Macular Degeneration
Concept and Etiology: The Macular Degeneration disease causes loss in the center of the field of
vision. Dry macular degeneration the center of the retina deteriorates (Mayoclinic,2021). The
disease affects the ear study show that there is a link between age related hearing loss and age
related with macular degeneration 50% had mild hearing loss and 20% had moderate hearing loss
(Vision Consulants,2011). Dr. Steenblock stated that a large percentage of patient who do not
respond to stem cell therapy for macular degeneration have a chronic sinus infection (nose)
(healing the eye,2021). The complement factor H variants also confer susceptibility to invasive
infection with several bacterial colonizers of the nasopharyngeal mucosa this susceptibility locus
implicates complement deregulation as a common disease mechanism (Pei Ho et al,2018). There is
a connection with the eye and digestive system a study on mice found that gut bacteria could cause
autoimmune uveitis inflammation eye condition (Your sight matter,2021).
How does it deviate from the definition of health?
The macular degeneration deviates from our healthy way of life. We need our eyesight that is
important function of the body. Being affect by this disease can cause major problems within a
person lifestyle especially if they do not have family or friends that can help assist them with
difficult things that pertain to having a healthy productive life.
Classification: c No AMD: a few (5-15), small <63) or no drusen without pigment changes. Early AMD:
Several small drusen, few intermediate sized (63-124) drusen and pigmentary changes in one or
both eyes. Intermediate AMD: Extensive i.e., 20 soft or 65 hard without any soft intermediate -sized
drusen one large (>125) druse, and geographic atrophy not involving the macula in one or both
eyes. Advanced unilateral AMD: Advanced dry form i.e., macula- involving geographic atrophy or
exudative form with choroidal neovascularization in one eye (Scruggs,2019).
Clinical Manifestations (Symptoms and Signs): The symptoms of macular degeneration are visual
distortions, reduced central visions in one or both eyes, increased difficulty adapting to low levels,
such as when entering a dimly lit restaurant, decreased intensity or brightness of colours, difficulty
recognizing faces. The signs of macular degeneration are changes in central vision, ability to see
colours and fine details becomes impaired (Mayoclinic,2020).
Diagnostic Tests: c Theses are the tests that are performed examination of the back of the eye, test
for defects in the center of your vision, a fluorescein angiography, Indocyanine green angiography,
Optical coherence tomography (Mayoclinic,2021).
Otitis externa and media
Concept and Etiology: How does the disease affect the ear, nose, throat, and gastrointestinal
systems in particular? How does it deviate from the definition of health discussed in Module One?
Otitis refers to inflammation of the ear. Otitis Externa refers to inflammation on the external ear
canal, and Otitis Media refers to inflammation of the ear drum. The inflammation is generally
caused by an infection but may be cause by other things such as allergies and irritation. Otitis
Externa can be caused by things just as swimmer’s ear, the drainage from otitis media, excessive ear
wax, cleaning ear wax, or foreign substances such as shampoo or hairspray. (Lowth, 2016) Otitis
Media can be cause by things such as a cold, sore throat, or respiratory infection (The John
Hopskins University, 2021). While this condition it can affect adults it is primarily seen in children.
Classification: How is the disease classified?
According to Medscape Otitis Externa (OE) is classified by the following (Waitzman, 2020):
Acute diffuse OE - Most common form of OE, typically seen in swimmers
Acute localized OE (furunculosis)- Caused by an infection of a hair follicle
Chronic OE - Same as acute diffuse OE but with a longer duration (>6 weeks)
Eczematous (eczematoid) OE – Caused by skin conditions such as atopic dermatitis, psoriasis,
systemic lupus erythematosus, and eczema that may infect the external auditory canal and cause OE
Necrotizing (malignant) OE – An infection that reaches into the deeper tissues adjacent to the
external auditory canal; occurs primarily in immunocompromised adults such as diabetes or AIDS
Otomycosis – An infection of the ear canal due to a fungal species such as Candida, Aspergillus
According to John Hopkins Otitis Media is classified by the following (The John Hopskins University,
2021):
Acute otitis media- Is middle ear infection occurs rapidly causing swelling and redness. Fluid and
mucus are trapped inside the ear, causing the patient to have a fever and ear pain.
Otitis media with effusion. Fluid (effusion) and mucus gather in the middle ear after an initial
infection subsides. The patient may have a feeling of fullness in the ear and it may affect their
hearing or may have no symptoms.
Chronic otitis media with effusion. Fluid remains in the middle ear for a extended period or
continues to return again and again, even though there is no infection.
Clinical Manifestations (Symptoms and Signs): What are the symptoms and signs of the disease or
disorder? Be sure you understand the difference between symptoms (subjective) and signs
(objective).
According to John Hopkins signs and symptoms may include (The John Hopskins University, 2021):
Pain in one or both ears
Drainage
Muffled or reduced hearing
Sore throat
Irritability in children
Difficulty sleeping
Fever
Pus draining from ears
Loss of balance
Children may pull or tug on ears
Diagnostic Tests: What are some additional diagnostic tests that can be done to illuminate the
diagnosis? For example, when you injure your ankle, they take an x-ray to determine if it is broken
or sprained.
Providers will have to conduct a physical examination to diagnosis otitis media and externa. They
will use an otoscope to inspect the ear canal and ear drum. In some case they may use a
Tympanometry to check and make sure the ear drum is working. Sometime if a patient has multiple
ear infections, providers may also do a hearing test to see if infections have cause hearing loss.
Lowth, M. (2016, October 19). Ear Infection. Retrieved from Patient: https://patient.info/ears-nose-
throat-mouth/earache-ear-pain/ear-infection-otitis-externa
The John Hopskins University. (2021). Ear Infection (Otitis Media). Retrieved from John Hopkins
Medicine: https://www.hopkinsmedicine.org/health/conditions-and-diseases/otitis-media
Waitzman, M. F. (2020, March 9). What are the classifications of otitis externa (OE)? Retrieved from
Medscape: https://www.medscape.com/answers/994550-8089/what-are-the-classifications-of-
otitis-externa-oe
Mayo clinic (2021, May 8). Dry macular degeneration.
https://www.mayoclinic.org/diseases-condition/dry-macular-degeneration/symptoms- causes/syc-
20350375
North Suburban (2011 March 20). Vision Consultants. Association between Macular Degeneration
Vision Loss. https://www.nsvc.com/easyblog/Association-between-macular-degeneration-vision-
loss-and-hearing-loss-found.html#
Healing the eye (2021). Is there a relationship between sinus disease and macular degeneration?
https://www. Healingtheeye.com/Articles/sinus-disease.html
Pei Home., et al (2018). Human Pharyngeal Microbiota in age-related macular degeneration. 13(8),
e0201768 https://doi.org10.1371/journal.pone0201768
Your Sight Matter (2021). Eye Disease Could be Caused by Gut Bacteria.
https://www.yoursightmatters.com
Scruggs, B.A., Avdic, A., & Gehrs, K., (2019) Age-related macular degeneration. Eye Rounds.
https://www.webeye.ophth.uiowa.edu/eyeforum/atlas/pages/AMD.htm
