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[Health] CPAP and eye pressure
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PaulaO2 Offline
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Post: #1
CPAP and eye pressure
I've had the diagnosis of 'ocular hypertension' for a while. Normal range is 10 - 21. The pressure in my left eye is always the highest. I've had the visual field test so many times I think I have it memorized. Next week I go for yet another test because for the first time, the optic nerve is showing signs of damage. My primary condition, EDS, is a defect in collagen and the eye is nearly all collagen. Eye issues, including eye pressure, is common with EDS.

Meanwhile, I woke up yet again with my left eye nearly glued shut. This incidence has been increasing and is now quite annoying. Usually it is limited to allergy season or other allergies with nasal symptoms. It is always my left eye because I sleep predominantly on my left side. I am assuming the fluid is helped by gravity and comes out the left eye.

This got me to thinking whether or not CPAP has anything to do with intraocular pressure.

And it does.

Quote:RESULTS:

Baseline measurements showed a significant nycththemeral fluctuation in the average IOP, with the highest IOPs at night. After 1 month of CPAP therapy, the average IOP was significantly higher than baseline. The increase in overnight IOP was also significantly higher. A 24-hour IOP fluctuation of > or =8 mm Hg was found in 7 patients at baseline and in 12 patients during CPAP therapy. The mean difference between trough and peak IOP was 6.7 +/- 1.5 mm Hg at baseline and 9.0 +/- 2.0 mm Hg during CPAP therapy. Thirty minutes after CPAP cessation a significant decrease in IOP was recorded. There was a statistically significant decrease in mean OPP during CPAP therapy.

CONCLUSIONS:

Patients with OSA demonstrated significant 24-hour IOP fluctuations, with the highest values at night. CPAP therapy causes an additional IOP increase, especially at night. Regular screening of visual fields and the optic disc is warranted for all patients with OSA, especially those treated with CPAP.

(source: http://www.ncbi.nlm.nih.gov/pubmed/18326715 )

Quote:Nasal CPAP during wakefulness increases intraocular pressure in glaucoma

Few important side-effects of nasal continuous positive airway pressure (nCPAP) have been reported. No increase of intraocular pressure (IOP) complicating this treatment has previously been described. The goal of our study was to analyse the influence of nCPAP on IOP. We evaluated 18 patients previously diagnosed as having glaucoma and 22 normal subjects. nCPAP was used during wakefulness, at +12 cmH2O for 15 min. The results showed that nCPAP significantly increases IOP in patients with glaucoma (before nCPAP 20.3 +/- 6.3 mmHg) (mean +/- SEM); after nCPAP 22.3 +/- 5.7 mmHg. We believe that nCPAP might be relatively contraindicated in difficult to manage glaucoma patients, if these results are corroborated.

(source: http://www.ncbi.nlm.nih.gov/pubmed/7841974 )

So I was wondering if anyone else has any information or has glaucoma or ocular hypertension.

PaulaO2
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
10-12-2012 03:44 PM
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Moriarty Offline

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Post: #2
RE: CPAP and eye pressure
Hi Paula

I don't know about your conditions but I do know that the 'Tear Ducts' connect down to the nasal passages from the corner of the eye socket. There is a valve at the nasal end of the duct that is supposed to stop air pressure from the nasal passages bubbling back up through the eye socket but it is supposed to allow tear flow back. I expect that positive airways pressure could interfere with that and perhaps stop the natural drainage. If that is right then it could produce gummy eyes similar to the so-called 'Blocked Tear Duct' condition...

I really don't know - but it is a thought.

http://en.wikipedia.org/wiki/Nasolacrimal_duct
(This post was last modified: 10-13-2012 04:12 AM by Moriarty.)
10-13-2012 04:11 AM
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archangle Offline
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Post: #3
RE: CPAP and eye pressure
I wonder if an oral mask would make any difference. That doesn't put any pressure into your nasal cavity.

They are a bear to get used to sleeping with, though.

Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
10-13-2012 06:37 AM
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PaulaO2 Offline
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Location: western NC, USA

Post: #4
RE: CPAP and eye pressure
I went to a different eye doc today because she has the doohickey needed to do a different test. She had been my eye doc for a while but her office moved further south of us, too far away. So I went to a doc who was closer but still within the same practice. Ironically, I had to go see her anyway since her office has the device. Karma.

