Medical Assisting Chapter 39 PowerPoint® to accompany Medical Assisting Chapter 39 Second Edition Ramutkowski  Booth  Pugh  Thompson  Whicker Chapter 39 Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Providing Eye and Ear Care Objectives: 39-1 Describe the anatomy and physiology of the eye. 39-2 State the ways that vision changes with age. 39-3 Describe ways to detect vision problems. 39-4 List treatment of eye disorders. 39-5 Identify ways that patients can practice preventive eye care. 39-6 Describe the anatomy and physiology of the ear.

Providing Eye and Ear Care Objectives (cont.) 39-7 State ways that hearing changes with age. 39-8 List the types of hearing loss. 39-9 Explain the procedures for screening and diagnosing ear problems. 39-10 Describe treatments for ear and hearing disorders. 39-11 Explain how patients can be educated about preventive ear care.

Introduction Duties may involve performing basic tests for vision and hearing You may also assist the doctor in providing treatment related to eyes and ears You will need to know the basic structure and function of these organs and to advise patients about general eye and ear care and concerns.

Vision Eye Sclera Choroid Inner layer Cornea Iris, pupil, ciliary body, lens, aqueous humor & vitreous humor Inner layer Retina Rods Cones Can you identify the parts of this eye?

Process of Seeing Eye works like a camera Light passes through the cornea, pupil, lens & fluids of the eye which focuses the light onto the retina The image is projected upside down on the retina Retina converts the light into nerve impulses that are sent to the brain The brain interprets these impulses, turns the image right-side up and develop a picture of the object.

The Aging Eye With age, changes occur in the eye: Amount of fat tissue diminishes – may cause droopy eyelids Quality & quantity of tears decrease Conjunctiva becomes thinner Cornea begins to appear yellow Sclera may develop brown spots

The Aging Eye (cont.) With age, changes occur in the eye: Iris causes the pupil to become smaller Lens becomes denser and more rigid Changes in the retina may make vision fuzzy Ability to adapt to changes in light intensities may be reduced Night vision may be impaired

The Aging Eye (cont.) With age, changes occur in the eye: Peripheral vision is reduced Vitreous humor breaks down causing the patient to see floaters Rubbing of the vitreous humor on the retina produces flashes of lights or “sparks’

Vision Testing Ophthalmologist – medical doctor who is an eye specialist. Vision Tests performed: Distance vision – Snellen chart Near vision – handheld charts Contrast sensitivity – Pelli-Robson contrast sensitivity chart Color Vision – Richmond pseudoisochromatic color test Can you identify the number in this portion of the color vision test?

Treating Eye Problems Common eye problems Conjunctivitis – inflammation of the conjunctiva Blepharitis – inflammation of the eyelid Corneal abrasions – scratching of the cornea

Administration of Eye Medications Teach the patient to check medication labels carefully before administering them at home. Optic medications for use in the eye can easily be confused with Otic medications for the ear. Medications other than optic meds may be too concentrated and injure sensitive eye tissue.

Eye Irrigation Foreign materials in the eye must be flushed out. Flushing or irrigation should be done with sterile solution formulated for this purpose. Will relieve discomfort from smog, pollen, chemicals, or chlorinated water.

Vision Aids Common refractive disorders Myopia Hyperopia Presbyopia Astigmatism Optometrist – trained to prescribe corrective aids

Apply Your Knowledge You are performing vision testing on a patient who wears glasses. What is a common order for testing the eyes? Number the list from 1 to 6. _____ Both eyes without glasses _____ Left eye with glasses _____ Right eye without glasses _____ Both eyes with glasses _____ Left eye without glasses _____ Right eye with glasses

Apply Your Knowledge -Answer You are performing vision testing on a patient who wears glasses. What is a common order for testing the eyes? Number the list from 1 to 6. __1__ Both eyes without glasses __6__ Left eye with glasses __2__ Right eye without glasses __4__ Both eyes with glasses __3__ Left eye without glasses __5__ Right eye with glasses

Hearing Hearing depends on normal transmission of nerve impulses from the ear to the brain

The Ear External ear Middle ear Inner ear - labyrinth Auricle Tympanic membrane Middle ear Malleus Stapes Incus Inner ear - labyrinth Cochlea Semicircular canals Can you identify the parts of this ear?

