Vision & CPAP

[MaxDarkside]

I have an eye poke exam coming up on Monday. Before Auto-PAP my IOPs were high and different from eye to eye but I had negative tomography and peripheral vision test for glaucoma, tho I could see a cloud in the lower right of my left eye (the higher pressure one) in the peripheral vision test. As a curiosity now after 3-4 months on Auto-PAP I booked an appt with the eye doc and I'm curious whether my pressures have gone up.

[Unsuspected Severe OSA]

Maxdarkside, be sure and have the visual fields checked and the optic disc carefully inspected for cupping. Unfortunately, we have to rely on signs of glaucoma damage from the nightly pressure increase , not just the pressure number during the day apt. Let us know how this goes...

[MaxDarkside]

Maxdarkside, be sure and have the visual fields checked and the optic disc carefully inspected for cupping. Unfortunately, we have to rely on signs of glaucoma damage from the nightly pressure increase , not just the pressure number during the day apt. Let us know how this goes...

I'll ask him to look at the cupping. He probably won't order another peripheral vision test unless he sees something justifying it. I don't remember what the difference in the eye-to-eye pressure was, but it was significant (quite a lot).

[MaxDarkside]

Oh, and I've read up on glaucoma quite a lot. It is my understanding that the inner-ocular pressure (IOP) aggravates the degeneration, particularly where the optic nerve comes into the retina, but the true cause of glaucoma is still being researched. There are plenty of people with glaucoma with normal pressures. One current theory is that glutamates are involved in triggering a neural degeneration of the optical nerve and not just at the eye, but all the way along, including back to the brain.

[Lizistired]

I have an eye poke exam coming up on Monday. Before Auto-PAP my IOPs were high and different from eye to eye but I had negative tomography and peripheral vision test for glaucoma, tho I could see a cloud in the lower right of my left eye (the higher pressure one) in the peripheral vision test. As a curiosity now after 3-4 months on Auto-PAP I booked an appt with the eye doc and I'm curious whether my pressures have gone up.

Please update when you have more information.

[-tim]

I wonder if CPAP vs APAP makes this worse. I think its something someone should be looking into.

[RipVW]

After reading the study and doing some additional googling, I called a friend with OSA and asked if her eye doctor knew she had OSA and if he had ever discussed with her the increased incidence of Glaucoma in OSA patients. She said he had mentioned it and that he checked her pressure at annual appointments, though she didn't know much about it.

Well I haven't had an eye exam in about 10 years and I want to know why our sleep doctors don't even mention this!

My eyesight has been wacky for the last year or so, at least 3 months before my PSG. My friends don't understand why I carry multiple pairs of readers.... Because I need different ones at different times to see different things!!!! I'm making an appointment Monday.

I'm posting to vent, and to share an interesting site I found today: http://fiteyes.com/
For the data geeks here, one of the things they do is monitor their own eye pressure and what affects it, water, stress, caffeine, exercise(which types), alcohol(which actually reduces the pressure), posture.....
I thought some here might find it interesting.

This is so cool! Looks like for now, one may purchase a home Self-Tonometry unit only through their opthomologist. Still haven't been able to find what these units cost.

Home Eye Pressure Monitoring Recommended
http://fiteyes.com/home-eye-pressure-mo ... ecommended

[BlackSpinner]

The first thing I noticed when I started treating my apnea was that my vision was blurry in the morning. I had a hard time reading the screen on my machine, which was a little abnormal to me. It seemed after an hour or two my vision would clear a little, but it feels like I have seen a step change down in my vision overall since I started using a machine. I had discounted the correlation between therapy and vision impairment until now.

I have been considering getting my eyes examined. I wonder how many eye doctors are familiar with XPAP therapy?

Do any of you forum members have any experience with this?

I had the same issue almost 3 years ago when I started.
Saw an ophthalmologist and an optometrist and the DME . All of them said it was all in my imagination.

[WearyOne]

Well, wonder if this is part of my problem.

I have a health issue that can cause eye problems, plus I have worn glasses for almost 50 years, plus I'm in my fifties. Anyway, I started having blurry eye issues on and off about six months after starting CPAP. I have regular doctor visits anyway, but sometimes I've gone in, complained for blurry vision, and there's no change in prescription, no change in pressure. The only thing he believes is that my dry eye problems are caused mostly by CPAP.

It may have been in there and I just missed it, but did the article say anything about whether the pressure setting on the machine made any difference, like if a higher CPAP pressure might cause more problems? Love to know the answer to that.

Pam

[chunkyfrog]

My ophthalmologist has a lot of other patients on XPAP, I consider that a plus.

