PowerPoint® to accompany
Medical Assisting
Chapter 39
Second Edition
Ramutkowski  Booth  Pugh  Thompson  Whicker
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
1
Providing Eye and Ear Care
Objectives:
39-1
39-2
39-3
39-4
39-5
Describe the anatomy and physiology of the eye.
State the ways that vision changes with age.
Describe ways to detect vision problems.
List treatment of eye disorders.
Identify ways that patients can practice preventive
eye care.
39-6 Describe the anatomy and physiology of the ear.
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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.
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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.
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Vision
Eye
Sclera
 Cornea
Choroid
 Iris,
pupil, ciliary
body, lens, aqueous
humor & vitreous
humor
Can you identify the parts of this eye?
Inner layer
Retina
Rods
Cones
5
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.
6
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
7
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
8
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’
9
Vision Testing
Ophthalmologist – medical doctor
who is an eye specialist.
Vision Tests performed:

Distance vision – Snellen chart

Near vision – handheld charts

Contrast sensitivity – PelliRobson contrast sensitivity chart

Color Vision – Richmond
pseudoisochromatic color test
Can you identify the
number in this
portion of the color
vision test?
10
Treating Eye Problems

Common eye problems



Conjunctivitis – inflammation of the conjunctiva
Blepharitis – inflammation of the eyelid
Corneal abrasions – scratching of the cornea
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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.
12
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.
13
Vision Aids
Common refractive disorders
 Myopia
 Hyperopia
 Presbyopia
 Astigmatism
Optometrist – trained to prescribe
corrective aids
14
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
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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
16
Hearing
Hearing depends on normal
transmission of nerve impulses
from the ear to the brain
17
The Ear

External ear



Middle ear




Auricle
Tympanic membrane
Malleus
Stapes
Incus
Inner ear - labyrinth


Cochlea
Can you identify the parts of this ear?
Semicircular canals
18
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.
19
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.
20
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.
21
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.
22
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.
23
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
24
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
25
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
26
Treating Ear and
Hearing Problems

Problems




Cerumen impaction
Rupture of the
eardrum
Otitis media
(inflammation of the
middle ear)
Otitis externa
(inflammation of the
outer ear)
27
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
28
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
29
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
30
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?
31
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.
32
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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End of Chapter
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