CPAP eye damage

[onelegmike]

I have always had perfect vision but recently I started using a CPAP machine and my eye started hurting in the mornings. One day I woke up and my right eye was swollen shut and I was almost blind in both eyes while I was getting dressed to go to the hospital my left eye got considerable better. I went to the doctor who was convinced that it was diabetes that caused the problem, thing is I don’t have diabetes or high blood sugar. Y eye improved over a week’s time but never got back to 20/20. Now I have to wear glasses because I am a peace officer and need my vision to be perfect. Every once in a while I will wake up and my eye will be very sore and dry. I know I need the CPAP but I don’t want to go blind.


This discussion is related to CPAP MACHINE.

[dean_park]

There is a non surgical  treatment for sleep apnea using dental appliances.  I can direct you to someone close to you for a further evaluation.      

[John C Hagan III, MD, FACS, FAAO]

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[dean_park]

There is a non surgical  treatment for sleep apnea using dental appliances.  I can direct you to someone close to you for a further evaluation.      

[John C Hagan III, MD, FACS, FAAO]

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[Drucifer]

I continue to see ophthalmologists and apnea “specialists” repeatedly parrot the dry eyes theory without so much as a nod to physiology of the eye. Lactrimal duct air regurgitation and nerve damage due to sinus pressure are not treatable by eye drops and mask leakage. When is someone in the medical community going to take the lead and start addressing issues not easily solvable by cultural practices? The side effects of sinus pressurization are real and the medical community needs educating.

[John C Hagan III, MD, FACS, FAAO]

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[ffhester2]

☝️Agree it’s much more than “DRY EYES”!!!

[John C Hagan III, MD, FACS, FAAO]

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[AlienWrangler]

I too had terrible double vision after using my new CPAP with a face mask that covered my whole nose and mouth. I tried to hydrate my eyes with no effect. I changed my mask to the Amara view mask which  covers only my mouth and the tip of my nose. My vision went back to normal in 3 days. It's not dry eyes, it's the mask putting pressure on the muscles around your eyes.

[JohnHaganMD]

Problems with CPAP are much less of a problem with modern small nosepieces and also adjusting the pressure to fit the body type and lung compliance. Most CPAP users do have dry eyes and use lubricating drops at bedtime. Regular artificial tears will not last so we have our patients use GELS like Refresh Liquigel

[JohnHaganMD]

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[upsidedowner]

Started CPAP a few years ago. Tried many masks, none fit properly, so I quit. Started again two nights ago after experiencing over half an hour of abnormal breathing in the night. Last night was very disrupted with the usual CPAP trouble: mask gets dislodged and leaks with small movements, and when I tighten it enough to not leak, the pressure hurts forehead and face. Woke this morning with the entire white of the eye from nose to iris blood red! Not painful but very disturbing. Don't know if it is from air leaking or from mask pressure, but in any case I have nothing good to say about CPAP technology. I cannot use just the nose pillows--my mouth opens in sleep. I had surgery nearly two years ago for deviated septum, supposedly to help CPAP use, but that doesn't seem to make a difference. Have also tried chin strap, mouth guard--nothing fits or works. I am a slender fit woman with small face.

[JohnHaganMD]

Hey its your reaction to the CPAP not the technology which has continued to get better and better over the past 2 decades. You are describing a "subconjunctival hemmorhage" which are very common and not serious. May or may not be related to your CPAP. Use a lubricating gel at bedtime in both eyes (e.g. Refresh-PM or Liquigel). Talk to your MD about having CPAP technicians work with you to get best model and the most ideal settings.

[JohnHaganMD]

This is an ultra common problem. Your eyes are drying out when you sleep. I'm sorry when the CPAP is set up and adjusted that they do not discuss the eyes drying during sleep. Be sure your CPAP is properly adjusted, fitting and that the setting are appropriate for you. At bedtime put a long acting lubricating gel in both eyes  examples: genteal gel, liquifilm gel, refresh PM. When you get in put in a regular set of artificial tears.  I see this problem in my office ever couple of weeks.

[blizzarduk]

Can CPAP cause permanent vision problems even when ceased using ? I used CPAP for 6 months from September 2015 to February 2016, during that time my eyes became slightly blurred all the time and I had to get +1.00 glasses, which I now have to wear all the time. I constantly wake up with gritty eyes and my vision is still blurry without my glasses, all through the day. Oddly my eyes will become gritty even when lying down and having my eyes closed for a mere 20 minutes.  Everything was fine in August 2015 before I began with CPAP. I only needed it until February 2016 as by then I had lost enough weight to not need it anymore. I used the CPAP on auto mode with 11 to 18cm pressure with nose pillows. They did sometimes leak on to my eyes. Given I have not used the machine since February 2016 and my vision is still poor concerns me, but my optometrist says they are fine and my eye pressure is fine and a OCT was fine. They also gave me weekly demodex removal treatment and BlephEx. I think my LipiView score results for both eyes were within the 60's. Have you ever heard of short term CPAP causing permanent vision issues when use has ceased ? Thanks for your help.  

[emersonran]

I've been experiencing increasingly blurred vision for the past few months since increasing the pressure on the APAP to 16/20. Both my short distance, but especially my far distance vision were becoming blurrier, which I found strange since my eye tests before that were always perfect (I'm 43 years old)

I got home late last night, and thus didn't use the APAP/CPAP machine.
This morning my vision is back to normal.

I use a full face mask and it doesn't usually leak on my eyes, sometimes the leak happens underneath - but I tend to strap it on extra tight, which is effective in reducing leaks.

