Chapter 13 - Eye and Ear Exams and Procedures
Cerumen
A buildup of excess earwax
Titmus Vision Tester
A compact electric testing device that uses computerized-designed optics to screen visual acuity
Pomeroy Syringe
A metal syringe that is filled with irrigating solution; the tip of the syringe is placed in the ear canal and the plunger is depressed to push the fluid into the ear
Tympanometry
A procedure used to measure whether or not the middle ear is transmitting sound waves; useful in diagnosing middle ear infections that commonly cause hearing loss in children
Tympanostomy
A procedure where a "surgically created" new opening in the tympanic membrane is created to allow fluid to drain from the middle ear
Audiologist
A professional trained to identify and treat hearing or balance problems
Oval Window (Cochlea)
A small snail shaped structure of the inner ear, that vibrations are converted into nerve impulses and transmitted via the auditory nerve to the brain, where they are processed as sound
Weber Test
A tuning fork is held against the crown if the patients head to determine which ear can hear sound the best
Rinne Test
A tuning fork is placed on the mastoid bone or inches from the patients ear to determine bone conduction of sound
Astigmatism
Abnormal curvature of the cornea, which causes blurry vision
AOM
Acute Otitis Media
Otorhinolaryngologist
An MD who specializes in disorders of the ear; ear, nose and throat (ENT) doctor
Fovea Centralis
An area in the posterior retina where incoming light, color and shapes are formed into nerve impulses.
Corneal Abrasion
An injury, such as a scratch or irritation, to the outer layers of the cornea
Otoscope
An instrument used to examine the ears, during physical examination
Audiometer
An instrument used to measure hearing
Conjunctivitis (Pink Eye)
Any infection or inflammation of the conjunctiva;
What temperature should ear irrigation solution be?
Body temperature whenever possible; 99 F to 100 F
Ossicles
Bones in the middle ear that carry sound vibrations
AU
Both ears
OU
Both eyes
Profound (deafness)
Both speech and language deteriorate
Jaegar Chart
Commonly used for near vision assessment; consists of a series of readings with the type ranging in size from newspaper headline print to the small print commonly found in telephone directories
Tumbling E Chart
Consist of the letter E arranged in different directions and in decreasing sizes; patient is asked to describe the direction the open end of the E is facing; children often point to the direction
Elephant Ear Wash
Convenient and easy to use; consists of a spray bottle with tubing attached to a nozzle; the bottle is filled with warm water and as the medical assistant pumps the trigger, it sprays the water into the ear with enough pressure to clean the ear but it doesn't cause discomfort or damage
Moderate-Severe Hearing Loss
Difficulty with speech; does not hearing most conversational speech
DVA
Distance visual acuity
Combination Antibiotic - Corticosteroid
Drugs that are both an antibiotic and corticosteroid combined into one medication (ex: TobraDex, Ciproflaxin-hydrocortisone, acetic acid - hydrocortisone)
ENT
Ear, Nose, Throat
Tympanic Membrane (TM)
Eardrum; drum-like structure that receives sound collected in the external auditory canal and amplifies it through the middle ear
Presbyopia
Farsightedness due to aging
Hyperopia
Farsightedness; the ability to see only objects that are far away
Ear Irrigation
Flushing of the ear canal with water or saline to dislodge foreign bodies or impacted cerumen (earwax)
Lens
Focuses light onto retina
Neurosensory Hearing Loss
Hearing loss associated with auditory nerve damage.
