1. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Chapter 16 Eye and Ear Diseases and Disorders

2. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Anatomy and Physiology of the Eye Sensory organ located in orbit of skull Components: –Sclera, cornea, iris, and pupil –Anterior and posterior chambers –Lens, retina, choroid layer, and posterior cavity

3. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Animation Click Here to Play Vision Animation

4. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Anatomy and Physiology of the Ear External ear –Pinna and auditory canal External and middle ear separated by tympanic membrane Middle ear –Also known as tympanic cavity –Malleus, stapes, and incus bones

5. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Anatomy and Physiology of the Ear Inner ear –Most sophisticated –Vestibule, semicircular canals, round window, and cochlea Responsible for hearing and equilibrium Cochlea –Organ of hearing

6. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Animation Click Here to Play Hearing Animation

7. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Common Signs and Symptoms of the Eye Pain or burning in or around eye Decreased visual acuity or ability to see Any disorder –E.g., seeing flashes of light Eye redness

8. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Common Signs and Symptoms of the Ear Otalgia Deafness Vertigo Tinnitus

9. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diagnostic Tests of the Eye Ophthalmoscopy Visual acuity Tonometry Slit lamp Angiography

10. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diagnostic Tests of the Ear Otoscopy Audiometry

11. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Refractive Errors of the Eye Inability to focus images on retina One-third of population affected Types: –Myopia Nearsightedness –Hyperopia Farsightedness

12. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Refractive Errors of the Eye Types: –Presbyopia Age-related hyperopia –Astigmatism Irregularity of cornea surface

13. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Inflammation and Infection of the Eye Conjunctivitis –Inflammation of conjunctiva –Excessive tearing, itching, burning, and pain –Treatment: Warm compresses Anti-inflammatories Analgesics Perhaps antibiotic ointment

14. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Inflammation and Infection of the Eye Conjunctivitis –Prevention: Good hygiene

15. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Conjunctivitis Photo courtesy Mark L. Kuss

16. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Inflammation and Infection of the Eye Blepharitis –Inflammation of edge of eyelid, eyelash follicles, and glands –Causes: Bacterial infection Allergic reaction Seborrhea

17. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Inflammation and Infection of the Eye Blepharitis –Symptoms: Red, swollen, and crusted eyelids –Treatment: Antibiotics Allergy medication Treatment of seborrhea

18. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Inflammation and Infection of the Eye Keratitis –Inflammation of cornea caused by trauma or infection –Usually unilateral –Symptoms: Photophobia Pain Excessive tearing

19. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Inflammation and Infection of the Eye Keratitis –Treatment: Antibiotic ointment or drops Analgesics Eye patch

20. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Inflammation and Infection of the Eye Stye –Also known as hordeolum –Inflammatory infection of sebaceous gland of eyelid –Resembles pimple –Usually caused by staphylococcus bacteria –Treatment: Warm compresses Topical or systemic antibiotics

21. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Stye Photo courtesy Mark L. Kuss

22. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Cataract Clouding of lens Causes: –Change in metabolism and nutrition in lens –Aging

23. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Cataract Symptoms: –Decreased visual acuity Treatment: –Lens replacement surgery

24. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Cataract Photo courtesy Mark L. Kuss

25. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Glaucoma Characterized by excessive eye pressure Slow progression with or without symptoms Permanent damage can occur before symptomatic

26. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Glaucoma Treatment: –Eye drops –Surgery

27. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Nystagmus Constant, involuntary movement of eyes May affect one or both eyes Causes: –Brain tumors –Disease –Alcohol abuse –Congenital defects

28. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Nystagmus Treatment: –Correct underlying cause

29. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Strabismus Eyes fail to focus in same direction simultaneously Due to muscle weakness in one or both eyes

30. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Strabismus Treatment: –Cover normal eye to train affected eye to function –Eye exercises –Corrective lenses –Surgery

31. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Strabismus Photo courtesy Mark L. Kuss

32. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Macular Degeneration Degeneration of macular area of retina Cause: –Most commonly age-related Symptoms: –Loss of central vision Treatment: –Laser surgery to improve vision

33. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diabetic Retinopathy Leading cause of blindness in United States Diabetes mellitus causes vascular changes in retina leading to decreased visual acuity

34. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diabetic Retinopathy Treatment: –Laser photocoagulation Prevention: –Controlling blood sugar

35. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Color Blindness Also called color vision deficiency (CVD) Ability to see color diminishes with age due to yellowing of lens Inherited Most common affects ability to distinguish between red and green No cure

36. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Infection of the Ear Otitis media –Inflammation in middle ear –Usually affects infants and young children –Types: Serous Suppurative

37. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Infection of the Ear Otitis media –Treatment: Analgesics Decongestants Antibiotics

38. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Infection of the Ear Otitis externa –Also known as swimmer’s ear –Inflammation of external ear canal caused by bacterial or fungal infection –Symptoms: Extreme pain Fever Pruritus

39. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Infection of the Ear Otitis externa –Symptoms: Hearing loss Clear or purulent drainage –Treatment: Keep ear canal clean and dry Analgesics Antibiotics

40. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Infection of the Ear Mastoiditis –Inflammation of mastoid bone or process –Acute mastoiditis usually result of middle ear infection –Symptoms: Tinnitus Otalgia

41. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Infection of the Ear Mastoiditis –Treatment: Antibiotics Mastoidectomy

42. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Deafness Affects more than 25 million people Conductive and sensory –Conductive Caused by external or middle ear disorders that decrease or stop sound conduction –E.g., impacted cerumen, otosclerosis, ruptured eardrum

43. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Deafness Conductive and sensory –Sensory Cochlear or auditory nerve damage preventing sound to be carried to brain Cause related to damaging noise levels and ototoxic medications

44. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Deafness Impacted cerumen –Cerumen Soft, yellow-brown secretion Also known as earwax

45. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Deafness Impacted cerumen –Causes: Skin dryness Excessive hair Narrow ear canal Excessive dust –Treatment: Ear irrigation

46. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Deafness Otosclerosis –Bony fixation of middle ear bones do not allow vibrations from eardrum to inner ear –Treatment: Stapedectomy

47. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Deafness Sensorineural deafness –Sensory deafness due to damage to cochlea or auditory deafness Damage may be due to exposure to loud noise Damage often permanent

48. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Deafness Presbycusis –Progressive sensory deadness related to aging –Symptoms usually begin after age 50 –Treatment: Use of hearing aid

49. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Motion Sickness Experiencing nausea when traveling by car, boat, or airplane Symptoms: –Nausea and vomiting –Diaphoresis –Vertigo

50. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Motion Sickness Treatment: –Anti-motion sickness medication –Rest –Closing of eyes

51. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Trauma Corneal abrasion –Causes: Obstruction trapped between eyelid and cornea Ill-fitting or worn contact lenses Accidentally poking finger in eye Extreme light –E.g., welding

52. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Trauma Corneal abrasion –Treatment: Remove obstruction Antibiotic ointment or analgesics Pressure dressing to prevent eye movement Reduce photophobia pain

53. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Trauma Retinal detachment –Often occurs with trauma, diabetes, and other retinopathies –Symptoms: Blurred vision Flashes of light Floating spots

54. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Trauma Retinal detachment –Painless disorder, but needs attention –Treatment: Surgery

55. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Retinal Detachment

56. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Trauma Ruptured tympanic membrane –Causes: Middle ear infection Sticking sharp object in ear canal –Symptoms: Pain Partial loss of hearing Bloody or purulent discharge

57. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Trauma Ruptured tympanic membrane –Treatment: Antibiotics Surgical patching of membrane with tissue graft

58. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Rare Diseases Retinoblastoma –Hereditary malignant tumor of eye occurring during infancy and childhood –Fatal if untreated –Treatment: Enucleation Radiation Chemotherapy

59. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Rare Diseases Meniérè’s disease –Chronic disease of inner ear –Symptoms: Tinnitus Vertigo Progressive hearing loss Feeling of fullness in ear –Attacks last few hours to several days

60. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Rare Diseases Meniérè’s disease –Treatment: Medications to control nausea Low-salt diet Diuretics Antihistamines Smoking cessation –Surgery may be necessary

61. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Effects of Aging on the Eye Changes in ability to focus on near objects, color perception, some sensitivity to light, and decreased visual acuity Glaucoma and cataracts Arcus senilis

62. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Arcus Senilis Photo courtesy Mark L. Kuss

63. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Effects of Aging on the Ear Thinner and less flexible tympanic membrane Degenerative changes in neurons, bones of middle ear, and cochlea