Chapter 79 Sensory System Disorder

Front 1

(2) Identify two n/c for each of the following types of testing: refractive examinations, Opthalmoscope

Back 1

Refractive Examinations: used to identify the degree of refractive error and determine the type of lens necessary to correct a visual defect. N/C (1) explain to pt if the eyes will be dilated and if so, that they may need a driver. (2) Adjust the chair for the correct height of the client and the doctor for optimum comfort. (3) may assist client in picking out glasses, if ordered.
Opthalmoscope: an instrument used by teh examiner to look through the pupil to see the retina and other interior structures N/C (1) explain the procedure to reduce any stress the client may have (2) Be sure the client is aware of when or what the test results mean and what the next step is: if tumor is present what happens next? keep client informed.

Front 2

(2) Identify two n/c for each of the following types of testing: slit lamp, tonometry

In general, the nurse commonly assist the doctor by providing appropriate equipment, checking light on equipment and helping client to remain still.

Back 2

Slit Lamp is special type of microscope that directs a beam or light onto or through the cornea to view the eye's anterior structures. The magnification of the images enables the examiner to identify abnormalities of the conjunctiva, cornea, anterior chamber, iris, lens and anterior vitreous. N/I (1) clean the instrument used between clients (2) turn out the light, if required before the procedure.
TONOMETRY is an instrument that can indirectly measure intraocular pressure. N/I (1) make sure the instrument is within reach of the doctor (2) hold the client's eye open, if required

Front 3

(2) Identify two n/c for each of the following types of testing: ERG, Audiometry

Back 3

ERG records the minute electrical impulses given off by the retina when it is struck by light. N/C (1) make sure client is aware they cannot drive home due to the local anesthesia (2) confirm allergies
EAR
Audiometry is a test for hearing; two types: pure tone audiometry which tests both conductive and sensorimeural hearing and bone conduction audiometry whoch tests only conduction loss. N/C (1) minize distractions, make sure outside noises are tuned out, by closing the door (2) check the batteries frequently

Front 4

(2) Identify two n/c for each of the following types of testing: Caloric Test, ENG

Back 4

Caloric Test is designed to determine if an alteration exists in the vestibular origin of the acoustic nerve. Abnormal result suggest a diseaed labyrinth or a tumor. N/C (1) keep client NPO or clear liquids (2) have emesis basin in reach due to nausea associated with this test
ENG is when electrodes are placed near the client's eye to assess for alteration in the vestibular system. N/C (1) keep client NPO, provide the emesis basin (2) keep client still for placement of the electrodes
These test are done together, in the ENG, the caloric test is performed while eye movements are recorded on a graph.

Front 5

(3) Discuss or demonstrate a dry wipe and ear irrigation, differentiate between adult and child techniques

Back 5

Eye Patching
In some cases, a physician orders one or both of a client’s eyes to be patched. Several types of patches are available. A
simple single patch or
double patch may be used to cover the eye for rest or protection. A pressure patch
taped in place may be used to keep the eye closed. A metal shield over the patch is also commonly used to protect the eye.
Dry Wipe
A dry wipe may be ordered to clean drainage out of the external auditory canal and the auricle. Supplies: gloves, cotton-tipped applicators. P. 1219

Front 6

(4) State at least ten nursing considerations for the care of the client with: a visual deficient, including pre- and postoperative nursing considerations
1 - 5 Visual Deficient

Back 6

Visual Deficient
•Encourage clients to gradually assume responsibility fortheir own care.
•Identify yourself when you enter the room.
•Speak before touching clients to prevent frightening them.
•Speak in a normal tone.
•Keep the call light within reach and place the bed in thelowest position

Front 7

(4) State at least ten nursing considerations for the care of the client with: a visual deficient, including pre- and postoperative nursing considerations
6 - 10 Visual Deficient

Post op educate on ways to protect the suture line as it is delicate. Do not change the dressing for several days.

Back 7

Visual Deficient
Place food on the plate in the same “clock positions” for every meal. Tell the person what is being served and where it is located on the plate.
•When ambulating, walk slowly and allow the person to take your arm. (Do not push.)
•Orient the client to the location of objects in the room such as furniture, the door, grooming articles, and the waterpitcher; keep these objects in the same place.
•Let the client know when you are leaving the room.
Post Op: do not remove the dressing; do not use eye medication until you see the surgeon, do not sleep on operative side for at least a week to prevent fluid and pressure from accumlating on the suture line.

