Y khoa - Dược - Chapter 43: Assisting with eye and ear care

43Assisting with Eye and Ear CareLearning Outcomes (cont.)43.1 Describe the medical assistant’s role in eye exams and procedures performed in a medical office.43.2 Discuss various eye disorders encountered in a medical office.43.3 Identify ophthalmic exams performed in the physician’s office.43.4 Summarize ophthalmologic procedures and treatments.Learning Outcomes (cont.)43.5 Describe the medical assistant’s role in otology. 43.6 Describe disorders of the ear encountered in the medical office.43.7 Recall various hearing and other diagnostic ear tests.43.8 Summarize ear procedures and treatments.IntroductionThink how often you use your eyes and earsGood eye and ear care is criticalOphthalmology and otology DisordersExams and proceduresOphthalmologySpecialty of the anatomy, function and diseases of the eyeOphthalmologists Medical assistantVisual acuityColor visionIntraocular pressureEye Diseases and DisordersDisorders of external eye structuresBlepharitis ~ chronic inflammation of the eyelid’s edgesPtosis ~ droopy upper eyelidSty ~ eyelash follicle infectionEye Diseases and Disorders (cont.)Disorders of structures of the front of the eyeConjunctivitis Allergic Infectious Corneal ulcers and abrasionsEye Diseases and Disorders (cont.)Disorders involving internal eye structuresCataracts ~ cloudy or opaque lensGlaucoma ~ increased fluid pressureIritis ~ inflammation of the iris and sometimes the ciliary bodyEye Diseases and Disorders (cont.)Disorders of the RetinaRetinal detachment ~ retina separate from the middle, vascular layer of the eyeDiabetic retinopathy ~ damage to small blood vessels supplying the retinaMacular degeneration ~ dark spot in the center of the field of visionEye Diseases and Disorders (cont.)Disorders involving eye movement Strabismus Deviation of one eyeChildren – misaligned or unbalanced musclesAdults – nerves and/or musclesAmblyopia ~ “Lazy” eyeEye Diseases and Disorders (cont.)Refractive disordersMyopiaHyperopia PresbyopiaAstigmatismApply Your KnowledgeTrue or False An ophthalmologist specializes in treating eyes and  related tissues. Blepharitis is the result of an eyelash follicle infection. Viral or bacterial conjunctivitis is not easily spread. In glaucoma, fluid pressure builds up in the eye. There is a loss of the vision in the center of the eye with  retinal detachment. Presbyopia is related to aging. Visual defects are the most common eye disorders  treated by ophthalmologists.ANSWER:TTTTFFFA stymacular degenerationOphthalmic ExamsOphthalmoscope TestsVisual fieldsConvergence of the eyesGlaucoma – tonometer Ophthalmology ExamsSlit lamp Refraction examTypes of Vision Screening TestsIncludes tests forThe ability to see clearlyThe ability to distinguish shadesof grey and colorsScreeningSnellen chartJaegar chartIshihara bookTypes of Vision Screening Tests (cont.)Near VisionHyperopia PresbyopiaContrast SensitivityShades of grayCataracts / retinal problemsColor visionColor-blindnessRetina / optic nerve problems(Reprinted with permission of Richmond Products, Inc.)Apply Your KnowledgeMatch the following: used to view the inner eye measures intraocular pressure used to examine the anterior eye verifies the need for corrective  lenses Snellen chart Jaegar chart Ishihara book Refraction examOtoscopeDistance visual acuityColor-blindnessTonometer Near visionSlit lampBANSWER:EGACFDCorrect!Ophthalmologic Procedures and TreatmentsMinor injury or infection – lasting consequencesMedical assistantProper techniquePatient education Routine careWarning signs Use of protectiveequipmentAdministering Medications to the EyePurposesAssist patients in eye testsReduces pressure in the eyeRelieves eye painTreats infectionsMedical assistantDispense eye medicationPatient instructionsAdministering Medications to the Eye (cont.)Eye irrigationRemove foreign materialsRelieve discomfortUse sterile solutionApply Your KnowledgeWhen administering eye medications, you should avoid touching the tip of the dropper or tube to the eye. Why?ANSWER: Touching the tip of the dropper or ointment tube can injure the eye, cause infection, and contaminate the medication.Excellent!OtologyOtologist – treats diseases and disorders of the earsMedical assistantAuditory screeningAdminister ear medicationsPerform ear irrigationsAssist with diagnostic testsApply Your KnowledgeWhat are the functions of a medical assistant related to otology?ANSWER: The medical assistant may Perform auditory