Sensory Perceptual

• General manifestations of hearing impairment

  • Inattentiveness
  • Speaking out of turn-in conversations
  • Withdrawal from social situations
  • Increase volume of voice when speaking OR radio/television
  • Confusion
  • Loss of reaction to loud sounds
• Manifestations of hearing impairment in children

  • Inattentivness
  • Difficulty with articulation and speech development
  • Frustration
  • Emotional outbursts
• Conductive hearing impairment


  More of a mechanical problem. Dysfunction of the middle and outer ear.
• Causes of conductive hearing impairment

  • Obstruction: cerumen, foreign body
  • Chronic OME, frequent AOM
  • Otosclerosis, alteration in middle ear bones
• Treatment for conductive hearing impairment


  Correctable with medical or surgical therapy, or both
• Sensorineural hearing impairment


  Damage to nerve, hair cells. The hearing mechanism is disturbed in the inner ear.
• Sensorineural hearing impairment is the most common type of loss
• Causes of sensorineural hearing impairment

  • Damage to cochlea or nerve
  • Long-term exposure to loud sounds
  • Trauma
  • Ototoxic medications
  • Aging
  • Metabolic causes
• Sensorineural hearing impairment involves irreversible damage to the nerves
• External Otitis

  Inflammation of the outer ear, also known as "swimmer's ear"
• Causes of external otitis

  • Excess moisture in the ear canal
  • Fungi
  • Bacteria
  • Trauma which changes the normal flora of the ear canal lead to another organism to take over
• The common organism in external otitis is Pseudomonas aerugenosa
• Manifestations of external otitis

  • Pain (especially when touching tragus)
  • Fullness in ear
  • Decreased hearing
  • White particles on sides of the canal
• Treatment for external otitis

  Antibiotic ear drops or sticking a cotton ball in the ear
• Otitis Media


  Inflammation or infection of the middle ear (Ear infection)
• Poor functioning of the eustachian tube and presence of effusion (fluid accumulates) are factors in otitis media
• Children are more susceptible to otitis media due to their shorter, more flexible, and horizontally positioned Eustachian tubes
• Causes of otitis media

  • Bacterial
  • Viral
• Otitis media often follows an upper respiratory infection
• Manifestations of otitis media


  • Pain
  • Fever
  • Irritability
  • Ear drainage is possible
• General manifestations of visual impairment

  • Squinting
  • Redness of the eye
  • Excessive tearing
  • Eye rubbing
  • Blurred vision
  • Floaters
  • Headaches
• Errors of Refraction


  Visual acuity depends on the formation of discrete patterns of light on the retina. Lenses can correct.
• Myopia


  Near-sighted (can see near fine). Elongation of the the eye, image focused in front of the retina. Concave lenses will correct.
• Hyperopia

  Farsighted (can see far fine). Eye is shorter than normal, image focused behind retina. Convex lenses will correct.
• Presbyopia


  Loss of accommodative capacity due to aging. Inability to see near objects. Reading glasses.
• Astigmatism


  Irregular curvature of the cornea. Distorted image. Lenses will need to be formed with the opposite curvature.
• Cataracts


  Clouding or opacity of lens. Most common in people 65 years or older. Leads to gradual, painless blurred vision, eventual loss of sight.
• Causes of cataracts


  • Sun exposure
  • DM
  • Age
• Manifestations of cataracts


  • Blurred vision
  • Visual distortion
  • Abnormal presence of light in visual field
  • Light coming in gets scattered, refracted
• Diabetic Retinopathy


  Disease of the vasculature of the retina (damaged leaky vessels). Retinal capillary becomes diseased which loses the ability to transport RBCs and O2 to the retina which causes hypoxia and ischemia.
• Manifestations of diabetic retinopathy

  • Blurred vision
  • Darkened/distored vision
  • Visual changes can fluctuate in severity
  • Start with vague vision changes, difficulty reading
• Retinal Detachment


  Separation of sensory layer of the retina from choroid.
• Causes of retinal detachment

  • Tumors
  • Inflammation
  • Trauma
  • Cataract extraction
• Manifestations of retinal detachment

  • Floaters
  • Flashes of light in visual fields
  • Loss of visual acuity
  • Sense of veil coming down in visual field
• Strabismus


  Ocular (muscle) misalignment of the eyes (crossed eyes). Corneal light reflex is not even.
• Manifestations of strabismus


  • Squinting and frowning when reading, closing one eye
  • Having trouble picking up objects
  • Dizziness, headache
• Amblyopia


  Poor vision of one or both eyes despite proper optical correction (Lazy eye). Eye is normal, but eye and brain not working well together.
• Etiology of amblyopia


  Untreated strabismus or severe refractive errors
• Amblyopia is decreased visual acuity not explained by organic causes
• Glaucoma


  Increased intraocular pressure and progressive vision loss.