There is definitely a connection between the machine (I suspect pressure) and blurred vision.

[John C Hagan III, MD, FACS, FAAO]

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[calendar_girl]

you asked in a related forum has anyone had trouble with their eyes while using bipap.

I often find the highly pressurized air leaking right into my eye generally my lft eye which coincidentally has much worst vision.

Recently I sat on the mask and felt like maybe it was leaking at the top so I put straps very tight.

I awoke in bad pain to find either the strap or the edge of the hard plastic with the thin veneer of sorter plastic over it (not sure which as was half asleep and moved it immediately, My eye was extremely sore for days like I had been punched.

the eye was blood red all over.very bloodshot  (still is going into day 4) and it seemed my vision was blurred or diminished.

Pain got a better though still hurt if turned eye certain way..got in to eye doctor today 3 days after injury.

She said the clear part of my eye was bunched up where the strap/mask apparently lay across my eye. She said my vision was same as before which surprised me as I had not realized my eye was that bad and still feel it did get worst but who knows.

sh said my eye was extreme dry..thankfully, she said it would get better but said to see if can get a better mask fit which is veer hard as I need the full face mask as I mouth breathe and most of the full face masks are too big. she said to use artificial tears 4 times a day.

It may be contributed to by uncontrolled diabetes extremely high glucose for several months and I notice at time severe dry mouth so wonder if maybe I am dehydrated all over  but I never realized that this air blowing over my eye was making them dry as I dont really notice it till she told me that.

Unfortunately, went to get the eye drops for redness etc (a steroid drug) and they said I had to have a prior authorization insurance wise and it takes 5 to 7 days. My eye is so red...I am worried to go this long without help.

Not sure what to do as the mask it either so tight, I  cannot sleep well or if sort of comfortable, it seems to leak a lot.  They only cover one a year and I am too poor to pay for one.

Now I am wondering what damage that is doing to the lungs and other body areas to be breathing unnatural, pressurized air !/3rd of my life. I am not aware of it leaking into my eyes unless I wake up to use the bathroom but having it slip right over my eye and crush it like that scares me form using it but I must or I cannot sleep. when lights go out, I cannot sleep for 2 or 3 days at all or however long it takes them to fix the electric power.

Any advice would b appreciated.  I dont really see the sleep doctor..only when he forces me to every several years,..they just keep renewing my masks and tubes with the old prescription online so I dont especially want to go see him,...he has not really helped me.

I was on the wrong pressure  (13 to 17) between him and other sleep doctors over 18 years. Way too low,. I had to figure everything out myself and still no improvement in energy etc,.  Only morning headaches went away. I was never told anything about having PLMD till I remembered to bring it up after 5 therapist told me I had it kicking my leg1000s of times a night. but not to tell him they told me. I had many life problems going on and forget to bring it up. Th md he finally gave me caused e to fall aslep when driving twice something I never did in decades ever, so I had to stop it.

He did not tell me silent reflux was strongly associated with sleep apnea. Like over 1/3rd of apnea patients have it.

I thought I had a lung problem for decades till I finally was told by doctor that he thought I had silent reflux..it is different from regular reflux which I never had heartburn ever so never dreamed I had severe reflux..the doctor was no help.

But I guess I go to him as the others before him were so awful and I do not have to go in just wear my mask..at least till now.

I only feel rested if I get double the sleep like 13 to 17 hours. ON normal amount of sleep I have zero energy and feel tired all the time.

I am on a pressure of 20 to 23 on automatic. Very very high.

I am due for new mask in February I am thinking of seeing if the respiratory company can come before them and help me find a mask that finds better.  I have the smallest one they make I think but maybe in last 5 yeas they have gotten more masks.

[John C Hagan III, MD, FACS, FAAO]

No the relationship between CPAP and floater increase would be coincidental.

JCH MD

[MariainGeorgia]

I would challenge the medical community to do some research or studies because I am certain there is a correlation between CPAP & the condition of the eyes .  I use a nasal mask & its been a noticeable & quick  downhill for my vision.

[JohnHaganMD]

1.  The longer we live the older the eye gets and especially after late 30's early to mid-40s the poorer our vision is without glasses and the more likely we are to develop eye disease.
2. Sleep apnes is associated with a variety of diseases and medical conditions such as diabetes, cardiovascular disease and obesity that adversely affect eye health.
3. Wearing a CPAP can cause problems with the cornea as the first post her suggests.
4. Sleep apnea is treated because low oxygen levels develop during sleep, this is bad for every cell in the body including all the cells associated with sight and vision.
5. If you can't make peace with your CPAP including the very small ones that just go in the nose and have the CPAP settings adjusted by a sleep technician there is a new treatment that involves no CPAP at all but a device worn on the chest that stimulates breathing.   FOLLOW THIS LINK:  http://www.sleepreviewmag.com/2017/10/fda-approves-implanted-device-treat-central-sleep-apnea/

[Den903]

Dear Doctor
I'm having increasing vitreous floaters with the use of a nasal mask possibly related to air pressure on eyes from leaks in mask or from the air exhaust. Is this possible and any changes could help ie nostril cpcp.?Has this 'side effect' been reported before?

Thanks
Dennis Jack

[John C Hagan III, MD, FACS, FAAO]

There are two possible solutions: move to one of the new mini CPAP masks.  Second use Refresh PM ointment in both eyes at bedtime and Refresh or Systane ULTRA artifical tears on awakening.

JCH MD