Front 8

(4) State at least ten nursing considerations for the care of the client with: a hearing deficient, including pre- and postoperative nursing considerations
1 - 5 Hearing Deficient

Back 8

Hearing Deficient
•Get the client’s attention before beginning to speak.
•Face the client on the same level.
•Place yourself in good light, so the client can see your mouthclearly.
•Do not chew, smoke, put objects in the mouth, or cover it while talking.
•Decrease background noises, such as television and radio.

Front 9

(4) State at least ten nursing considerations for the care of the client with: a hearing deficient, including pre- and postoperative nursing considerations
5 - 10 Hearing Deficient

Back 9

Hearing Deficient
Speak slowly and clearly; repeat entire phrases rather than specific words.
•Restate the conversation with different words.
•Use contextual clues such as objects, persons, and hand motions to facilitate the conversation.
•Verify that the person understood the conversation
POST OF
watch for dizziness; avoid vomitting as it can disrupt the suture line; do not blow nose

Front 10

(5) Define the following refractive errors: myopia, hyperopia, astigmatism and presbyopia

Back 10

Myopia nearsightedness, light rays focus in the front of the retina
Hyperopia condition in which light rays facus behind the retina; farsightedness
Astigmatism condition in which the eye cannot bring horizontal and vertical lines into focus at the same time, causing blurry vision; irriegularties in the cdurvature of the cornea and lens
Presbyopia farsightedness that occurs with aging

Front 11

(6) Identify the advantages and disadvantages of the following methods of visual correction:
eyeglasses, hard contact lenses

Back 11

Eyeglasses, advantages is better sight and you don't have to squit your eyes which causes wrinkles. Disadvantages is that eye glasses can be expensive and lost easily as they are not attached to anything.
Hard Contact Lenses
Advantages: speical cleaning

Front 12

(6) Identify the advantages and disadvantages of the following methods of visual correction:
soft contact lenses, extended-wear lenses

Back 12

Soft contact lenses: advantage is that they are more flexible; Disadvantage is they are damaged more easily.
Extended wear contact lenses: Advantage is they allow oxygen and carbon dioxide to pass freely through the lens allowed longer wear--up to two week. Disadvantage is greater risk of infection.

Front 13

(7) Define Radial Keratotomy, PRK and LASIK

Back 13

Radial Keratotomy procedure wherein partial-thickness, radial incisions are made in the cornea to correct the refractive error. p. 1211

PRK "photorefractive Keratotomy" is procedure that corrects refractive errors.

LASIK "laser-assisted-in-site-keratomileusis" procedure to correct refractive erros.

Front 14

(8) Describe the following inflammatory and infectious eye disorders: Conjunctivitis,

Blepharitis is inflammation of the eyelid, which is caused by excessive dryness of the eyes, excessive oiliness of the skin, or infection. It is characterized by red lid margins and purulent drainage. Treatment involves applying warm packs to the eye to help loosen crusted drainage

Back 14

Conjunctivitis, also called pink eye, is inflammation of the
conjunctiva, the membrane lining the eyelids and covering the sclera. It causes pain, redness, swelling, itching, and sometimes purulent discharge (pus). The discharge may be so thick and copious that the eyelids stick together. Following a culture study, antibiotic eye drops or ointments are prescribed for bacterial infections, and antiviral medications for viral infections. Treatment of allergy-related conjunctivitis includes avoiding the offending allergen, taking antihistamines, and undergoing desensitization. Boric acid or saline solution irrigations or warm soaks may remove discharge, reduce swelling, and decrease pain and itching. Conjunctivitis is contagious.

Front 15

8) Describe the following inflammatory and infectious eye disorders: Hordeolum, Chalazion

Back 15

A hordeolum or stye is an acute inflammation of an oil or sweatgland of the eyelid. Styes are red, raised, swollen, and painful. They contain pus. After the area drains, pain is relieved and healing begins. Treatment includes applying warm, moist compresses and a topical antibiotic ointment to the area to help localize the infection. In severe cases, the abscess is incised and drained. Teach the client not to squeeze a stye, which could spread infection.
Chalazion
A chalazion (meibomian cyst)
is an accumulation of lipid (fatty) material from a chronically obstructed meibomian
(sebaceous) gland found on the eyelid. If the lesion is small and does not affect vision, treatment is unnecessary. However, if it becomes infected or interferes with vision or eyelid closure, incising and draining the area may be necessary.

