XPAP and high intraocular pressure?

LavenderMist · Post by **LavenderMist** » Wed Apr 16, 2008 2:34 pm

Has anyone had an eye exam since beginning xpap and were told that their intraoccular pressure was high or have been diagnosed post x-pap with glaucoma? I'm curious if there is a correlation. I just had my eyes checked today and was told my pressures were high. I have to go back for a vision field test and another pressure check. I just had my eyes checked last year and there was no mention of high pressure. As my xpap pressure has increased since then I'm wondering if there is a connection.

LavenderMist · Post by **LavenderMist** » Wed Apr 16, 2008 4:02 pm

Edited

I read some things that said CPAP helps and others that contradict that opnion. I did find this study that had a conclusion that OSA patients using CPAP should have their IOP monitored on a regular basis.

Continuous Positive Airway Pressure Therapy Is Associated with an Increase in Intraocular Pressure in Obstructive Sleep Apnea
Stefan Kiekens,1 Veva De Groot,1 Tanja Coeckelbergh,1 Marie-José Tassignon,1 Paul van de Heyning,2,3 Wilfried De Backer,3,4 and Johan Verbraecken3,4
1From the Departments of Ophthalmology, 2Ear, Nose and Throat, and 4Pulmonary Medicine, and the 3Sleep Disorders Center, Antwerp University Hospital and University of Antwerp, Antwerp, Belgium.

PURPOSE. Several reports have demonstrated an association between glaucoma and obstructive sleep apnea (OSA), though the origin of this association remains unknown. In the present study, the influence of OSA and continuous positive airway pressure (CPAP) therapy on intraocular pressure (IOP) and ocular perfusion pressure (OPP) was examined.

METHODS. IOP, blood pressure, and pulse rate were measured every 2 hours during 24-hour sessions in 21 patients with newly diagnosed OSA. A first series of measurements was performed before CPAP therapy, and a second series was performed 1 month after the initiation of CPAP therapy. OPP was then calculated.

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 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.

grumpygirl · Post by **grumpygirl** » Wed Apr 16, 2008 5:14 pm

My eye pressure has been elevated just a little bit for the last two years. This started before I was DX'd with severe sleep apnea. I often wondered after my apnea diagnosis if it had anything to do with the elevated pressure. I have not had the pressure checked since starting CPAP my check up is in the fall. I wonder if it will be better or worse. I am beginning to think that apnea has had more of an affect on my body than I ever realized. My inflammation has improved a lot since starting CPAP (in Nov.) along with my blood pressure and heart palpatations. We'll see about the elevated eye pressure.

Snoredog · Post by **Snoredog** » Wed Apr 16, 2008 5:25 pm

it would seem to me from that study that IOP would increase with CPAP or without, simply the fact of body position would play into changing the IOP established baseline.

Logic says IOP would be less during the day when you are standing, sitting or in a vertical position. Then simply laying down where the head becomes level with the feet would increase IOP.

In a hospital like after a heart catheter should you start to bleed and it sends the alarms off what they do is invert the foot of the bed to get your feet well above your head to restore blood pressure, add fluids via IV and apply pressure to the bleeding artery.

I always read where hypertension can contribute to IOP. Would seem to me if CPAP therapy lowered your blood pressure that IOP would lessen, but that doesn't appear to be the case from that study.

Of course I need my glasses to read that study

RipVW · Post by **RipVW** » Wed Apr 16, 2008 5:27 pm

Man. This is disturbing news! I have an eye exam coming up soon, plan to ask my doc about the need for closer monitoring of my IOP.

davem · Post by **davem** » Wed Apr 16, 2008 9:27 pm

I don't know if being on xPAP contributes to higher IOP but I do know that higher IOP is not caused by blood pressure within the eye. It's caused by an inability to properly drain the fluid from within your eye.

I've been on CPAP for 11 years AND I was diagnosed as glaucoma suspect 3 years ago. Still being treated for it too. So...who knows...

DaveM

Guest · Post by **Guest** » Wed Apr 16, 2008 9:32 pm

Five+ years on XPAP, six eye exams, no problems with eyes.

Goofproof · Post by **Goofproof** » Wed Apr 16, 2008 9:46 pm

I found out my pressure was too high, an am on drops to correct it, and they are working. I never had the pressure tested before XPAP. I also have diabetes, not controlled well.

