Sleep apnea can affect your eye sight

by | Dec 4, 2013 | News

Obstructive Sleep Apnea (OSA) is a common condition in which a person has brief breathing pauses or experiences shallow breaths while sleeping. Sleep apnea affects more than 12 million people in the United States, mostly adults, but children can also be afflicted. It is diagnosed by a painless overnight sleep test called a polysomnogram, or “sleep study”. More than 80% of OSA patients are undiagnosed and a large number of those that have been diagnosed are often untreated.

OSA has been associated with many systemic diseases, what is often not generally known is its relation to several eye disorders such as:

  • Floppy Eyelid Syndrome (FES):  the upper eyelids become rubbery and easily everted and may turn inside-out during sleep, leading to the eyes becoming dry, causing blurry vision, discomfort, irritation, tearing and mucus discharge. It is estimated that more than 96% of patients with FES have OSA; up to 15% of OSA have FES.
  • Keratoconus: structural deformity of the cornea, the dome-shaped clear lens in the front of the eye. In Keratoconus the cornea becomes thin, irregular and conical shaped, resulting in blurry distorted vision.
  • Dry eye: inadequate quantity or quality of the tear film that protects and nourishes the front part of the eyes, resulting in discomfort, burning, blurry vision.
  • Filamentary keratitis: the outer layer of the cornea becomes inflamed and the outer most layer of the corneal cells die and form attached fillaments to the cornea.
  • Infectious keratitis: swelling of the cornea due to infection.
  • Papillary conjunctivitis: chronic eye irritation due to the underside of the upper eyelids becoming inflamed and developing large bumps or “papillae” causing itching and mucous discharge.
  • Papilledema: swelling of the optic nerve in both eyes, frequently due to increased pressure in the skull that may lead to loss of vision.
  • Nonarteritic Anterior Ischemic Optic Neuropathy (NAION): a sudden, painless loss of vision in one eye. Some 6,000 patients annually in the United States are diagnosed with this condition, which can cause irreversible vision loss. Up to 89% of NAION have OSA.
  • Glaucoma: it is a common cause of irreversible blindness.  It is estimated that 20 to 57% of patients suffering from Glaucoma have OSA.
  • Retinal Vein Occlusion: blockage of the veins of the retina, leading to painless decrease in vision in the affected eye.
  • Diabetic Macular Edema: leakage in the macula, the central small part of the retina, responsible for clear vision and color vision. The macula swells causing distorted vision and loss of vision.
  • Iris Neovascularization: microscopic abnormal blood vessels grow in the iris, the color part of the eye. These blood vessels obstruct the drainage of aqueous fluid in the front to the eye, causing high increase in pressure inside the eye, leading to Glaucoma.

At the present it is not known how OSA may contribute to certain eye disorders, however it is important that patients and health care professionals be aware of the possible associations between OSA and eye diseases in order to facilitate early diagnosis. Patients with OSA should have their eyes examined on a regular basis and should inform their optometric physician of their condition. On the other hand, patients suffering from these eye diseases should notify their health care providers to possibly be evaluated for OSA.