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A. Kadyan, J. Asghar, A. Ali, S. Sandramouli; Ocular Findings in Sleep Apnoea Syndrome. Invest. Ophthalmol. Vis. Sci. 2007;48(13):364.
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To study the ocular findings in patients with established sleep apnoea syndrome.
Patients on the sleep register at a district teaching hospital, diagnosed with obstructive sleep apnoea syndrome (Respiratory Disturbance Index, RDI > 10/h), were invited for the study, following approval of protocol by Local Research and Ethics Committee. All patients were consented and underwent a comprehensive ocular examination.
65 patients (mean age: 56.4 yrs +/- 11 SD, 55 males and 10 females) were included in the study. 89 % (58/65) had moderate to severe sleep apnoea (RDI> 20/h); with mean body mass index of 34.8 kg/m2 +/- 6.4 SD (range: 26-55 kg/m2). 85% had symptoms of ocular irritation. Mean Schirmer’s from both eyes was 8.7mm +/- 7.3. Only 26% (17/65) had a normal Schirmer’s test (> 10mm/ 5 min). Significant lid laxity (> 5mm for upper lids and > 6 mm for lower lids) was noted in 86% (53/65) upper lids and 81.5% (50/65) lower lids (average for both eyes). Floppy eyelid syndrome with easily evertible lids and chronic papillary conjunctivitis was present in 18/65(27.7%). One patient had keratoconus and 5 had mild blepharoptosis. 3/65 had open angle glaucoma and 4 other were diagnosed with ocular hypertension. Only 26/65 (40%) patients had pachymetry values in the normal range (550µ+/- 30 SD). No patient was noted to have lacrimal gland prolapse, disc swelling or pallor. 11/56(19.6%) patients receiving CPAP therapy were aware of mask edge leaks causing recurrent redness/conjunctivitis.
Our data shows a high prevalence of various pathological ocular findings in patients with established sleep apnoea syndrome. All patients diagnosed with sleep apnoea should be considered for an ocular opinion.
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