Eye and Ear Disorders
Cataracts, glaucoma, retinal problems, hearing and balance
| Condition | Signs | Care |
|---|---|---|
| Cataract | Gradual, painless blurred or cloudy vision; glare; halos | Surgery (lens replacement). After: eye shield at night; avoid bending, heavy lifting, straining and rubbing the eye; eye drops; report sudden pain or vision loss |
| Open-angle glaucoma | Painless, gradual loss of side vision ("tunnel vision") | Lifelong drops: latanoprost (can darken iris), timolol (can slow HR, cause bronchospasm), others. Press the inner corner of the eye 1–2 min after drops |
| Angle-closure glaucoma | Sudden severe eye pain, headache, nausea, red eye, halos, fixed mid-dilated pupil | Emergency: drops and IV meds to lower pressure, then laser surgery. Avoid anticholinergics (atropine, diphenhydramine) in at-risk patients |
| Macular degeneration | Loss of central vision | Dry: AREDS2 vitamins; Wet: anti-VEGF eye injections. Home Amsler grid checks |
| Retinal detachment | Flashes, floaters, a curtain or shadow over vision | Emergency surgery. Afterwards, position as the surgeon orders (e.g., face-down with a gas bubble); no flying or high altitude while gas is present |
Eye emergencies and drops
- Chemical splash: flush immediately with water or saline for at least 15 min, before anything else.
- Penetrating object: don't remove it; protect with a rigid shield (no pressure); keep the patient still.
- Giving drops: pull down the lower lid, drop into the pocket, don't touch the eye; wait ~5 min between different drops; drops before ointments.
Ears and balance
- Hearing loss: conductive (outer/middle ear) vs. sensorineural (inner ear, nerve). Face the person, speak clearly in a lower pitch; don't shout.
- Ear irrigation: body-temperature fluid; adults: pull the outer ear up and back; children <3: down and back. Not if the eardrum may be perforated.
- Ménière's disease: attacks of vertigo, ringing (tinnitus), fullness, hearing loss. Low-sodium diet, limit caffeine and alcohol, meclizine; lie still during attacks; fall precautions.
- Ototoxic drugs: aminoglycosides, loop diuretics (fast IV), cisplatin, high-dose aspirin, vancomycin.