Disturbances in Visual and Auditory • HYPEROPIA /

Function HYPERMETROPIA
– Management: BICONVEX
Management: LENS
– Topical Miotics • PRESBYOPIA
– pupil constrictor – Management: Biconvex lens
• pilocarpine (Pilocar) • ASTIGMATISM
– Topical Epinephrine – pupil dilator – Management: Astigmatic lens
• epinephrine
– Topical Beta-blockers – suppress secretion of AH
• betaxolol (Betoptic), metipranol (Optipranolol),
timolol (Timoptic)
• C/I in pts w/ bronchial asthma
–Oral Carbonic Anhydrase Inhibitors – reduces
production of AH Ears
• acetazolamide (Diamox),
• may cause malaise, anorexia & fatigue but do not Anatomy & Physiology
d/c drug. • External Structures:
–Osmotic diuretic / Hyperosmotic agents – Auricle / Pinna
• mannitol (Glycerol), Glycerine (Glyrol, Osmoglyn) – External Auditory Canal
– Tympanic membrane
• Surgical Management: (Eardrum)
– Laser Trabeculoplasty • Middle Ear
– Trabeculectomy – Ossicles
– Peripheral Iridectomy • Mallus (Hammer)
– Cyclotherapy / Cyclodestructive Procedure • Incus (Anvil)
• Stapes (Stirrups)

Nursing Management:
• Pre-op:
– Admin. prescribed meds.
– Routine pre-op procedure
• Post-op:
– Position accdg. to physician’s orders
– Admin. eyedrops/meds as ordered
– Orient pt. to environment
– Avoid activities that may raise IOP
– Observe for complications – Eustachian Tube
• Inner Ear
OTHER DISORDERS – Vestibule
 MYOPIA • Semicircular canals
– Management: BICONCAVE LENS • Utricle & Saccule
– Cochlea • PSYCHOGENIC HEARING LOSS
• Organ of Corti
– Fluids
• Perilymph
• Endolymph

MENIERE’S DISEASE (Endolymphatic Hydrops)

• Causes:
– Unknown
– May be related to the degeneration of cochlear
hair cells.
– Hypernatremia
– Endocrine disturbances
– Emotional disorders
– Allergic reactions

Diagnostic Studies:
• Otoscopic Examination
• Hearing Acuity Screening Test
– Voice
– Watch
• Weber test • Rinne test
Audiometry
– Pure tone
– Speech
• Romberg’s test Signs & Symptoms
• Electronystagmography
• Caloric test – 3 Cardinal signs:
TINNITUS, VERTIGO, HEARING LOSS
– nausea/vomiting, nystagmus, severe headache –
Warning sign of an attack:

EAR DISORDERS
• CONDUCTIVE HEARING LOSS
– Hearing Aids
• SENSORINEURAL HEARING LOSS
– Cochlear Implant
• Diagnostic Test
– Caloric Test
– Electronystagmography
– Audiometry
• Management:
– Furstenburg Diet
– Vasodilators, Antihistamines, Mild sedatives
– Diuretics
– During attack: assume comfortable position
• Surgery: – Labyrithectomy
• PRESBYCUSIS – No effective medical or surgical
TX.
Nursing Management:
 Assess the severity and frequency of
attack, any associated ear symptoms
(hear loss, tinnitus)
 Help patient prevent from aura, so
patient has time to prepare for an attack.
 Encourage patient to lie down during
attack in safe place.
 Put side rails in the bed id patient is in
bed
 Place pillow to restrict movement.