Obstructive Sleep Apnea Linked to Eye Diseases

[jskinner]

http://www.sleepfoundation.org/site/app ... id=4242479

[LoQ]

and CPAP-associated eye complications----YIKES!

[Slinky]

Thanks, James. I was aware of a connection between OSA and glaucoma. Its been one of my worries in getting my OSA under control in addition to the COPD. I do have glaucoma in one eye but so far well controlled by Xalatan eye drop.

[randyd501]

I was diagnosed with glaucoma 4 months ago with very high eye pressure 40 (normal is 12)! I Have some blindness, anyway a month later I decided to go to doctor for sleep study at University at Miami as I was falling asleep daily around 2pm and always felt tired. Anyway it came back that I have severe apnea with over 70 events per hour.
Bascom Palmer Eye Center is one of the leading eye hospitals and research centers in the world and my doctor who specializes in glaucoma is convinced that my glaucoma was caused by my apnea.
Iam now on Xalantan and my pressure is down to 17. Now being on Cpap hopefully it will get down to normal
Anyone who has apnea should get their eyes checked yearly and make sure they do a pressure test on your eyes!!!

[GuyK]

This is interesting...I've been under treatment for glaucoma for many years (pressure isn't too out of whack, hovering around 17-19).

About 3 weeks after starting APAP therapy, I had a visit to my PCP, where my BP registered lower than it had in years. I posted something here online, and it turns out that isn't such an unusual occurrence. Since then, I've seen the posting on the link between OSA and hypertension.

I was scheduled shortly afterward to visit my ophthalmologist, and I speculated that my pressures would be lower. They weren't -- they were about the same. I did discuss OSA with him, and he said there is definitely a link (so this Mayo Clinic study now reveals that too). In the musician thread, I noted that I'm a brass player too, and have had the discussion with him about that. He claims glaucoma is very common in wind players.

BTW, and this is a little bit of soapbox material here -- the puffy tonometer (which measures IOP, or internal eye pressure) in optometrists offices aren't always that accurate. The ophthalmologist had a direct pressure reading method is that is absolutely painless and is comfortable. That being said, my ophthalmologist also says that he has a patient going blind with a pressure of 6 (extremely low). Pressure readings alone aren't enough to diagnose glaucoma, and that was certainly true in my case. It wasn't caught until there were changes in my "visual field", which happened several years later.

Since all of us here are on CPAP, probably most of us with OSA -- this article means we are under risk for glaucoma. Don't rely solely on an optometrist for screening. They may not catch it. See an ophthalmologist, and tell them you have OSA, and it will probably take regular screenings.

Also -- now 2-1/2 months into therapy -- all of a sudden I have dry eyes on waking up and during the day. That's not unusual for me, because of the beta blocker drops I use for glaucoma, however, this is persistent, and drops of Visine (actually, I use Refresh Tears) aren't helping much. I'm guessing this might be APAP-related. I'll be talking about it with the ophthalmologist next time I see him.

[nightjar]

Thanks for the link, James, and the curiosity it inspired.

After I read that blurb, I googled [ sleep apnea central serous retinopathy ]. I was diagonosed with CSR (aka, CSCR--central serous chorioretinopathy) back in 1992, six years before I was diagnosed with sleep apnea. Looking at the links I'd googled up, I wonder how long I'd had sleep apnea before I was diagnosed.

From the tiny bit I've read this morning, it seems the link isn't definitive, but researchers think more studies are called for. So who knows.

One thing, though: central serous retinopathy is generally associated with young (say, 25-50) white males under higher-than-normal stress. So the womenfolk on the list probably needn't worry about it. (Unless, of course, they happen to be involved with someone who's a "young" white male under a lot of stress. . . .)

How connected everything is. . . .

nath

[Arizona-Willie]

I had been on cpap for over a year and a half and one day my right eye was hurting really bad. I put it off thinking it would get better.
Next day still hurt. Next day hurt worse and it was a Friday afternoon and I decided to go to Lenscrafters where I had had my eyes checked only a year before and everything was fine pressure wise.

