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109 Ch. 58

Eye/ear disorders

QuestionAnswer
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