Front 16

8) Describe the following inflammatory and infectious eye disorders: Trachoma, Keratitis

Back 16

Trachoma is another form of conjunctivitis found in hot, dry climates. Its cause is the organism Chlamydia trachomatis,
which may also cause the infection inclusion conjunctivitis.
Trachoma is highly communicable and is one of the world’s leading causes of preventable blindness. Treatment includes topical and systemic antibiotics, which are very effective. Trachoma is rarely seen in the United States.

Keratitis is an inflammation of the cornea caused by bacterial, viral, or fungal infections, often after trauma. Herpes simplex keratitis is the most common cause of unilateral visual loss from infectious keratitis in the United States. Symptoms include pain, photophobia (sensitivity to light), blurred vision, purulent drainage, and redness of the sclera. Corneal ulceration is a common sequela.

Front 17

(8) Describe the following structural eye disorders: Ectropion, Entropoin

Back 17

Ectropion, an outward turning of the eyelid due to the aging process. The eye is no longer able to drain effectively and tearing occurs. Surgical intervention is necessary.
• Entropion an inward turning of the lid margin common in older adults. The lower lashes turn inward and are often not visible, but they irritate the conjunctiva and cornea. Corrective surgery may also be necessary.

Front 18

(8) Describe the following inflammatory and infectious eye disorders: Ptosis

Back 18

Ptosis drooping of the upper eyelid. Ptosis may be due to muscular weakness, damage to the oculomotor nerve, or interference with the sympathetic nerves that maintain the lid’s smooth muscle tone. Depending on the cause, corrective surgery and/or correction of the neurologic disorder maybe necessary.

Front 19

(9) Differentiate chronic open-angle glaucome and closed angle glaucome

Three N/I for each

Treatment. Eyedrops, to increase aqueous out flow; or oral medication such asacetazolamide (Ak-Zol, Dazamide, Diamox), to decrease production of aqueous humor. Beta-blockers, such as timololmaleate (Timoptic), are used as well. Laser treatment is often used to facilitate the drainage of aqueous humor. Fltration surgery is an option.

Back 19

Open Angle Glaucoma is the most common type of glaucoma. In this condition, drainage of the aqueous humor through the
trabecular (supporting) mesh-work (located in the angle of the anterior chamber of the eye) is inadequate. The result is the accumulation of aqueous fluid in the anterior chamber, which causes an increase in IOP. Both eyes are commonly affected. The onset of chronic open-angle glaucoma is slow, with gradual loss of peripheral vision. Glaucoma is often diagnosed at a routine eye examination when increased IOP is discovered. Often symptoms are absent, mild, or intermittent. Therefore, a serious vision loss may occur before the condition is discovered. S/S eye discomfort, temporary blurring of vision, reduced peripheral vision, and head-aches. Late signs are the appearance of halos around lights and central blindness.

Front 20

(9) Differentiate chronic open-angle glaucome and closed angle glaucome

Three N/I for each
(1) client education (2) avoid excessive fluid intake (3) avoid meds containing atropine; side effect is blurred vision

Back 20

s an emergency requiring immediate recognition and treatment to prevent irreversible visual changes and blindness. Untreated, acute-angle glaucoma can result in blindness in 2 to 5 days. One or both eyes may be affected. In acute-angle glaucoma, the aqueous humor is blockedby a bulge of the iris at the anterior chamber before it
filters through the trabecular meshwork. The result is an accumulation of aqueous humor, with resultant increased IOP. In some cases, the cause of acute-angle glaucoma may be iatrogenic
(caused by medical interventions), such as when dilating the pupils with medications for routine eye examinations. S/S usually occur suddenly but may occur gradually and intermittently. S/S blurred vision, halos around lights, severe eye pain, headaches, and occasionally nausea and vomiting
Treatment.
Treatment of acute-angle glaucoma consists of miotic eye drops (which constrict the pupil). These eye drops are given immediately,to allow drainage of the aqueous humor and decrease IOP. Analgesics

