Chapter 30 Assisting in ophthalmology and otolaryngology

Cornea

Light reflection

Macular Degeneration

Progressive deterioration of the macula lutea. Causes severe vision loss and blindess. No cure, but antioxidants may prevent or slow progression. Two forms: dry (90% of cases) and wet.

sensorineural hearing loss

Results from an abnormality of the organ of Corti or of the auditory nerve

Ophthalmology

Science of the eye and its disorders and diseases.

Otitis Media

Serous or suppurative. Often associated with upper respiratory tract infection or allergic reaction. More common in children

otosclerosis

hardening of the bony tissue of the middle ear

mastoiditis

inflammation of the mastoid bone; Can cause ear infection

Otitis Externa

inflammation of the outer ear and ear canal (Redness)

otoscope

instrument used for visual examination of the ear

Vitreous Humor

jellylike substance found behind the lens in the posterior cavity of the eye that maintains its shape

Retinal Layer

light receptor that transforms optic signals into nerve impulses

Lens

light refraction

Optic nerve

one of a pair of nerves that transmit visual stimuli to (cranial nerve 11) the brain

Notice of Privacy Practices (NPP)

outlines the patients rights and facility's legal responsibilities to safeguard patients health protection

Chalazion

Small cyst from blockage of meibomian gland

Cerumen

Soft, yellowish, waxy substance that lubricates the external auditory canal.

Ishihara color vision test

Test for defects in color vision (congenital or acquired). Asses perception of primary colors and shades of colors. Polychromatic plates with numbers of one color, and background dots different color

Fovea Centralis

area consisting of a small depression in the retina containing cones and where vision is most acute

Inner ear

called the labyrinth. organ of Corti

Macula lutea

center of the retina; contains the fovea centralis, the area of most highly acute vision

Excessive secretion can cause

Hearing loss •Tinnitus •Feeling of fullness •Otalgia

Pupil

the adjustable opening in the center of the eye through which light enters

conjuctiva

the mucous membrane that covers the front of the eye and lines the inside of the eyelids.

Retina

third layer of the eye

Sclera

white of the eye; Outer layer of the eye. (External protection).

Outer (external) ear

Auricle, auditory canal

Snellen Alphabet chart (distance)

Best single test for vision screening. Chart should be illuminated with maximum light. Patients are allowed to use glasses or contacts. Document use of corrective lenses, results of each eye separate and as fractions, outcomes of each test with appropriate abbreviations.

Choroid

Blood supply to eye

impacted Cerumen

Can cause conductive hearing loss

Conductive hearing loss

Caused by a problem that originates in the external or middle ear

Corneal Abrasion

Caused by foreign body or direct trauma. Diagnosis is confirmed by fluorescence stain, highlighted by cobalt blue light. Foreign bodies are removed first, then treated with antibiotic ointment and nonsteroidal antiinflamatory ophthalmic ointments.

Meniere's disease

Causes swelling and edema in the semicircular canals •Triggers episodes of recurring attacks of vertigo, tinnitus, a sensation of pressure in the affected ear, and advancing hearing loss

Presbyopia

Changing the point of focus from distance to near becomes difficult, due to age. Difficulty seeing at reading level.

Cataract

Cloudy area blocks passage of light into retina. Condition may result from eye injury, exposure to extreme heat or radiation, or inherited factors, but is usually due to aging. Blurred, dimmed vision. Effective treatment is surgical removal of the lens

Cones

Color Vision

Iris

Colored part of the eye. (Light absorption and regulation of pupil width).

Glaucoma

Common and serious, increased intraocular pressure (IOP). Danages the optic nerve and causes blindess is untreated. Tonometer and gonioscopy used to diagnose. Miotic and beta-blocker eye drops or surgery for treatment.

Rinee Test

Compares air conduction sound with bone conduction sound in normal hearing, sound is heard twice as long by air as by bone conduction.

Myopia Corrected

Concave lens

semicircular canals

Conduct Sound waves.

Nystagmus

Constant, involuntary movement of one/both eyes. Accompanied by blurred vision. Caused by an abnormal function in part of the brain that controls eye movements.

