Snoring May Blind You

Eyelid Problems with Sleep Apnea

When I was an Ophthalmology resident at LSU, I was taught about a certain eyelid condition, called Floppy Eyelids, associated with sleep apnea.

This is a condition where the lids become loose against the eyeball which in turn causes dry eyes, excessive tearing, foreign bodies (e.g. hairs and fibers), exposure of the surface and corneal scarring.

People with sleep apnea may rub their eyes a lot when trying to start breathing again and the chronic rubbing causes the tissue to become chronically stretched.  Over the years, I have been able to diagnosis sleep apnea on some patients by just examining their eyelids.  Once the sleep apnea is treated the eyelids can be fixed by an outpatient surgical procedure to tighten them.

Optic Nerve Problems and Sleep Apnea

When I finished training 7 years ago, sleep apnea was not associated with vision loss, but that has since changed.

A new emerging area for neuro-ophthalmology is damage to the optic nerve caused by sleep apnea.  I see many patients referred for problems of the optic nerve not explained by normal causes such as glaucoma.  Often the patient will have a “negative workup,” meaning tests like MRIs and blood tests are normal.

Until recently, there was no further workup, yet we’d have no idea about the cause of the vision loss.  Now I am sending many of our patients for sleep testing looking for evidence of sleep apnea.  I do this for all patients in whom I suspect sleep apnea and not just the typical overweight patients who have sleep apnea.    I diagnose optic nerve damage due to sleep apnea in all shapes and sizes and old and young.

Why Does Sleep Apnea Damage the Eye

In short, I’m not exactly sure how sleep apnea causes optic nerve damage, but there are some very convincing theories.

During sleep apnea the oxygen level in the blood decreases since the person is not breathing normally.  Perhaps this decreased oxygen level is damaging to the optic nerve, a tissue highly sensitive to variation in oxygen levels.

The optic nerve is a very active part of the body and such it needs a lot of oxygen. When the oxygen level decreases this causes stress and damage to the nerve which over time can cause vision loss.  Sleep apnea also causes changes in the blood vessels which can also decrease the oxygen delivered to the eye.

If the thought of high blood pressure, strokes and or heart attacks is not enough to get you checked for sleep apnea, then possible blindness might be.  To learn more about this call 941-921-5335 and make and appointment to talk with one of our doctors.

 

 

Jody Abrams, MD, FACS
Oculoplastics/Neuro-ophthalmology
Sarasota Retina Institute
Sarasota, Florida 34239

Comments

  1. Very useful information. We know how much diabetes can affect the body, but most of us, are not aware of the wide range of affect that sleep apnea causes.

  2. Margaret Del Castillo says:

    My husband is waiting to get into a study for sleep apnea, he’s already had surgery on his nose. and a polyp was removed. He’s had problems with dry and itchy eyes for many years , more so after cataract surgery
    It seems to me he puts refresh eye drops in his eyes about every 15 minutes. He’s also a type 2 diabetic, I wonder if the diabetes medication has anything to do with it.

    • Jody Abrams, M.D. says:

      Medications can defiantly cause problems with dryness and irritation to the eyes. I would look at having his lids evaluated for laxity. It might be that he needs more aggressive treatment of the irritation, especially if he is using drops every 15 minutes. Medications like Restasis can help the irritation, but often a small out patient procedure to tighten the lids is needed to solve the problem.
      Definitely get him a sleep study since it could save his life.

      Jody Abrams, MD

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