Front 21

(9) Differentiate between secondary glaucoma; identify three N/I

Back 21

Secondary glaucoma usually results from swelling, infection, hemorrhage, or eye trauma. It usually develops gradually and is painless. Treatment for secondary glaucoma is the same as for open-angle glaucoma.
N/I (1) how to instill eye medication (2) avoid excessive fluid intake (3) freqeunt follow up exams are needed

Front 22

(10) Explain the causes and treatments for cataracts

A cataract is an opacity or cloudiness of the lens

Back 22

Cataracts may be congenital; caused by injury to the eye;or occur as part of the aging process. Cataracts have been associated with excessive exposure to ultraviolet rays and radiation; certain drugs, such as steroids; and systemic diseases, including diabetes mellitus. When a cataract occurs due to trauma, it usually develops quickly. A majority of cataracts, however, are associated with changes in the eye related to aging and develop slowly.
Treatment.
The only remedy for cataracts is surgery to remove the lens. This procedure is one of the most frequently performed surgeries in the United States. Cataract surgery is usually done as an outpatient procedure using a local anesthetic.

Front 23

(11) Identify at least two nursing considerations for each of the following types of eye traumas: Hematoma, Foregin Bodies

Back 23

Hematoma; A blunt injury to the eye may cause swelling and bleeding into the soft tissues surrounding the orbit, resulting in a contusion or hematoma, also known as a “black eye.” N/I (1) Apply cold packs for the first 24 to 48 hours to decrease bleeding and edema. (2) When the swelling has stopped, usually after 24 to 48 hours, use warm packs on the site to hasten the absorption of the blood from the tissue.
Foreign bodies can be internal or external: eyelash in eye. To prevent damaging internal ocular structures, N/I (1) instruct client to never attempt to remove a penetrating object from the eye. If the object is embedded, a topical anesthetic may be ordered for severe ocular pain until the object can be removed. Ultrasound may be used to locate an embedded foreign body, and an electro magnet or surgery may be necessary for removal

Front 24

(11) Identify at least two nursing considerations for each of the following types of eye traumas: Hyphema and Chemical Burns

Back 24

Hyphema, a hemorrhage into the anterior chamber of the eye, is usually caused by blunt trauma and can lead to glaucoma and vision loss.
N/I (1) education client to report signs of bleeding in the eye immediately. Treatment consists of mydriatic (dilating) or miotic (constricting) medications. Occasionally, an ophthalmologist may need to evacuate the accumulated blood. (1) educate that they will not be able to drive if they need TX for this condition
CHEMICAL BURN
Treatment.
N/I (1) advise that if any accidental substance comes in contact with a person’s eye, irrigation with water should be done for a minimum of 5 minutes. During irrigation of the eye, direct the flow of water so the solution does not come in contact with the other eye. After this initial irrigation, the person should immediately report to an emergency department or an ophthalmologist’s office for further treatment. (2) do not rub the eye it can cause further damage

Front 25

(11) Identify at least two nursing considerations for each of the following types of eye traumas: Corneal Abrasions and Detached Retina

Back 25

Corneal Abrasions involve the outer (epithelial) layer of the cornea and are often caused by tree branches, fingernails, paper,and contact lens injuries. Symptoms include severe pain, redness, and tearing (lacrimation). N/I (1) dim the lights in the room if irritating the client (2) have tools ready for doctor
DETACHED RETINA
A detached retina is a separation of the retina from the choroid, thus depriving the image-receiving layer of its blood supply. Separation of these layers usually follows a hole or tear in the retina, which may result from a blow or injury.
N/I (1) Advise patient to be NPO (2) do not sleep on the operative side after the surgery

Front 26

(12) Compare and contrast conductive hearing loss, Sensorineural hearing loss

Types of Sensorineural:
• Sensory (cochlear): Factors such as trauma, viral infections, toxic drugs, or Ménière’s disease can result in cochlear hearing loss. These sensory conditions are usually not fatal.
• Neural (eighth cranial nerve defect): A tumor of the cranial nerve called an acoustic neuroma can cause a sensorineural hearing disorder. These tumors are potentially fatal.

Back 26

A conductive hearing loss is sometimes referred to as a
transmission hearing loss, in which the conduction of sound waves to the organs of hearing is disrupted. It may becaused by a disorder in the auditory canal, the eardrum, or the ossicles
(tiny bones of the middle ear). Fluid in the middle ear is the most common cause. Conductive hearing losses are further classified as follows:
• Air conduction loss is due to a defect in the external auditory canal.
• Bone conduction loss is due to a defect in the bones of the middle ear.

