Ocular pathology associated with obstructive sleep apnea syndrome.

Objective: The purpose of this study was to describe the ophthalmological findings in patients with obstructive sleep apnea syndrome (OSAS). Methods: The study group was made up of 65 patients with OSAS diagnosis and the findings were compared with the ones of the control group (n=39), which comprised patients without OSAS. An observational, analytic study, with a transversal component and a prospective component, was performed. Results: The IOP (intraocular pressure) was similar in both groups (p=0,9786). In the OSAS group, IOP increased with a higher AHI (apnea/ hypopnea index), but not significantly (p=0,057). Similarly, there was no correlation between a higher AHI and the lacrimal secretion in the OSAS group (p=0,3282). However, when we compared control with OSAS patients, we found a significantly higher degree of lacrimal hyposecretion in the latter (p=0,0003). CPAP treatment had no effect on IOP, as initial and final medium IOP were 15.06 and 14.89 respectively (p=0,8327). Regarding lacrimal secretion, it seems that CPAP treatment had an improving effect, as tear production rose from a 9.25 mm medium to 10.45 mm on the Schirmer I test (p=0,0118). Conclusions: Overall, OSAS patients showed similar IOP and glaucoma prevalence as the normal population. However, they had an abnormal tear secretion and a higher prevalence of eyelid laxity (a sign of floppy eyelid syndrome). Abbreviations: OSAS/ SASO = obstructive sleep apnea syndrome, AHI = apnea/ hypopnea index, CPAP = continuous positive airway pressure, FES = floppy eyelid syndrome, TSch/ TSCH = Schirmer test, IOP = intra-ocular pressure, PSG = polysomnography.

Eyelid laxity and sleep apnea syndrome: a review.

The purpose of this paper is to review the association between a medical entity called the floppy eyelid syndrome (FES) and a very serious respiratory disease with repercussions on various other body organs and systems: the obstructive sleep apnea syndrome. The epidemiology, pathophysiology, and treatment of these two diseases are intertwined but still not enough recognized. Eye disorders affect a great number of patients in modern societies and the cause of their suffering is often left undiscovered, practitioners preferring a symptomatic treatment. However, the ophthalmologist should be aware of the possibility of a sleep disorder in their patients with certain pathologies, as well as sleep physicians, who should be aware of the possibility of eye problems and refer them for a checkup. Finally, a review of literature is undergone, evaluating the possibility that the treatment of one or the other disease may benefit both.

Diagnosis difficulties in a patient with progressive loss of vision - a case report.

The paper presents the case of a 57-year-old male patient who complained of slow progressive loss of visual acuity. Anamnesis revealed he was a heavy drinker and he was previously diagnosed with a pancreatic cancer, observed on the MRI. The clinical examination revealed ocular features that made the diagnosis difficult. Initially, it seemed to be a case of narrow angle glaucoma but further ocular examinations revealed macular thinning.