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109 Ch. 58
Eye/ear disorders
| Question | Answer |
|---|---|
| What is glaucoma | optic nerve damage related elevated IOP(intraocular pressure)caused by congestion of aqueous humor. 2nd cause of blindness in US |
| what does aqueous humor do | nourished cornea/lens, flows bn iris and lens. 90% of fluid goes out of ant. chamber |
| what are risk factors for glaucoma | hx, Af. Am, old, DM, CVD, corticosteroids |
| When aqueous humor fluid production and drainage are in balance, what is normal IOP level | Bn10-21mmHg |
| what is 1st stage of glaucoma | factors i.e. illness, emotional stress, narrow angles, corticosteroids, mydriatics(dilate) |
| what is 2nd stage of glaucoma | 2nd- changes in aqueous outflow |
| what is 3rd stage of glaucoma | 3rd - fx changes: incr IOP |
| what is 4th stage of glaucoma | 4th - optic nerve damage |
| what is 5th stage of glaucoma | 5th - visual loss |
| what are 4 types of glaucoma | open-angle, angle-closure, congenital, dev anomolies/corticosteroid use |
| what are primary adult types | open-angle and angle-closure |
| what is glaucoma nicknamed | "silent thief of sight" bc pt unaware of disease til sight loss. Because no s/s, noncompliance common |
| what are s/s of sight loss | blurred vision, halos @ lights, diff focusing, adjust in low light, loss of peripheral vision, aching, HA |
| what changes are seen in optic nerve with glaucoma | pallor, loss of blood supply, and cupping, exaggerated bending of blood vessels of optic nerve disc |
| what are 5 major types of exams for glaucoma | tonometry- measure IOP, puff of air ophthalmoscopy - inspect optic nerve gonioscopy - see filtration angle of ant chamber perimetry - assess visual fields |
| what is aim of all glaucoma treatment | prevention of optic nerve damage by maintaining IOP in range. Lifelong therapy, never cured |
| what are some pharmacologic therapies | Beta blockers(topical miotics)- decr aq humor production. cholinergics- incr outflow adrenergic agonsist- reduce aq hu and incr outflow. Treat one eye with other as control to monitor effects of med, then treat other. |
| Which type of glaucoma is most common 90-95% of time | open angle (chronic): decr drainage of aq humor thru canal of Schlemm causing incr aq humor to remain in eye and incr IOP |
| what is open angle glaucoma | loss of trabecular permeability, usually affects both eyes, gradual progression, optic nerve degeneneration, |
| what is angle closure glaucoma (pupillary block) | narrow angle/closed angle, less common, unilateral, blockage of ant angle inhibit flow of aq hu, incr IOP, rapid onset with quick damage(emergency) |
| what are s/s of angle closure glaucoma | pain around eyes, sudden rise IOP, cloudy cornea/fixed pupil, red conjunctiva, rainbow halos |
| How often should evaluated for glaucoma | q6mos - 1yr |
| what are cataracts | lens opacity or cloudiness, painless blurry vision, sensitvie to glare |
| who is at risk for cataracts | aged >50, trauma, ocular inflammation, corticos, leading cuase of visual disability, lower income, smoker |
| three most common types of senile cataracts | nuclear, cortical, post subcapsular |
| what is nuclear cataracts | caused by central opacity in lens, genetic component, assoc wtih nearsightedness(myopia), blurs |
| what is cortical cataract | ant, post, euqatorial cortex of lens. Vision worse in bright light, i.e. sun |
| what is post subcapsular cataracts | younger people, glare of bright light, caucasians more for sub, and nuclear. Af am more cortical |
| Risk Factors for aging for cataracts | loss of lens transparency, clumping of lens protein, accum of yellow/brown pigment from protein breakdown, incr Na/Cl |
| What are risk factors for assoc ocular conditions | myopia, retinal detachment, infection(herpes zoster, uveitis) |
| Whaqt are toxic risk factors | corticos, chemical burns(wash 15 min), smoking |
| What are systemic diseases at risk for cataracts | DM, renal disorders- HTN |
| What are other effects of cataracts | astigmatism, monocular diplopia(double vision), color shift, colors shift to yellow/brown |
| how long is surgery last | less than 1 hour. treat one eye and weeks/months later, the other eye. |
| surgery options | extracapsular extraction, phacoemuslification (suck lens out), lens replacement (intraocular lens implan IOL). |
| what are three lens replacement options | aphakic(without lens) eyeglasses, contact lenses, IOL implants(usual approach)-most common, single-focus lens/monofocal IOL |
| what are some postoperative care teaching | wear patch at night, avoid incr IOP by valsava man., bending, do not sleep on operative side, call md if flashing lights, pain, redness, floaters |
| what is macular degeneration | most common cause of visual loss in 60+, drusen present, cental vision affected |
| what is drusen | tiny yellow spots beneath retina |
| what are two types of AMD | dry/wet |
| what is dry type | outer layer of retina slowly break down, showing drusen. If drusen on outside of macular area, no s/s, within = blurring |
| what is wet type | abrupt onset, lines appear crooked, letters broken, lose color vision, more severe |
| what vitamins/minerals can slow AMD | antioxidants(vit c, e, beta carotene), xinc oxide |
| what is types of retinal disorders | macular degeneration, retinal piece sep from blood supply |
| what are s/s of AMD | sensation of shade/curtain cross eye, bright flashing lights, sudden onset of floaters |
| what is surgical tx | scleral buckle, pars plana vitrectomy, pneumatic retinoplexy(inject gas bubble) |
| what can cause retinal vv/aa occlusion | atherosclerosis, CVD, HTN |
| what are risk factors for AMD | smoking, long term UV exposure |
| what is emergency tx if foreign obj in eye | do not remove, flush chemical injuries, protect with shield |
| what are consequences of systemic disease | diabetic retinopathy - DM leading cause of blindness in 20-74 age |
| what do meds do for glaucoma | incr aq outflow or decr aq produciton |
| what is Meniere's Disease | abnormal inner ear fluid balance by malabsorption of endolymphatic sac or blocked duct |
| what are s/s of Meniere's Disease | hearing loss, tinnitus, pressure, vertigo |
| what is tx for Meniere's disease | Low Na diet, 2000mg/2g/day Drugs: antihistamines, Antivert, phenergan |
Created by:
palmerag
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