AMS1

• Increased intraocular pressure
• Optic nerve atrophy
• Visual field loss

• Primary open-angle glaucoma
• --Most common (90%)
• --Genetic component
• --Bilateral
• --Insidious in onset
• --Slow to progress

• Angle-closure glaucoma
• --acute attack develops in an eye in which the anterior chamber angle is anatomically narrow
• --attack occurs because of a sudden blockage of the anterior angle by the base of the iris

• Primary open-angle glaucoma
• --Symptoms appear late in the disease
• --Mild aching in the eyes
• --Loss of peripheral vision
• --Seeing halos around lights

• Acute angle-closure glaucoma
• --Ophthalmic emergency due to rapid onset
• --Unilateral inflammation and pain
• --Pressure over the eye
• --Moderate pupil dilation that’s nonreactive to light

• Triad of signs: loss of visual field, cupping of optic disc, ^ intraocular pressure.
• Tonometry (air puff). (Good to know for test). Eye will be more firm than person w/out gloucoma. 
• Slit-lamp examination
• Gonioscopy
• Ophthalmoscopy
• Perimetry or visual field tests
• Fundus photography

• Drug therapy to decrease aqueous humor production and to lower IOP
• --beta blockers 
• --alpha agonists
• --miotic eyedrops
• ----facilitate outflow of AH
• Argon laser trabeculoplasty
• --thermal burn increases the outflow of aqueous humor
• Trabeculectomy
• --flap of sclera is dissected free and removed, followed by peripheral iridectomy

• Dilating agents are contraindicated in narrow-angle glaucoma
• --Mydriatic agents dilate the pupil
• --Cycloplegic agents paralyze the ciliary muscle and the dilator muscle of the iris

• Desired outcomes
• --Patient will report no further loss of vision, adapt to any visual loss, be able to perform ADLs, and recognize clinical manifestations of complications

A condition which develops when the crystalline lens of the eye begins to develop barriers stopping light from getting through it.

• Blurred vision
• Monocular diplopia
• Photophobia
• Glare
• See better in low light
• No complaint of pain
• Cloudy lens
• Red reflex seen with the direct ophthalmoscope is distorted or absent
• Accurate determination of type and extent of lens change requires slit-lamp examination

• Surgery to remove the opacified lens
• ICCE
• --removing lens and lens capsule
• ECCE
• --removing lens and anterior portion of lens capsule
• most common

• Leave eye patch until f/u visit next day
• Limit activity 24 hrs
• Do not lift more than 5 pounds (gal of milk)
• Do not strain
• Take eye drops
• Take Tylenol for pain or itching (common)

• Progressive disorder
• --Caused by microscopic damage to the retinal vessels, resulting in occlusion of the vessels
• --Inadequate blood supply causes sections of the retina to deteriorate
• --Vision is permanently lost
• A leading cause of blindness worldwide
• Two types: nonproliferative and proliferative

• liquid in the vitreous body with access to the hole
• subsequent fluid accumulation between the retina and the retinal pigment epithelium
• liquid seeps through the hole and separates the retina from its blood supply

• Described as shadow or curtain falling across the field of vision
• No pain
• Usually sudden onset
• Burst of black spots or floaters indicate that bleeding has occurred

• Places retina back in contact with the choroid
• Vision may improve over weeks and months as healing takes place

Floaters are tissue remnants located in the vitreous body. They will often move after a vigorous blink. Patients view.

• Conductive
• --otosclerosis
• --trauma
• Sensorineural 
• --presbycusis
• --noise-induced
• --sudden 
• Mixed hearing loss

• Progressive hearing loss, predominantly in the elderly (age related.)
• Involves changes in the labyrinthine structures over time
• Initially, a decrease in high-frequency sound
• Tinnitus (noise in ear) may accompany

• Affects both vestibular and auditory function
• Caused by excess endolymph in the vestibular and semicircular canals. NS is CX for pt w/Miniere's. 
• Hearing loss is fluctuant, usually subtle, and reversible in early stages

• Talk directly to the client while facing him or her
• Speak clearly but do not overaccentuate words
• Speak in a normal tone; do not shout
• Mover closer to the client and toward the better-hearing ear
• Do not smile, chew gum, or cover the mouth