UNIT-IV Disorder of Special Senses (Eye & ear)
BY
SADIA ANWAR
OBJECTIVES
Discuss some common visual & auditory dysfunction
Glaucoma
Tinnitus & hearing Loss
Glaucoma
Glaucoma refers to a group of eye conditions that lead to
demage to the optic nerve .This demage is often caused by
increased intraocular pressure,but it can also result from
decreased blood flow to the optic nerve.
Normal IOP is 16 to 23 mmHg .
RISK FACTORS
Genetic factors
Aging
Eye trauma
Hypertension
Severe Myopia
Ocular surgery
Diabetes mellitus
Caffeine consumption
PATHOPHYSIOLOGY
CLASSIFICATION OF GLOUCOMA
Open angle(chronic) glaucoma
Closed angle(acute) glaucoma
Congenital glaucoma
Secondary glaucoma
CLINICAL MANIFESTATION
Eye pain
Blurred vision
Haloes
Red eye
Blinking
Headache
Eye swelling
Difficulty walking
Tunnel vision
Tears
DIAGNOSTIC MEASURES
History collection
Tonometry
Opthalmoscopy
Gonioscopy
Visual feild test
Slit lamp Examination
Nerve fiber analysis
COMPLICATIONS
Complete loss of vision
Choroidal detachment
Retinal detachment
Anterior segment necrosis
Medical Management
Beta adrenergic blockers
cholinergic
Carbonic anhydrase inhibitor
Prostaglandin analogs
Osmotic agent
SURGICAL MANAGEMENT
Trabeculectomy
Argon laser trabeculoplasty
Drainage implants and shunts
NURSING MANAGEMENT
Assess the IOP
Elevate the head end of the bed at 30 degree angle.
Instruct the patient not to touch tha eyes
Encourage the patient to wear eye sheild.(to prevent infection)
Administer medications as prescribed.
CONCLUSION
• Glaucoma is a condition that cause demage to the eyes optic
nerve and get worse over the time .Without the treatment the
glaucoma can cause permanat blindness within few years.
• so the treatment should be given at right time to prevent
complications.
Tinnitus
• Tinnitus is a condition when a person hears a ringing
sound or a different variety of sound when no
corresponding external sound is present and other people
cannot hear it
Signs and Symptoms of Tinnitus
• 1. Ringing, buzzing, hissing, or clicking sounds in the ears.
• 2. Sounds that are intermittent or continuous.
• 3. High-pitched or low-pitched noises.
• 4. Noise occurring in one ear (unilateral) or both ears
(bilateral).
• 5. Pulsatile tinnitus (sounds like a heartbeat or pulse).
• 6. Hearing loss (partial or progressive).
• 7. Sensation of fullness or pressure in the ears.
• 8. Difficulty sleeping due to persistent noise.
• 9. Problems concentrating or focusing.
• 10. Emotional distress, such as anxiety, irritability, or
Causes of Tinnitus
1. Hearing Loss
Age-related hearing loss (presbycusis)
Noise-induced hearing loss
2. Ear Problems
Earwax blockage
Ear infections
Otosclerosis
Eustachian tube dysfunction
3. Injury or Trauma
Head or neck injuries
Inner ear or auditory nerve damage
CONTI.......
4.Medication
5.Circulatory Problems
6.Neurological Disorders
TYPES OF TINNITUS
Subjective tinnitus
Neurological tinnitus
Somatic tinnitus
Objective tinnitus
Pulsatile tinnitus
DAIGNOSTIC EVALUATION
Hearing tests
Audiometry: A hearing test that measures hearing levels and
compares hearing in the bone of the ear to hearing via an
earphone
Tympanogram: A painless test that measures the stiffness and
functioning of the eardrum
conti....
Imaging tests
MRI scan: Creates detailed pictures of the brain, inner
ear, and nerves surrounding the ear
CT scan: Creates detailed pictures of the brain and
middle ear
Angiography: A blood vessel study that looks for
aneurysms or blood vessel abnormalities
X-ray: May be prescribed if a CT scan or MRI is not
possible
COMPLICATIONS
Anxiety and depression
Sleep problems:
Concentration problems:
Memory problems
Irritability
Headaches
Cognitive decline
Communication problems
Problems with work and family life
SURGICAL MANAGEMENT
Surgery can help with tinnitus in some cases, but it's not a
reliable treatment. Surgery is usually only recommended to
treat an underlying condition that's causing tinnitus.
Stapedectomy
Microvascular decompression
Cochlear implantation
Venous sinus stenting
Deep brain stimulation
NURSING MANAGEMENT
Assess the patient’s hearing ability using audiometry and clinical observations.
Monitor for signs of ear infections, ear pain, or changes in hearing.
Educate the patient on hearing protection, especially if exposed to loud
environments.
Teach the proper use of hearing aids or cochlear implants and provide emotional
support for patients adjusting to devices.
Explain the importance of regular follow-up appointments with an audiologist or
ENT specialist.
Encourage the use of clear and effective communication strategies (e.g., speaking
slowly, facing the patient directly, using sign language, or written communication
when necessary).
HEARING LOSS
Hearing loss refers to the partial or complete inability to hear
sounds in one or both ears. It can affect a person’s ability to
hear at different frequencies, leading to difficulty in
communication and social interaction.
TYPES OF HEARING LOSS
1. Conductive Hearing Loss:
Occurs when sound cannot efficiently pass through the outer
ear canal to the middle ear.
2. Sensorineural Hearing Loss:
Caused by damage to the inner ear (cochlea) or the auditory
nerve pathways to the brain.
CONTI...
3. Mixed Hearing Loss:
A combination of conductive and sensorineural hearing
loss.
4. Central Hearing Loss:
Results from damage to the brain areas responsible for
processing sound.
ETIOLOGY
Aging (Presbycusis)
Noise Exposure
Infections
Head Trauma
Genetic Factors
Ear Blockages
Congenital Conditions
Signs and Symptoms of Hearing Loss
Mild Hearing Loss
Moderate Hearing Loss
Severe Hearing Loss
Tinnitus
Speech Delays
Difficulty with Phone Conversation
Diagnostic Test
1. Audiometry
2. Tympanometry
3. CT/MRI Scan
4. Rinne and Weber Tests (Tuning Fork Tests):
Surgical Management
1. Cochlear Implants:
• A device surgically implanted into the inner ear for individuals with severe to
profound sensorineural hearing loss who do not benefit from hearing aids.
2. Stapedectomy/Stapedotomy:
• Surgery to replace or remove the stapes bone (in cases of otosclerosis) in the
middle ear to improve conductive hearing loss.
3. Tympanoplasty:
• Surgical repair of the eardrum, typically used in cases of perforation due to
chronic otitis media.
4. Middle Ear Implants:
• Implants that vibrate the bones in the middle ear to improve sound transmission.
NURSING MANAGEMENT
Assess the patient’s hearing ability using audiometry and clinical
observations.
Monitor for signs of ear infections, ear pain, or changes in hearing.
Educate the patient on hearing protection, especially if exposed to
loud environments.
Explain the importance of regular follow-up appointments with an
audiologist or ENT specialist.
Educate about the dangers of loud noise exposure and promote the use
of ear protection in noisy environments.
ASSIGNMENT
• PATHOPHYSIOLOGY OF TINNITUS