Hearing Process Sound enters the external ear which makes the eardrum vibrate. The middle ear amplifies the vibrations and the waves cause the tiny hairs to the cochlea to bend. Movement of the hairs triggers nerve impulses. The impulses are transmitted via auditory nerve to the brain. The brain perceives the sound.

Ear and Balance The brain constantly monitors the position of one’s body on the information received from the semicircular canals, eyes, and muscles. A change in position is detected by the canal and passed to the brain. The brain uses this information to maintain balance.

The Aging Ear The external ear appears larger – caused by growth of cartilage and loss of skin elasticity. Ear lobe gets longer and may be wrinkled. Less production of cerumen. Middle ear begins to shrink and appears dull and gray. Bones of the middle ear degenerate and don’t move as freely. Semicircular canals become less sensitive and cause a reduced sensitivity affecting balance.

Hearing Loss Types of hearing loss Conductive – caused by interruption in transmission of sound waves to the inner ear Caused by obstruction of the ear canal, Infection of the middle ear Reduced movement of the incus Sensorineural –caused when there is damage to the inner ear, the nerve that leads from the ear to the brain, or the brain itself.

Working with Patients with a Hearing Impairment One-third of patients between 65 and 75 and one-half of patients between 75 and 79 have some hearing loss. Many patients wear hearing aids to amplify normal speech.

Improving Communications Speak at a reasonable volume Don’t shout Speak in clear, low-pitched tones Avoid speaking directly into the patient’s ear. Stand 3 to 6 feet away and face the patient Avoid overemphasizing your lip movements. Avoid hand gestures Treat patients with a hearing impairment with patience and respect

Hearing Tests Hearing Tests Audiometer – electronic device that measures hearing acuity by producing sounds in specific frequencies and intensities Tuning forks – differentiating conductive from sensorineural hearing loss

Diagnostic Testing Tympanometry – measures eardrum’s ability to move and gauges pressure in the middle ear. Used to detect diseases and abnormalities of the middle ear. Uses a small, soft rubber cuff placed over the external ear producing an airtight seal Measures and prints out a graph of results

Treating Ear and Hearing Problems Cerumen impaction Rupture of the eardrum Otitis media (inflammation of the middle ear) Otitis externa (inflammation of the outer ear)

Ear Meds and Irrigation You will teach patients how to administer ear medications at home Irrigation of the ear may relieve inflammation or irritations of the ear. Irrigation may loosen earwax or foreign body

Hearing Aids Hearing aids consist of the following parts: A tiny microphone to pick up sounds An amplifier to increase the volume of sounds A tiny speaker to transmit sounds to the ear

Hearing Aids (cont.) Otologist – medical doctor specializing in the health of the ear. Audiologist – non-physician specialist who focuses on evaluation and correcting hearing problems. Hearing aids run on batteries for about 2 weeks

Apply Your Knowledge A six-month old is seen at your clinic. The mother states that the infant has been cranky and pulling at her ears especially when she lays her down. What do you think might be wrong?

Apply Your Knowledge -Answer A six-month old is seen at your clinic. The mother states that the infant has been cranky and pulling at her ears especially when she lays her down. What do you think might be wrong? The infant may have otitis media, however a thorough examination of the infant by the physician is necessary.

You can help prevent, detect and treat eye and ear problems. Summary Medical Assistant You can help prevent, detect and treat eye and ear problems. A basic understanding of the anatomy and physiology of the eyes and ears will help you provide good eye and ear care to patients.

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