numbers. |
| Another gross screening involves | holding a ticking wristwatch 4 to 6 inches away from the ear to determine hearing ability. Further testing is indicated if a defect is found upon gross screening |
| A tuning fork can be used to screen for | general hearing. |
| Tuning Fork Screening Two common methods known as the | Weber test and the Rinne test are performed by the provider. |
| The Weber test is performed in patients who can | hear better in one ear than the other. It involves placing the base of a vibrating tuning fork against the crown of the head. The patient is asked where the sound is heard best |
| A conduction loss is indicated if the patient can | hear the sound better in the affected ear, and a sensorineural hearing loss is indicated if the patient can hear the sound better in the unaffected ear. |
| Instill Ear Medication - Liquids are instilled into the external auditory canal to treat | infections, relieve pain, and soften impacted cerumen for easier removal |
| The ear canal forms an | S-shaped curve as it leads inward and it must be straightened to ensure that the medication reaches. |
| Ear irrigation involves | washing the external ear canal with a stream of solution. This procedure is performed to dislodge a foreign object, cleanse the ear canal, remove impacted cerumen, or reduce inflammation. |
| mpacted cerumen may be softened with | mineral oil or hydrogen peroxide prior to removal. |
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