Mayo Clinic researchers outline several links between sleep disorders and eye disease in the November issue of Mayo Clinic Proceedings.
“Given the vascular consequences of OSA, it is not surprising that ophthalmologic manifestations exist,” says the lead author of the article, E. Andrew Waller, MD, a Mayo Clinic pulmonologist and sleep specialist.
Floppy eyelid syndrome
This disorder, which causes eyelids to evert (turn inside out) spontaneously during sleep, has been found to be a signal that a person also has OSA.
Glaucoma
The second most common cause of blindness, two forms of glaucoma have been linked with OSA—primary open-angle glaucoma and normal-tension glaucoma. Studies have shown that the severity of glaucoma appears to correlate with the number and duration of apnea episodes in patients with OSA.
Nonarteritic anterior ischemic optic neuropathy (NAION)
An increased incidence of OSA has been shown in people diagnosed with NAION, which is characterized by sudden painless onset of vision loss in one eye, often noticed upon awakening.
Papilledema
Papilledema, or swelling of the optic nerve in both eyes, occurs due to increased pressure within the skull and can lead to progressively worsening vision, and in some cases, blindness. People with OSA may have a higher incidence of papilledema.
“Our understanding of the mechanisms that link these disorders is minimal,” says Waller. “However, the recognition of these associations is important for primary care physicians, ophthalmologists, and sleep physicians. For patients with OSA, a routine eye examination to evaluate for early signs of glaucoma, particularly in the setting of visual loss or change, should be recommended. Patients with ophthalmologic diseases known to be associated with sleep apnea should be screened clinically for sleep apnea and referred to a sleep center if signs or symptoms are present.”