Sensorineural or perceptive hearing loss involves a disturbance of the organs of the inner ear or of the transmitting nerve. A sensorineural hearing loss involves the organ of Corti
(cochlea) or the auditory nerve
(eighth cranial nerve). Sensorineural hearing loss is further tested to differentiate between the following types:
SEE BESIDE

Deafness results if organs of hearing are impaired unless cause is discovered before damage occurs.

Front 27

(12) Compare and contrast Central Hearing Loss and Functional Hearing Loss

Back 27

Central Hearing Loss refers to the brain’s inability to interpret sounds after they have been transmitted. This sometimes occurs in atherosclerosis or after a cerebrovascular accident.

In functional hearing loss,
no organic cause is found and no damage to the auditory nerve is visible. Functional hearing loss is believed to stem from some underlying psychological problem. Professional counseling sometimes helps.

Front 28

(13) Discuss the causes and at least two nursing interventions for each of the following disorders of the external ear: Impacted Earwax, Furuncles, Foregin Objects

Back 28

Impacted Earwax Impacted earwax (cerumen) in the auditory canal is one example of a minor condition that requires medical attention. Wax can be removed by irrigating the outer ear with a solution warmed to body temperature (98.6°F or 37°C). N/I (1) instruct not to put any objects in ear (2) do not clean ears excessively.
Furuncles (boils) are infections in the auditory canal. N/I (1) treat infection immediately (2) do not place objects or oils in ear; see doctor
Foregin Objects: Caused by children or mentally challenged. N/I (1) insect, use flashlight to draw out insect (2) use mineral oil to kill insect and have it fall out with head to the side.

Front 29

(13) Discuss the causes and at least two nursing interventions for each of the following disorders of the external ear: External Otitis, Fungal Infections

Application of ear drops, composed of substances such asacetic acid (Domeboro Otic, VoSol Otic), boric acid (Ear Dry,Swim-Ear), or Chloramphenicol (Chloromycetin Otic), can be used for prevention.

Back 29

External otitis (otitis externa), inflammation of the externalear, is most commonly caused by chronic external ear inflammation; called “swimmer’s ear,” prolonged exposure to water often is the cause. N/I wear ear plugs, apply ear drops before swimming.
Fungal infections in the auditory canal tend to occur in warm, damp climates, especially when the auditory canal has not been completely dried. N/I (1) dry canal (2) do not clean excessivley

Front 30

(13) Discuss the causes and at least two nursing interventions for each of the following disorders of the external ear: punctured tympanic membrane

Back 30

A punctured or perforated
tympanic membrane
(eardrum) is a serious threat to hearing later in life, as well as a possible source of middle ear infection. Although the perforation will often heal spontaneously, surgery is sometimes necessary. Occasionally, a myringotomy
(surgical incision into the eardrum and drainage) is done for therapeutic reasons. N/I (1) NPO if surgery is required (2) take all medication of antibiotic

Front 31

(13) Discuss the causes and at least two nursing interventions for each of the following disorders of the MIDDLE ear: Otitis Media Serous Otitis Media

There are four different types of otitis media: (1) serous (S/S crackling sensations and fullness in the ear, with some hearing loss) (2) acute purulent, (3) chronic, and (4) chronic purulent.

Back 31

Otitis media is an inflammation of the middle ear. The ear is especially susceptible to upper respiratory infections, which can travel through the eustachian tube from the nose and throat. Children are especially vulnerable to these infections because their auditory tubes are straighter and shorter than those of an adult. CAUSES: fluid on inner ear or upper respiratory infection that spreads.
N/I (1) take all antibiotics (2) do not plug the ear with cotton.

Front 32

(13) Discuss the causes and at least two nursing interventions for each of the following disorders of the MIDDLE ear: Acute Purulent Otitis Media and Chronic Otitis Media

Back 32

Acute purulent otitis media
is generally caused by an upper respiratory infection spreading through the auditory tube. Pus forms and collects in the middle ear to create pressure on the eardrum. Symptoms include fever, earache, and impaired hearing. The eardrum is inflamed and bulging and may rupture. Initial treatment is often antibiotics. Myringotomy may also be indicated to prevent rupture of the eardrum. If spontaneous rupture of the eardrum occurs, scarring, which disrupts normal ossicle vibrations, can result. Often this permanently impairs hearing.
Chronic otitis media can develop if acute purulent otitis media is not treated promptly. In the past, mastoiditis was also a complication. However, today this is rarely seen in the United States due to the use of antibiotics. Meningitis is also a possible complication of otitis media because the infection can spread to the brain’s meninges.

