Hearing impairment

1. SALALE UNIVERSITY COLLEGAE OF HEALTH SCIENCE
DEPARTMENT OF ADULT HEALTH NURSING
Seminar Presentation on care of visual and Hearing
impairment
Presented by; Sufa M.(191/15) & Kedir M (182/15) & Gelato H[ 181/15]
Presented To: Mr.Bikila . {BSc, MSc.Ass’t. prof}
June 2023
Salale , Fitche
1

3. Over view of Anatomy and pyhsiology

4. VISUAL IMPAIRMENT
DEFINITION;
 Visual impairment is the common term used to
indicate any degree of vision loss.
 Visual impairment includes both blindness and
low vision.
 Both blindness and low vision are different from
each other in terms of loss and functions of
vision.

5. TYPES OF VISUAL IMPAIRMENT
1.Hyperopia (far sightedness)
 Can see objects of far away but not near
 Cause : size of eye ball is too shorter.
2. Myopia (near sightedness)
 Can see objects of near but not far away
 Cause : size of eye ball is too longer
3. Astigmatism
 Cause : irregularity in cornea or eye surface
 Cannot focus at one object regularly.

6. TYPES OF VISUAL IMPAIRMENT…
4. Color Blindness :
 Genetic causes – natal, prenatal, postnatal
 Problem with cones cells of the eye
 Decreased ability to differentiate between colors
5. Retinopathy of Prematurity:
 This condition is common in children who were
premature babies that required high
concentration of oxygen at birth. Scarring and
detachment of the retina can result from this
condition.

7. TYPES OF VISUAL IMPAIRMENT…
6. Macular Degeneration:
Loss of central vision
Two objects looks like one
7. Glaucoma :
Due to the blockage of the fluids that
normally circulate within the eye
Deficiency in formation of eyes

8. TYPES OF VISUAL IMPAIRMENT…
8. Diabetic Retinopathy :
 Cause : disease of diabetes
 Diabetes unusual interference with the blood
supply to the retina
 May result in serious vision impairment i.e. total
blindness.
9.Cataract :
 Condition or state of cloudiness in the lens into a
distorted or incomplete vision Because of
neurological vision loss of both eyes

9. TYPES OF VISUAL IMPAIRMENT…
10.Amblyopea :
 one eye vision loss due to muscle imbalance
Lazy eye
 Child sees two images of the one object
11.Crossed eye :
 It represents an inability of the individual to focus on
the same object with both eyes simultaneously.
12.Coloboma:
 A condition in which the central areas of the retina of
a new born are found incomplete in their formation.
 It may be serious impairment.

11. CAUSES
 Refractive erorr’s
 Cataract
 Diabetic retinopathy
 Glaucoma
 Age related maculor degeneration

12. DIAGNOSIS OF VISUAL IMPAIRMENT
a) Snellen tests [ snellen chart]
b) Visual field test
c) Tonometry test
d) Ocular motility test

13. MANAGEMENT
 Optical aids
 Medication
 Surgical procedures

14. PREVENTION
Primary eye care
 Treatment and prevention
 Provided with essential drugs
Secondary eye care
 Definitive management of blinding condition[
glaucoma, cataract..]
Tertiary eye care
 Sophisticated eye care- retinal detachment,
corneal grafting

15. HEARING IMPAIRMENT

16. HEARING IMPAIRMENT
Definition ; Deafness, Hearing impairment or
hearing loss refers to the total or partial inability to
hear.
 Hearing refers to the reception of sound by the
ear, its analysis, and its transmission to the
brain.
 An impairment is any loss or abnormality of
psychological, physiological or anatomical
structure or function.

18. TYPES OF HEARING IMPAIRMENT
1. Conductive hearing loss (CHL)
2. Sensorineural hearing loss (SHL)
3. Mixed hearing loss (MHL)
4. Others
1. Central hearing loss
2. Functional hearing loss

19. CONDUCTIVE HEARING IMPAIRMENT
 A conductive loss refers to a
decrease in sound caused by
a problem such as foreign
bodies, cerumens and
infection in the outer or middle
ear.

20. Sensorineural hearing loss
 Sensory hearing loss
originates in the cochlea and
involves the hair cells and
nerve endings.
 Sensorineural hearing loss
results from disease or
trauma to the sensory or
neural components of the
inner ear.

21. MIXED HEARING LOSS
 Mixed hearing loss occurs when an individual
has both conductive and sensorineural
hearing loss.
 This can be caused by a combination of any
of the disorders

22. CENTRAL HEARING LOSS
 Central hearing loss occurs when the central
nervous system cannot interpret normal
auditory signals.
 This condition occurs with such disorders as
cerebrovascular accidents and tumors.

23. FUNCTIONAL HEARING LOSS
 Functional hearing loss is a hearing loss for which
no organic cause or lesion can be found.
 Also called psychogenic hearing loss.
 Precipitated by emotional stress.
 Malingering is a type of psychogenic hearing
loss.

24. ETIOLOGY
 Age: increasing age
 Exposure to loud noise
 Genetic
 Head injury
 Ototoxic drugs
 Illness

25. PATHOPHYSIOLOGY
Disorders of external or middle ear
Interruption in the transmission of sound by air to
the inner ear
Conductive deafness

26. DIAGNOSTIC MEASURES
 History
 Physical examination
 Rinne’s test
 Weber’s test
 Audiometry
 Tympanogram

27. COMPARISON OF WEBER AND RINNE
TESTS

28. MANAGEMENT
 Restore hearing
 Antibiotics: to treat infections
 Remove impacted wax or foreign bodies
 Ceruminolytics for impacted wax
 Corticosteroids for inflammation
 Treat underlying disorders

29. MANAGEMENT…
 Assist hearing
 Hearing aids
 Implantable middle ear hearing devices
 Cochlear implants
 Sign language
 Auditory rehabilitation

30. MANAGEMENT…
 Hearing aids: Hearing aid is designed to
amplify sound.
 Implantable ; middle ear hearing devices

31. MANAGEMENT…
 Cochlear implants; Cochlear implants are
surgically placed electrical devices that receive
sound and transmit the resulting electrical signal
to electrodes implanted in the cochlear of the
ear.

32. MANAGEMENT…
 Sign language: It involves hand shapes,
movement of hands, arms, body and facial
expressions

33. SURGICAL MANAGEMENT
 Surgery is indicated for conductive or
mixed hearing loss.
 To restore conductive hearing
 Myringotomy
 Stapedectomy
 Assisted hearing in profound deafness
 Cochlear implants
 Middle ear implants (Semi-implantable
hearing device)
 Tumour excision for acoustic neuroma

34. PREVENTION
 Minimize the exposure to trauma, infection,
ototoxic drugs.
 Avoid the risk factors.
 Wear ear protection to prevent noise-
induced hearing loss when exposed to loud
noise.

35. Nursing Diagnosis
 Disturbed sensory perception: hearing related
to altered sensory reception and transmission
 Impaired verbal communication related
to impaired hearing
 Impaired social interaction related to impaired
hearing and decreased communication skills

36.  Inspect ear canals for mechanical obstruction.
 Remove mechanical obstructions like cerumen
or foreign bodies.
 Assess hearing by use of a tuning fork, or
verbal cues to determine auditory ability at
various distances.
 Speak slowly with careful pronunciation of
words.
 Add hand gestures, speak face to face and
adjust pitch downward without increasing
volume.
NURSING INTERVENTIONS