Ever hear of this?

[montana user]

My patient this evening just told me a story involving a CPAP machine. I am having a hard time believing this story but figured I would ask if anyone else has heard of this.
Here is the story. A down syndrome patient is on CPAP, and his retina's were blown by wearing the CPAP. He has been on the machine for a while now, and they wonder if someone "played with the machine" and increased the pressure so high that it caused the eye injuries.

Ok, anyone ever hear of a CPAP machine doing anything like this?

Thank-you!

[Julie]

I would want to know exactly what the term "blown" really meant in that context, but apart from anything being possible (someone playing with his machine), he might also have had eye problems to begin with that were made worse by either too high pressure (which I've otherwise never heard of in Cpap patients) or else who knows - it's one of those things you can't just hear rumors about without knowing specifics. If it was a question of air leakage into his eyes that went unreported by the patient or machine, that's again something for a doctor to look into.

[LSAT]

Max setting on CPAP is 20. Could that do damage?
e

[Myolin]

Is it the Cpap machine blown or air blown from mask leaks or the return of the air on the bed.

I have troubles with my eyes since I am sleeping with a FF mask, my eyes are sore and dry I need some artificial tears first thing in the morning.

[robysue]

I won't speculate on the OP's story since it sounds like an urban legend.

But I will say that when I first started CPAP, I felt air blowing into my eyes via my sinuses and tear ducts. [It was NOT mask or exhaust leaks blowing into my eyes.] Not only was it making my eyes dry in the morning, it was making my eyes and eye sockets hurt for most of the day. I reported this to my sleep doctor's office, and the PA clearly sat up and took notice: When I said that I was having eye pain and felt air was getting into my eyes at night via my sinuses and tear ducts, she immediately told me that those symptoms indicated that my pressure (at a mere 9cm) might be too high for me. She then ordered an auto-titration (for this as well as problems with aerophagia) and at the end of the autotitration, she lowered my pressure from a fixed 9cm to an APAP range of 4--8cm.

So while "blown retinas" may be an urban legend, I do think that the extra/excess pressure we're subjecting ourselves to every single night all night long (in order to breathe) just might have some not entirely benign side effects on everything connected to our nasal passageways and sinuses including our eyes---at least for some CPAPers.

Like any other serious and significant medical treatment, I think that CPAP is a trade-off, and the benefits of being able to breathe more normally at night do need to be weighed against the side effects suffered by the particular CPAPer. I also suspect that long term side effects (as in 30+ years of use are not (yet) well understood either in terms of how many CPAPers will eventually suffer a long term side effect or in the potential severity of certain side effects for small numbers of CPAPers.

[Ughmahedhurtz]

I fail to see how CPAP air pressure could cause an increase in internal eye pressure (which is what, as I understand it, usually causes retinal tearing/macular degeneration/etc.). Now, if your mask is too big or misadjusterated and actually presses on the eyes, I could see that, but would said person not then complain about that?

/ponder

[jlk]

Not sure where you would need to put the hose to cause internal eye damage, but my vote is for urban legend. john

[M.D.Hosehead]

Sounds like urban legend to me too.

As others have noted, air pressure from the nasal cavity can go up the tear duct and come out on the surface of the eye. I can't think of any mechanism that would allow air pressure in the nasal cavity to get inside the eyeball. Possibly some other eye defect could have been attributed falsely to the CPAP. But more likely it's just a tall tale.

[Guest]

My patient this evening just told me a story involving a CPAP machine. I am having a hard time believing this story but figured I would ask if anyone else has heard of this.
Here is the story. A down syndrome patient is on CPAP, and his retina's were blown by wearing the CPAP. He has been on the machine for a while now, and they wonder if someone "played with the machine" and increased the pressure so high that it caused the eye injuries.

Ok, anyone ever hear of a CPAP machine doing anything like this?

Thank-you!

Sorry about this. Software won't let me submit ANY PART of a link.

http : / / www . mat . or . th / journal / files / Vol92 _ No.7 _ 987 _ 4753 . pdf

A 46-year-old man was diagnosed with obstructive sleep apnea and began using a nasal continuous
positive airway pressure (CPAP) during sleep for a month. He presented with the complaint of a painful
blurred vision in his left eye upon awakening two days earlier. His visual acuity was 20/25 both eyes. There
was a mild anterior chamber reaction in the left eye. Fundus examination showed a localized choroidal
effusion at the inferotemporal part of the left retina.

Note that people with down's syndrome have unusual facial bone structures and other tissue structure differences. My guess is that it might make them more susceptible to this kind of problem.

[robysue]

Guest,

Thanks for providing the very interesting link. I've scanned it and plan on printing it out and adding it to my folder of CPAP-stuff since I was experiencing eye pain (in the absence of mask leaks) in the early going.

[chunkyfrog]

This sounds so much like an urban legend.
Let's submit this one to Mythbusters.
Since Adam is also a hose head, (I think), it could be a cool way for some more exposure.
--All other things aside; I'd like to see them blow up some cadaver/cow eyeballs.

[BlackSpinner]

The day after I started cpap I noticed my vision was more blurry. The DME said there was no connection, there was no way air could get near my eyes as there was no connection between the nasal passages and the eyes and she could see that my quatro didn't leak into my eyes from across the desk when she told me to hold it to my face! At that point I already knew more then her from my searches here and else where so I left.

I had my eyes checked by both an ophthalmologist and an optometrist. I was given a new eye glasses prescription and told I had a mild astigmatism in one eye. Never been told that before. I changed to a Hybrid and there is less issue with my eyes but some days they are worse then others.

[Janknitz]

I was thinking Mythbusters, too

I'm not volunteering, though!

[LoQ]

This sounds so much like an urban legend.
Let's submit this one to Mythbusters.

I was thinking Mythbusters, too

Just curious why so many people seem to think this is an urban legend or a myth? You might be right, but it doesn't sound improbable to me.
http://www.mat.or.th/journal/files/Vol9 ... 7_4753.pdf

The presented patient developed a localized
choroidal effusion that happened after sleeping
overnight. In the absence of known associated
systemic or ocular diseases, nasal CPAP might be
the probable risk factor in this patient.

The author highlights the importance for
ophthalmologists and internists to knowing this
serious potential complication of CPAP therapy.
Selection of the optimal fit mask for each individual
anatomy and the proper position of lying will prevent
this problem.

[emphasis mine]



Sigh.

[tattooyu]

People with Down's Syndrome might be susceptible to retinal detachment. Search on Google for "down's syndrome retinal detachment." Not sure how that correlates with CPAP. It might not at all and just be a coincidence.