Anyway, the good news is the optic nerve is well within norms so I do not have glaucoma. She was able to bring up the previous images she had taken as well as the ones he had done since they are on the same network. She agreed there was a difference and stressed this is something we'll need to keep an eye on (pun intended).

So I asked her about CPAP use and eye pressure. She said that yes, it can sometimes cause an issue in some patients but the risk is minimal. Then she said that using the CPAP keeps the oxygen levels up and this benefit by far outweighs the risks. She assured me that it was not an element in my case and even though I had high eye pressure before CPAP use, it has obviously not made it worse.

So I can literally sleep better now.

PaulaO2
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
10-17-2012 11:14 AM
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JudgeMental Offline

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Post: #5
RE: CPAP and eye pressure
Paula..

Yes, I also have had the visual field test many many times and like you,,probably have it memorized.

I have a DX of low (hypo) pressure glaucoma. The IOP in both eyes is 9 and has been pretty consistent for several years It was an 8 for awhile. The optic nerves in both eyes show some degradation, which we are watching closely. Just eye drops at this time.

My Doc and I have discussed the CPAP thingy at length and his interpretation is that the CPAP is of no consequence to my eye condition.

Yesterday is history; Tomorrow is a mystery; Today is a gift; Thats why its called "The Present".
10-17-2012 08:16 PM
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PaulaO2 Offline
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Posts: 8,065
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Machine: S9 Autoset
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
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CPAP Pressure: 14-20
CPAP Software: SleepyHead

Other Comments: Ehlers-Danlos Syndrome, Hypermobility Type; chronic sarcasm

Sex: Undisclosed
Location: western NC, USA

Post: #6
RE: CPAP and eye pressure
Wow. That is low! My left eye hasn't been below 22 in many years. Maybe we could trade for a bit? Too-funny

I would rank then the risk of increased eye pressure due to CPAP use as being very, very slim. While it may increase during the actual use (as in mask and pressure is on), it doesn't cause any harm.

PaulaO2
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
10-17-2012 08:43 PM
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zonk Offline

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Post: #7
RE: CPAP and eye pressure
for me it was mask leak goes to eyes and somehow an eyelash end up floating inside the eye and causes irritation
went to ophthalmologist few times to have the eyelash removed
you don,t see rabbits wearing glasses .. must be the carrots
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10-17-2012 10:27 PM
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PaulaO2 Offline
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Posts: 8,065
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Machine: S9 Autoset
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
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CPAP Pressure: 14-20
CPAP Software: SleepyHead

Other Comments: Ehlers-Danlos Syndrome, Hypermobility Type; chronic sarcasm

Sex: Undisclosed
Location: western NC, USA

Post: #8
RE: CPAP and eye pressure
We have several health food / organic food stores in this area and one is where we buy all our meat. We asked them about supplements and the like. They highly recommended a mixed formula of Lutemax 2020, Bil-Max (bilberry), and Blu-Max (blueberry). No clue if it will do any good but the best thing is you take just one a day. I hate when the daily dose is 6 a day which means your bottle of 30 capsules is only for 5 days.

PaulaO2
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Breathe deeply and count to zen.

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
10-17-2012 10:51 PM
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gumbloid Offline

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Post: #9
RE: CPAP and eye pressure
(10-17-2012 10:27 PM)zonk Wrote:  for me it was mask leak goes to eyes and somehow an eyelash end up floating inside the eye and causes irritation...

For the longest time, I hadn't realized that my mask had a leak. I would wake up and my right eye would be full of gunk. It was also tearing up during the day. I asked my optometrist and she chalked it up to allergies. It wasn't until I went in for an 18-month appointment with my sleep apnea doctor. He had me start up my machine and said "hey, you need a new mask." All is fine now.
10-18-2012 10:38 AM
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Barryt Offline

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Post: #10
RE: CPAP and eye pressure
My wife has serious vision loss as a result of advanced low pressure glaucoma. Her pressure has through several surgeries and eyedrops has been reduced to an acceptable level; however, the rate of deterioration is discouraging. Her (leading) ophthalmologist is now focusing on the other leading cause of glaucoma - blood supply to the ocular nerves. CPAP has been recommended following a sleep study - not to address apnea (from which she doesn't suffer) - but to improve oxygenation. (Another avenue to explore is blood pressure variations.) Having just started with CPAP, my wife is having difficulty to adjust - in respect to which I am about to post.
06-08-2013 02:25 PM
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