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B. Deen, M. Richard, J. Woodward; Eye Findings in Patients Referred for Overnight Polysomnography for Suspected Sleep Apnea. Invest. Ophthalmol. Vis. Sci. 2007;48(13):3571.
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To report Eyelid, corneal and conjunctival findings in subjects referred to the Duke University Sleep Center for the suspected diagnosis of sleep apnea.
Prospective case series of subjects referred for overnight polysomnography for suspected diagnosis of sleep apnea. All subjects were enrolled in our series on the night of their sleep study. Patients were excluded if they gave history of previous lid surgery, lid scarring, referred to sleep center for a study other than evaluation for sleep apnea, minor, or unable to complete the informed consent. 50 of 76 (66%) subjects met inclusion criteria and were enrolled. Subjects were asked to complete a questionnaire on ocular irritation including redness, foreign body sensation, tearing, eye rubbing, and eyelid swelling. Subjects then underwent examination of lids, cornea, and conjunctiva with a portable slit lamp. Lid distraction distances, scleral show and lower punctal distraction distances were measured in millimeters. Data was compared between those with a positive sleep study and diagnosis of sleep apnea and those with a normal sleep study. The results of the sleep study were unknown at the time of examination. The protocol and informed consent were approved by the IRB Duke University, Durham, North Carolina.
Increased lid distraction distances and scleral show were statistically significant when compared to subjects with normal sleep studies. There were no statistically significant difference in ocular irritation, corneal, and conjuctival findings in the two groups.
Obstructive sleep apnea syndrome (OSAS), the partial or complete obstruction of the upper airway during sleep, affects 2% of women and 4% of men. Despite the prevalence, disabling symptoms, and substantial associated morbidity and mortality of OSAS, moderate to severe cases are undiagnosed in an estimated 80% of men and 90% of women. The Ophthalmologist may play a critical role in recognizing patients at risk and recommend referral for further evaluation.
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