Anatomy and Conditions of the Eye

Eye Anatomy

• Anterior Cavity
  • Contains aqueous humor.
  • Includes anterior and posterior chambers.
  • Aqueous humor flows from the ciliary body through the pupil and anterior chamber.
  • Drains through the trabecular network into the canal of Schlemm.

Glaucoma

• Definition: Increase in intraocular pressure leading to optic nerve damage and visual field loss.
• Leading cause of preventable blindness.
• Primary Condition: Often has no identifiable cause.
• Risk Factors: Age over 60, genetics, eye trauma, diabetes, inflammation, hemorrhage, tumors, and cataracts.

Types of Glaucoma

• Closed Angle Glaucoma
  • Also called acute or narrow angle.
  • Accounts for 5% of cases.
  • Causes: Stress, impact injury, medications.
  • Symptoms: Severe eye pain, headache, nausea, vomiting, bloodshot eyes, halos around lights.
  • Requires immediate surgery.
• Open Angle Glaucoma
  • Most common (90% of cases).
  • Usually bilateral, develops slowly.
  • Asymptomatic, treated with medications.
  • Risk Factors: Corticoids, antihypertensives, antihistamines, antidepressants, high blood pressure, migraines, severe nearsightedness/farsightedness, aging.

Pharmacotherapy for Glaucoma

• Goals: Lower intraocular pressure to prevent optic nerve damage.
• Treatment
  • Combination Therapy: Often necessary.
  • Prostaglandins: Increase outflow of aqueous humor.
  • Carbonic Anhydrase Inhibitors: Decrease production of aqueous humor.
  • Osmotic Diuretics: Reduce aqueous humor formation.
  • Beta Adrenergic Blockers: Decrease aqueous humor production; may cause bronchoconstriction, dysrhythmias, hypotension.
  • Alpha 2 Adrenergic Agonists: Decrease aqueous humor production.
  • Miotics and Mydriatics: Affect pupil size to aid drainage.

Eye Exam Drugs

• Mydriatics: Dilate pupils, may increase intraocular pressure and cause CNS effects.
• Cycloplegics: Dilate and relax ciliary muscles; cause blurred vision and potential glaucoma attacks.

Anatomy and Conditions of the Ear

Ear Anatomy

• Functions: Hearing and equilibrium.
• Three Areas: Outer, middle, and inner ear.

Otitis and Ear Infections

• Otitis Externa: Associated with water exposure (swimmer's ear).
• Otitis Media: Associated with upper respiratory infections and allergies.
• Mastoiditis: Inflammation of mastoid sinus, can lead to hearing loss.

Pharmacotherapy for Ear Infections

• Antibiotics for infections.
• Topical Ear Drops: For external ear infections.
• Systemic Treatment: For middle/inner ear and extensive outer ear infections.
• Topical Corticosteroids: When inflammation is present.

Administration Notes

• Cleanse ear thoroughly before administering medications.
• Avoid using otic medications with perforated eardrum.
• Check for hypersensitivity to certain medications.

Patient Education

• Check pulse without thumb, ideally use index and middle finger.
• Preferred blood pressure measurement using an upper arm cuff.
• Understanding normal heart rate (60-100 bpm) and blood pressure (120/80 mmHg).