I don't believed XPAP caused it, because I had vision problems before the XPAP. I always had high blood pressure too. Jim

Country4ever · Post by **Country4ever** » Thu Apr 17, 2008 9:43 am

Hi LavenderMist,
I asked the same question awhile back. Here's a link to that thread:
viewtopic.php?t=26317&highlight=
I, too, seem to have borderline high pressures. I see the ophthalmologist every 6 months. Sometimes my pressures are 24, sometimes they're 20. They can be lower in the morning or afternoon, so you might vary your visit times.
All my special tests show that my optic nerve, peripheral vision, etc. is fine, so my doc is just watching it. He said some people just have higher pressures and never get damage from it. Hopefully your's will be fine. Good luck!

LavenderMist · Post by **LavenderMist** » Thu Apr 17, 2008 10:53 am

Thank you all for your responses. Thank you country for the link. I went there a read also. I am going to have the vision field test done and do whatever the dr recommends and then keep a close watch on it in the future.

Arizona-Willie · Post by **Arizona-Willie** » Thu Apr 17, 2008 11:22 am

I have just been preaching on this in another thread.

While I was using my Activa mask I had not had any problem with eye pressure.

I got a Hybrid mask, which I loved, and after using it for some time my eyes began to hurt and I took them to the doctor. My pressure was 44!!!

Supposed to be under 20.

I'm stubborn and loved that Hybrid so I kept using it and waging war with drops against the pressure. My doc said the pressure didn't seem to be related to diabetes ( which I have a mild case of ).

Finally, I went back to my Activa mask and my pressure last week was 12/13!!

While using the Hybrid my pressure was at or slightly over 20 sometimes 25 or so.

As soon as I went back to the Activa it dropped like a rock.

I suspect the Hybrid was injecting air into the tubes that drain the eyes and the air was going up and causing the high pressure ... or at least aggravating it.

I'm still on the drops and go back in a couple of months for another check. If it stays low I think he will begin to wean me off of the drops.

I believe mask type can play a role in increasing the pressure in your eyes.

kteague · Post by **kteague** » Thu Apr 17, 2008 11:39 am

I was recently diagnosed with glaucoma with pressures of 40 and 42. With using eyedrops they came down to 20 and 22. I go back to the opthamologist tomorrow. It's thought that my taking Prednisone was a contributing factor, and I've been off it for nearly a month now so I'm eager to see my progress. I asked my doc initially if cpap had anything to do with this and he didn't think so. I'll discuss it with him again tomorrow.

LavenderMist · Post by **LavenderMist** » Thu Apr 17, 2008 1:00 pm

Kathy,

As per your suggestion last night, I did call and ask what the pressures were. They were 35 in the right eye and 24 in the left eye. My right eye has perfect vision and my left eye is a little weaker. My eyesight is 20/25 and I use reading glasses only.

Mist

Country4ever · Post by **Country4ever** » Thu Apr 17, 2008 3:47 pm

Willie.........could you feel any of that air through your tear ducts?

LavenderMist · Post by **LavenderMist** » Thu Apr 17, 2008 5:18 pm

[quote="Arizona-Willie"]I have just been preaching on this in another thread.

While I was using my Activa mask I had not had any problem with eye pressure.

I got a Hybrid mask, which I loved, and after using it for some time my eyes began to hurt and I took them to the doctor. My pressure was 44!!!

Supposed to be under 20.

I'm stubborn and loved that Hybrid so I kept using it and waging war with drops against the pressure. My doc said the pressure didn't seem to be related to diabetes ( which I have a mild case of ).

Finally, I went back to my Activa mask and my pressure last week was 12/13!!

While using the Hybrid my pressure was at or slightly over 20 sometimes 25 or so.

As soon as I went back to the Activa it dropped like a rock.

I suspect the Hybrid was injecting air into the tubes that drain the eyes and the air was going up and causing the high pressure ... or at least aggravating it.

I'm still on the drops and go back in a couple of months for another check. If it stays low I think he will begin to wean me off of the drops.

I believe mask type can play a role in increasing the pressure in your eyes.

XPAP and high intraocular pressure?

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