Wednesday, May 25, 2011

Eye Diseases and Obstructive Sleep Apnea

A friend gave me a great review article entitled "The Eye and Sleep Apnea" written by Dr. Alan A. McNab in the 2007 edition of Sleep Medicine Reviews. Dr. McNab discusses a few eye diseases associated with obstructive sleep apnea (OSA), and I will summarize it for you.

The first condition is called floppy eye syndrome, characterized by "floppy" and enlargement of teh upper eyelids in obese middle-aged and older men. If the patient sleeps on one side, the eyelid on that side is affected more. Patients complain of excessive watering, stickiness, discomfort, and blurred vision in teh affected eyes - typically worse upon awakening. The condition is not too common, occurring in 2-5% of OSA patients. It can be a marker for more severe OSA, and CPAP may be all the treatment a patient needs. Others need surgery on the affected eyelid(s) despite CPAP therapy.

Glaucoma has also been associated with OSA. Another eye disorder is non-arteritic ischemic optic neuropathy (NAION) and a high proportion of NAION patients first report their visual loss on waking - meaning that the oxygen level decreases during apneas could be playing a role in their eye disease. I've gotten several referrals from ophthalmologists to rule out OSA as a contributor to their patient's NAION.

Patients with OSA can have headaches upon awakening and intracranial pressure of OSA patients measured overnight can be elevated in an episodic fashion, correlating with apneic episodes. This raised intracranial pressure can be associated with papilledema, or swelling of the optic nerve.

The bottom line is that there are eye diseases that can be related to OSA. Talk to your primary care doctor and/or eye doctor about your symptoms.

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