Retina
Inner most layer; Contains sensory receptors that process visual information and sends it to the brain
Opthalmoscope
Instrument used to examine the internal structures of the eye
Opthamolic
Intended for eye use only
Lactated Ringer's Solution is highly recommended because ______:
Its PH is closer to the PH of tears
Common solutions used to irrigate the eye include:
Lactated ringers solution, saline and water
Cataracts
Leading cause of blindness; cloudiness of lens
AS
Left ear
OS
Left eye
Opthalmologist
MD who specializes in the eyes; able to treat refractive disorders, prescribe medications, and perform various types of surgical procedures on the eye
Moderate Hearing Loss
May affect language development, articulation, interaction with peers and self-esteem; child may have difficulty hearing some conversational speech
Severe Hearing Loss
May affect voice quality
Mild Hearing Loss
May not hear soft speech; child may become fatigued after trying to listen for a long period of time
The Ishihara Method
Method used to for screening color vision by detecting color vision deficiency and red-green deficiency
Choroid Layer
Middle layer of the eye; helps supply retina with blood; dark, pigmented area that reduces reflection in the eye
NVA
Near visual acuity
Myopia
Nearsightedness; the ability to see only objects that are close up
Optician
Not an MD and cannot diagnose, prescribe, or treat eye disorders, but is able to fill prescriptions for eyeglasses and contact lenses
Optometrist
Not and MD, but a Doctor of Optometry (O.D). Cannot perform surgery, but can diagnose, prescribe, and treat eye disorders as well as refractive disorders
Macular Degeneration
Occurs when damage to the macula of the retina causes blurriness, darkness, or a loss of vision in the center of the visual field
Conductive Hearing 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, polyps, or swelling due to otitis media
OE
Otitis Externa
OI
Otitis Interna
OM
Otitis Media
Eye Irrigation
Performed to flush the eye and may be ordered to relieve inflammation, remove foreign particles , cleanse and remove secretions due to infection, and flush out harmful substances such as chemicals
Contrast Sensitivity Testing
Provides screening test for visual for earlier diagnosis and treatment of particular eye diseases
AD
Right ear
OD
Right eye
Cones
Sensitive to bright light and help differentiate colors
Rods
Sensitive to dim light
Electronic Ear Irrigator
Several on the market; come equipped with pressure controls and suction equipment to remove debris that are dislodged; designed so the stream of solution is directed to the wall of the ear canal to prevent damage to the eardrum
Visual Acuity Test
Standard eye examination to determine the smallest letters a person can read on a Snellen chart, or E chart, at a distance of 20 feet
Medications dispensed in the eye come in:
Sterile drops or sterile ointment
Speech and Word Recognition Test
Testing done by audiologists to determine if an individual has difficult clearly interpreting speech with varying levels of background noise
Waterpik System
The oral irrigator can be converted into an ear irrigator by using the proper tip for ears
Auricle
The outer ear; serves as a mini satellite dish to catch sound waves then pass through the auditory canal until it reaches the eardrum.
What will happen to the patient if ear irrigation solution is to hot or to cold?
The patient can experience dizziness and/or nausea; and extremely hot solutions can cause damage to the eardrum
Irrigation
The process of using liquid to flush out a substance (cerumen)
Gross Hearing Screening
The provider stands 1 to 2 feet away from the patient and whispers a series of words or numbers; the patient is then asked to repeat them
Conjunctiva
Thin mucous membrane that lines the eyelids and outer surface of the eyeball
TM
Tympanic Membrane
Snellen Chart
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
Antibiotic
Used to treat bacterial infections in the form of ear Commonly used for external infections of the ear. ( (ex: Bacitracin, Bleph-10, Cortisporin)
Corticosteroids
Used to treat ear inflammation, reduce swelling, irritation, and discharge (ex: Dexamethasone, Flucinone)
Antifungal
Used to treat fungal causes of ear infection (ex: Acetic Acid)
Alpha-Agonists
Used to treat glaucoma (ex: Apraclonidine, Brimonidine)
Carbonic Anhydrase Inhibitors (CAI)
Used to treat glaucoma (ex: Brinzolamide)
Cholinergic
Used to treat glaucoma (ex: Pilocarpine)
B-Beta Blockers
Used to treat glaucoma (ex: Timolol)
Vitamin/Nutritional Supplement
Used to treat macular degeneration (ex: Antioxidants, saffrron, Ginko)
Monoclonal Antibodies
Used to treat macular degeneration (ex: Eylea, Lucentis, Macugen, saffron supplements, and Visudyne used with photodynamic therapy (PDT)
Antivirals
Used to treat viral infections (ex: Vitrasert, Zirgan, Viroptic, Herplex, Vira-A)
The two common methods used to test for hearing acuity by the provider are the :
Weber test and Rinne test
Cornea
Where light enters the eye
Sclera
White part of the eye; outermost lining