Hyperopia Corrected

Convex lens

Ear irrigation

Done to remove excessive or impacted cerumen, to remove a foreign body, or treat inflamed ear with an antiseptic solutions. Administer irrigating solution with applicator tilted up toward the top of external canal. Always chart the treatment and its results immediately after completion

Strabismus

Eyes do not track together (do not look in same direction). In children, causes by weakness in eye muscles.

Shortened eyeball

Hyperopia (farsightedness) uncorrected

True

If the tip dispenser touch the eye, dispose in bio hazard

Conjunctivitis

Inflammation of conjucnctiva caused by irritation, allergy, or bacteria infection.

Keratitis

Inflammation of cornea, results in superficial ulcerations.

Blepharitis

Inflammation of glands and lash follicles along eyelids. (conjuctivitis and blepharitis can both be present).

Hordeolum (stye)

Localized purulent infection of sebaceous gland of eyelid.

Tuning Fork Testing

Measures hearing by air conduction and bone conduction. To activate the fork hold it but the stem and strike the tines softly on the palm of the hand.

audiometric testing

Measures the lowest intensity of sound an individual can hear. Wearing headphones, the patient is exposed to sound and is asked to signal when a sound

Instilling otic medications

Medication ordered for ear instillation is given to soften impacted cerumen, to relive pain, or as an antibiotoic drop for an infectious pathogen.

External ocular muscles

Movement of eyeball

Lengthened eyeball

Myopia (nearsightedness) uncorrected

Optometrist

Not a medical doctor, but can perform eye examinations, diagnose vision problems and eye diseases, and treat visual defects through corrective lenses and eye exercises.

Conduction Deafness

Occlusions of ear canal with cerumen

Astigmatism

Occurs when light rays entering the eye are focuses irregularly. Occurs because the cornea or the lens is not a smooth sphere, but has an irregular shape. Corrected with glasses, contacts, or surgery.

Near Visual acuity test (close up)

Patient holds card with varying sized font 14 to 16 inches from face. Test each eye, other eye covered, but open document number at which the patient stops reading.

Ophthalmologist

Physician who specializes in the diagnosis and the treatment of the disorders and diseases of the eye.

Opticians

Trained to fill prescriptions written by ophthalmologists and optometrists.

Middle ear

Tympanic Cavity

Medical assistant's role

Use good listening skills, appropriate nonverbal methods, and touch to communicate empathy and understanding . including family members in the patients treatment plan. Offer referrals to community resources.

Eye irrigation

Use sterile technique and equipment to avoid contamination. Used to relieve inflammation, remove drainage, dilute chemicals, or wash away foreign bodies. Never attempt to remove foreign body with applicator. Instillation of medication to treat infections, soothe irritation, anesthetize eye, dilate pupils. Eye drops or ointments are common. Aseptic procedures in ophthalmology avoid contamination of eye medication applicators. Sterility of Medications is critical.

Weber test

Used if patient reports better hearing in one ear

otitis interna

Vertigo, hearing loss. Antibiotics can help it

labyrinthitis (nerve deafness)

Viral, Autoimmune, Toxic injury of labyrinth.

Process of Vision

Visual impulse begins with light passing through the cornea. Cornea refracts the light and passes it through the aqueous humor and pupil into the lens. Ciliary muscle adjusts the curvature of lens to again refract light rays. Rays pass into the retina, trigger photo-receptor cells of rods and cones. Light energy converts into an electrical impulse and is sent through the optic nerve to the brain.

Otitis (Swimmer's Ear)

dermatologic conditions, Trauma, continuous use of earplugs/earphones, swimming

Rods

distinguish light from dark, perceive shape and movement

lacrimal gland

produces tears.

Opthalmoscope

projects light to view interior parts of eye and retina. Eyelids are examined for edema. Pupils examined for shape, symmetry, reactivity to light, and movement coordination. Slit lamp biomicroscope to view details of eye, requires mydriatic eye drops. Exophthalmometer measures how far eye protrudes beyond edge of socket.

Optic disc

region at the back of the eye where the optic nerve meets the retina;