There was a new doc in there and he checked my pressure and about had a heart attack. It was 44!!
I had never had high pressure before. This had come out of the blue.

So he gave me some drops and made an appointment with a specialist for Monday and I have been going there ever since. About a year and a half now I guess.

They have me on 3 drops ( 2 for pressure and 1 for inflammation ) and my pressure has been down around 8-10 when I get tested.
I have a scheduled appointment tomorrow and it has probably been six months since the last one. I'm curious to see how it is going now.
For a long time they had me coming in every 2 weeks and kept a really sharp eye on it.

Took awhile to bring it down but once down it has stayed under control.

I'm pretty sure it is related to OSA too. Doc says it doesn't appear to be diabetic related glaucoma. My diabetes is pretty well controlled.

The doc is a board certified glaucoma specialist / surgeon with an alphabet behind his name ( doesn't necessarily mean good -- but it gives cause for hope ) and he takes time to talk to you and appears to actually give a damn. I don't feel like just another number being run through the system.

The doc even called me at home at 8:30 pm one night, to see how I was doing, right after I got started going to him. I was stunned. A personal call from the doc ... not an assistant.

At the time I was using a Hybrid mask and I theorized that the air blowing directly up the nostrils was entering the tubes that come down from the eyes into the throat and causing problems. I switched back to the Activa but the damage had been done. Pressure did go down with medication but the Activa is also a nasal mask although it doesn't direct the air stream directly up the nostrils quite the same as the Hybrid.

I have since found the Quattro which is the best mask I've ever had comfort and leakwise.

But all masks give me some problem because they tend to crawl up my face a bit and then the sides of the nose area winds up resting on the eyes.

Not good.

All masks should have some kind of chin cup to keep them from sliding up.

But I'm pretty sure the OSA caused the eye pressure problem.

CPAP creates two problems.

First is that when you pressurize the air going into the throat to keep the airway open, there is nothing to prevent that pressure from going up the tubes to the eyes and irritating them.

Second is that most masks fit around the nose and the masks often ride up and wind up resting on the eyes and putting pressure on them. Not a lot usually, but they aren't designed to have something pressing on them for hours every night while we are sleeping.

Not hard to see why CPAP might cause eye problems.

[Captain_Midnight]

Guy K writes that intraoccular pressures did not abate after some weeks of pappian therapy.

That corresponds with the findings presented in this study http://tinyurl.com/5skznd

I've seen several posters report eye problems with CPAP (me included). In my case, my vision improved (which is actually a bummer, since I had laser surgery years earlier, and now I'm over-corrected.)

Regards all - - Capt M


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[GuyK]

Interesting! Thanks for the link...

[Ms Piggy]

I was reading a few articles on AWAKE IN AMERICA last night re eye probs and OSA.
One that I thought possibly could refer to me was NAION, although years ago - 80'a - it was labeled as
Optic Nueritus, but they didn't really seem to know for sure as said it could be MS. (but wasn't as a recent
test for something else proved. It presented the same way as NAION. One morning I just could not see
out of one eye at all, no pain involved. Just lost all sight in one eye, some of which
I recovered but not great. In strong light my eye shuts down so I see even less then. I wonder just how long
I, and the rest of us, had OSA before being diagnosed.
How long could you have OSA before you really started to notice the effect I wonder.
I complained of headaches for years before being diagnosed - at my request .

[jrfoster]

I guess this is the good Lord's way of telling me I need to get my eyes examined! I have not had an eye exam since starting CPAP over two years ago. I have noticed a change in my vision
and have been thinking about going to get it checked. After reading this article and other posts, I will do it the first of next week. I would hate that CPAP that saves my life from sudden
death would make me go blind! Good information to know and be aware of.

Jeff