Ocular Surface in Patients With Obstructive Sleep Apnea Syndrome: Evaluation of Clinical Parameters and Impression Cytology.

PURPOSE: To evaluate the effect of obstructive sleep apnea syndrome (OSAS) on the ocular surface and conjunctival cytology and the relationship between the findings and disease severity. METHODS: One hundred six eyes of 106 patients (77 patients with OSAS and 29 control subjects) were included in the study. Twenty-three patients with an apnea-hypopnea index (AHI) of 5 to 15 were classified as mild OSAS (group 1), 27 patients with an AHI of 15 to 30 were classified as moderate OSAS (group 2), and 27 patients with an AHI≥30 were classified as severe OSAS (group 3). The following tests were used to evaluate the ocular surface: tear break-up time (TBUT), Schirmer I test, ocular surface disease index (OSDI), and conjunctival impression cytology (CIC). The results obtained from the tests were analyzed and compared between the groups. RESULTS: The mean value of the Schirmer I test was 15.03±10.16 (1-35) mm in the control group, whereas it was found as 13.39±8.80 (3-35) mm, 9.85±7.81 (1-30) mm, and 9.41±7.53 (2-35) mm in the mild, moderate, and severe OSAS groups, respectively, and the difference between the groups was significant ( P =0.002). Although the mean TBUT score was 9.83±5.03 (3-23) seconds in the control group, it was 11.04±6.22 (3-20), 6.26±3.48 (1-16), and 5.44±3.09 (1-10) in the mild, moderate, and severe OSAS groups, respectively, and the difference between the groups was significant ( P <0.001). Although the mean OSDI score was 12.76±14.84 (range, 0-41.65) in the control group, it was 11.52±12.95 (range, 0-44.40), 25.06±19.45 (range, 0-75), and 20.31±19.87 (range, 0-77.70) in the mild, moderate, and severe OSAS groups, respectively, and the difference between the groups was significant ( P =0.015). Although the mean CIC stage was 0.47±0.60 (0-2) in the control group, it was 0.89±0.74 (0-2), 1.52±0.75 (0-3), and 1.83±0.69 (1-3) in the mild, moderate, and severe OSAS groups, respectively, and the difference between groups was significant ( P <0.001). CONCLUSION: In addition to decreased tear production and TBUT, cytological changes including squamous metaplasia were detected between patients with OSAS and the control group.

Evaluation of applicants unable to perform military service due to eye disease in terms of disease etiology and preventability: A cross-sectional study.

Purpose: Our study's goal was to investigate the individuals who took a pre-military examination and were pronounced "unfit for military service," in terms of etiological grouping, legal blindness, and whether or not the illness could have been prevented. Methods: The files of 174 individuals deemed "unfit for military service" due to eye disease at the State Hospital Ophthalmology Department between January 2018 and January 2022 were retrospectively evaluated. The disorders were classified as refractive error, strabismus, amblyopia-related, congenital, hereditary, infectious/inflammatory, degenerative, and trauma-related pathologies. The reasons for unsuitability for military service were classified according to monocular and binocular legal blindness, preventability, and treatability with early diagnosis. Results: In our study, the reasons associated with refractive error, strabismus, and amblyopia were placed first in the etiology of unsuitability for military service (40.2%). The next most prevalent condition was trauma (19.5%), which was followed by degenerative (18.4%), congenital (10.9%), hereditary (6.9%), and infectious/inflammatory disorders (4.0%). There was a history of penetrating trauma in 79.4% of trauma patients and blunt trauma in 20.6% of patients. When the etiology was evaluated, 19.5% were in preventable and 51.2% were in treatable group with early diagnosis. In our study, legal blindness was detected in 116 patients. Of these patients, 79% had monocular legal blindness and 21% had binocular legal blindness. Conclusion: It is vital to investigate the etiology of visual disorders, control preventable causes, and determine the methods that will provide early diagnosis and treatment of curable causes.