Sensorineural Disorders

Terms to remember

Astigmatism Blurred vision due to irregular

shape of the cornea or lens that prevents proper focusing of light on the retina

Decibel (dB) Measurement of intensity of

sound waves Emmetropia

Normal vision, perfect vision Hyperopia

farsightedness

Legally blind Vision of 20/200 that cannot be

improved with corrective lenses Myopia

nearsightedness Mydriatic

Causes pupillary dilation Presbycussis

Age-related sensorineural hearing loss

Presbyopia Difficulty in focusing on near

objects due to loss of flexibility of the crystalline lens due to aging

Essential Procedures

Tonometry

To measure intraocular pressure (IOP)

Normal: 12-21 mmHg (Mosby); 10-20 mmHg (Brunner)

Eyes

Flashback!

Cataract

Main problem Opacity of the lens usually associated with aging, prolonged intake of

steroids and chromosomal aberrations Initial Manifestation

Painless blurring of vision Laboratory Data

Slit lamp test reveals milky white color of the pupils Intervention

Prepare the patient for surgery. Post-op instruct the client to avoid activities that require bending

Report sudden eye pain Avoid lifting and rapid head movements

Glaucoma Main Problem

Increased intraocular pressure due to accumulation of aqueous humor

Initial Manifestation Tunnel Vision

Laboratory data Tonometry reading

of 25 mmHg and above

Intervention Explain to the client that

glaucoma CANNOT be cured but can be controlled

Instruct the client to avoid lifting, pushing, emotional upsets and exposure to URTI: may increase IOP

Instruct the client to avoid products that contains atropine sulfate

Explain to the client that trabeculoplasty involves creation of an opening to increase outflow

Retinal Detachment Main Problem

Separation of the sensory retina from the pigment epithelium of the retina Initial Manifestation

Visual floaters described by clients as “cobwebs” or “curtains” in the eyes; flashing of lights and visual field loss

Laboratory Data Eye exam Opthalmoscopy

Interventions Priority is immediate bed rest Position the client with the affected side towards the bed Avoid coughing, sneezing, sudden eye movement and straining Prepare the client for eye surgery

Ears

Flashback!!!

Essential Procedures

Rinne’s Test

To differentiate between conductive and sensorineural hearing losses

Weber’s Test

To detect the presence of unilateral hearing loss

Otosclerosis

Main Problem Overgrowth of spongy bones in the middle ear

Manifestation Tinnitus Conductive Hearing loss

Laboratory data Audiometry reveals hearing loss

Intervention Prepare the client for surgery After surgery, instruct the client to void blowing the nose,

diving, smoking, flying in small plane

Meniere’s Disease A.K.A.

– Endolymphatic hydrops

Main problem Dilation of the

endolymphatic system causing degeneration of the vestibular and cochlear cells in the inner ear.

Affects CN VIII Manifestation

Vertigo Tinnitus Sensorineural hearing loss

Interventions Priority: PROMOTE

CLIENT SAFETY Keep the client in supine

position during attack of vertigo

Maintain low sodium diet Encourage the client to

stop smoking Keep the room dark

when photophobia is present

End