Front 33

(14) Describe the care for a client who is undergo a tympanoplasty and myringotomy with insertion of PE tubes

Polyethylene (PE) tubes are often inserted through the eardrum incision into the middle ear. This procedure is most commonly done in children with recurrent ear infections. PE tubes allow continuous drainage from the middle ear. In this case, the client must use caution to prevent water from entering the ear. Swimming and showering are contraindicated.

Back 33

Tympanoplasty is the plastic reconstruction of the tiny ossicles of the middle ear. It is done when infection or tumor has destroyed or fused these bones together. The bones reconstructed involve the structures from the oval window to the tympanic membrane. Tympanoplasty is a delicate procedure, performed with the aid of an operating microscope. The goal of the surgery is to preserve and to maximize hearing

Myringotomy is the common procedure used to treat otitis media. It releases pressure and relieves pain. Healing proceeds rapidly. Discharge from the ear is bloody at first, then purulent. To avoid interfering with drainage, do not plug the ear with cotton. Place a small piece of cotton in the outer ear to absorb the drainage and change it frequently. Give ordered antibiotics. Rest, adequate diet, and prevention against chilling are recommended.

Front 34

(15) Discuss at least three nursing considerations for a client with Meniere's Disease

Remember, the attacks are so devastating that the client is understandably apprehensive. Reasssure the client that relief is possible.

Back 34

Ménière’s disease is a disturbance of the inner ear’s semi-circular canals, which are responsible for maintaining a sense of stability and balance. Although it is not fatal, Ménière’s disease is not curable. No known cause exists, but fluid distention of the labyrinth leads to destruction of the cochlear hair cells.
N/I
When caring for a client with Ménière’s disease, avoid jarring the bed, making sudden movements, turning on bright lights, or making loud noises.
RATIONALE: These actions may precipitate an attack.
Do everything slowly and explain actions to the client ahead of time. Protect the client from falls. RATIONALE: If vertigo issevere, the client is in danger of falling.
Side rails should be up; keep the bed in low position at all times to protect against dangerous falls. Give fluids and foods in small amounts. RATIONALE: The nauseated client is better able to tolerate small amounts.

Front 35

(16) Identify at least wo nursing considerations for clients with tactile, gustatory, and olfactory disorder

Back 35

N/I Tactile (1) have a family member test the temperature of water before bathing (2) get assitance with ambulating if they feel dizzy due inability to maintain balance.
Gustatory (1) have family test temperture of food before eating (2) education client they must eat even if they have no desire to their lack of taste
Olfactory (1) due to gas leaks educate to buy a safety sensor for detecting gas in home (2) buy smoke detectors for fire prevention

Front 36

(17) Identify dietary modifications for the client with sensory system disorders

Back 36

Low sodium diets are recommended to reduce edema. Dietary modifications: the type of foods may not be as big of concern as the need to educate about regimen of putting foods in same place on plate; for those with gustatory or olfactory disorders acknowledge their lack of desire to eat but stress that they must remember to eat to avoid getting illness.

Front 37

(18) Identify common medications for the client with sensory system disorders


Extreme caution is necessary when instilling any type of medication into the eye. Containers of eye medications are similar to bottles for other solutions. For example, some non–eye solutions come in small bottles with droppers (eg, guaiac solutions used to test for occult blood). These solutions can be extremely caustic and can cause blindness.

Back 37

Medications:
Application of ear drops, composed of substances such asacetic acid (Domeboro Otic, VoSol Otic), boric acid (Ear-Dry,Swim-Ear), or chloramphenicol (Chloromycetin Otic), can be used for prevention.

Oral medication such asacetazolamide (Ak-Zol, Dazamide, Diamox), to decrease production of aqueous humor. Beta-blockers, such as timololmaleate (Timoptic), are used as well.

Front 38

(19) Discuss general client and family teaching for clients with a sensory system disorders, include ages across the life span.

Back 38

As we age our sight and hearing diminshes.