screeningAdminister ear medicationsPerform ear irrigationsAssist with diagnostic testsHEAR! HEAR!Ear Diseases and DisordersCommon Disorders of the Outer EarCerumen impactionEardrops to soften waxIrrigation to remove itOtitis externa Swimmer’s earMedicated dropsPruritusLess wax with agingMineral oil dropsCommon Disorders of the Middle EarOtitis MediaFluid buildup Ear infectionMastoiditisOtosclerosisAbnormal bone tissue growthHearing loss and tinnitus Ruptured ear drumCommon Disorders of the Inner EarLabyrinthitisInfection of labyrinthVertigo Ménière’s diseaseIncreased fluid in labyrinthVertigo, nausea, and vomitingCommon Disorders of the Inner EarPresbycusisDeterioration of sensory receptors in the cochleaAging TinnitusRinging in the earsDamage to hearing receptorsHearing LossNot a normal aging processTypes Conductive hearing loss ~ sound waves do not reach the inner earSensorineural hearing loss~ damage to the inner ear, nerve, or brainNoise pollution Working with Patients with a Hearing ImpairmentSpeak at a reasonable volumeSpeak clearly, in low-pitched tonesStand facing the patient Do not over-emphasize lip movementsWorking with Patients with a Hearing ImpairmentAvoid hand gesturesRe-state message in short, simple sentencesTreat patients with patience and respectApply Your KnowledgeArrange disorders properly:Inner Ear Middle Ear Outer EarCerumen impactionRuptured eardrumMastoiditis Pruritus Otitis externaOtitis mediaTinnitus Presbycusis OtosclerosisLabyrinthitisNice Job!Ménière’s DiseaseMénière’s DiseaseOtitis externaOtitis mediaRuptured eardrumTinnitus MastoiditisCerumen impaction OtosclerosisLabyrinthitis Pruritus PresbycusisHearing and Other Diagnostic Ear Tests Medical assistantAssist with testingEducate patientsTuning forkHearing and Other Diagnostic Ear Tests (cont.)Audiometer Measures hearing acuityVaries frequency and decibelsTympanometry Measures eardrum’s ability to moveGauges pressure in the middle earEar Treatments and Procedures Medical assistantPatient education ~ preventive ear careAdminister ear medicationsPerform ear irrigations Assist with earwax removalEar Treatments and Procedures (cont.)Administering medications Local effectWarm before administeringEarwax removal Ear curetteIrrigation Ear Treatments and Procedures (cont.) Ear irrigation Relieve inflammation or irritationLoosen and remove impacted cerumenRemove foreign bodyMicroscopic earwax and foreign body removalHearing Aids PartsMicrophone AmplifierSpeaker Obtaining a hearing aidOtologist Audiologist Care and useOther Devices and StrategiesIf hearing not helped by hearing aidDevices that light up as well as ringAmplifiers for phone, TV, and radioClosed-captioningCochlear implant Does not amplify soundStimulates the auditory nerveApply Your KnowledgeWhat is the differences in technique for administering eardrops to a child or an adult? ANSWER: To administer eardrops you need to straighten the ear canal by pulling the auricle upward and outward for adults, down and back for infants and children. In Summary43.1 The medical assistant may perform some of the procedures that involve measuring various aspects and functions of the eye, such as visual acuity, color vision, and intraocular pressure. 43.2 Disorders of the eye include: those of the external eye structures, disorders of the anterior eye structures, and refractive disorders.In Summary43.3 Ophthalmic exams performed in the physician’s office include: inspecting internal eye structures; testing visual fields; glaucoma testing; inspecting external eye structures; and refraction exams.43.4 Ophthalmologic procedures and treatments include administering eye medications like eyedrops and ointments, and performing eye irrigation.In Summary43.5 Medical assistants in an otology office may assist with or perform auditory screening, administer ear medications, perform ear irrigations, and help with diagnostic tests such as tympanometry.43.6 Ear diseases and disorders include: those of the outer ear, middle ear disorders, and those of the inner ear. In Summary43.7 Hearing and other diagnostic ear tests include audiometry and tympanometry.43.8 Ear treatments and procedures include administration of ear medications, ear irrigation, microscope-aided earwax or foreign body removal, hearing aid fitting, and cochlear implants.End of Chapter 43There is no such thing as an empty space or an empty time. There is always something to see, something to hear. In fact, try as we may to make a silence, we cannot- John Cage