[PST]

Well, wonder if this is part of my problem.

I have a health issue that can cause eye problems, plus I have worn glasses for almost 50 years, plus I'm in my fifties. Anyway, I started having blurry eye issues on and off about six months after starting CPAP. I have regular doctor visits anyway, but sometimes I've gone in, complained for blurry vision, and there's no change in prescription, no change in pressure. The only thing he believes is that my dry eye problems are caused mostly by CPAP.

It may have been in there and I just missed it, but did the article say anything about whether the pressure setting on the machine made any difference, like if a higher CPAP pressure might cause more problems? Love to know the answer to that.

I don't know if it makes any difference with respect to intra-ocular pressure, which is the subject of much of this thread and a very serious issue. It can make an indirect difference with respect to the less dangerous condition I mentioned in an earlier post, epithelial basement membrane dystrophy. (The condition is less serious. The name, unfortunately, sounds like something that should prompt you to write your will or at least buy a dog, so it may be better to call it by its more whimsical name, map-dot-fingerprint.) The pressure itself is no problem, but leaks are, and high pressure causes more leaks than low pressure. Air blowing across the corneas is the issue, so it can be countered by better mask fit (easier said than done) or changing to nasal pillows (not for everyone). There is a goopy ointment, that I hate, that can be squeezed onto the eyes at night as well. So there are many solutions, but higher pressure works against them.

[BlackSpinner]

The pressure itself is no problem, but leaks are, and high pressure causes more leaks than low pressure. Air blowing across the corneas is the issue, so it can be countered by better mask fit (easier said than done) or changing to nasal pillows (not for everyone). There is a goopy ointment, that I hate, that can be squeezed onto the eyes at night as well. So there are many solutions, but higher pressure works against them.

I found when I switched to the Hybrid from the quatro that the problem reduced a lot.
I didn't think the Quatro was leaking into my eyes until one day I went to bed with a migraine and a cold wet clothe over my eyes. I noticed when i removed to cloth my eyes got cold and yet I couldn't really feel a leak. So I went to my DME (silly me) to talk about the fit. She told me to hold the mask up to my face and from across the desk she stated that it fit well and couldn't possibly be leaking into my eyes. That was the last time I went there except to purchase filters.

[portiemom]

Like BlackSpinner, I was told changes in my vision were my imagination, so I switched eye doctors and new glasses were ordered, they were delivered 2 weeks later and I couldn't see out of them. The doc saw me once a week for a month and the eyesight was so inconsistent she finally decided to settle on a lense in between the lowest and highest readings and I have days that I can read well and days not so much. I did use some drops and ointment for awhile and then the cost just got to be too much. I have blurry days for sure, but I try to wear an eye mask at night to avoid the exhaust air blowing in my eyes. This doc was not an opthalmologist, so that is my next stop on the doctor bus.
Grateful for all this important information regarding cpap.

[PST]

My 94 y/o mother has corneal dystrophy and her doctor informally checked me assuming that I would have it (some forms are autosomal dominant), but I did not within this past year, but before CPAP. After my first few months, I noticed the eyes were slightly dry, attributable to the exhaust air, so I'm using OTC eye ointment at night. My mother just uses Restasis, an immunosuppressive eye drop to decrease eye inflammation and stimulate tear production. Sounds like PST has controlled this eye condition despite CPAP; unlike my mother who battles with lubricants& antibiotics intermittently possibly due to the Restasis.

There are different kinds of corneal dystrophy, so my good result may be just good luck in having a mild form. I use an over-the-counter solution called Muro 128 which is nothing but expensive saltwater. It bugs me to pay for it. I want to reach for the familiar blue Morton's box, but of course having exactly the right concentration in a sterile solution is the smart thing to do. I would not think of recommending this to anyone except on a doctor's instruction. The purpose is to draw moisture out of the cornea. That seems terribly counter-intuitive, but I guess the point is that one needs a surface film of moisture on the cornea, not a soggy cornea. This keeps it from getting fragile. It has worked like a charm for me, but again I wouldn't think of trying it except as directed. Plus, it does sting a bit. It beats the salty Vaseline ointment version, though.

I have a quick thought for portiemom. A clue that you may have a corneal problem is that adjustments to your lenses don't help. It is kind of like how no matter how accurately you focus a camera, you won't get a really clear shot through a screen door. I'm glad I saw the ophthalmologist.

[portiemom]

Thanks PST, an opthamologist is my next stop, of course there is a line of Doc.s in front of him but he is definitely on the radar now thanks to all of you great folks!