Ocular Manifestations of OSA: The 5 Most Common
Editor's Note:
Obstructive sleep apnea (OSA) is associated with numerous comorbid conditions. In many, a causative relationship has either been well established or strongly associated. As the knowledge of sleep-disordered breathing and its consequences continues to grow, so does the list of associated or consequential conditions. The following is part 4 of a 5-part series exploring more recently identified consequences if OSA.
Several ophthalmologic conditions have been found to have a clear association with OSA. Similarly, OSA may present with several ocular manifestations. Simple and benign findings, such as drooping of the eyelids, are a common and early sign of sleepiness, whereas other sequelae may herald a more serious underlying condition.
It is important for optometrists, ophthalmologists, and primary care providers to be aware of these physical findings and unusual associations, because they may represent a potentially vision-threatening disorder. Routine screening for sleep-disordered breathing in these conditions is highly recommended.
Floppy eyelid syndrome (FES) is the most common ocular disorder associated with OSA. FES is characterized by papillary conjunctivitis and a rubbery, redundant upper eyelid tissue. Similar to OSA, FES is more prevalent in obese, middle-aged men. Of note, FES frequently presents unilaterally, affecting the eyelid on the side the patient most often sleeps on.
FES is observed in 2%-5% of patients with OSA. However, among patients with FES, the prevalence of OSA approaches 90%. The association of OSA and FES was explored in a case/control study by Ezra and colleagues. In this study, 102 patients with FES were compared with 102 matched controls. OSA was identified in 32 of 102 patients with FES (31.4%), compared with only 9 of 102 controls (8.8%).
Editor's Note:
Obstructive sleep apnea (OSA) is associated with numerous comorbid conditions. In many, a causative relationship has either been well established or strongly associated. As the knowledge of sleep-disordered breathing and its consequences continues to grow, so does the list of associated or consequential conditions. The following is part 4 of a 5-part series exploring more recently identified consequences if OSA.
Introduction
Several ophthalmologic conditions have been found to have a clear association with OSA. Similarly, OSA may present with several ocular manifestations. Simple and benign findings, such as drooping of the eyelids, are a common and early sign of sleepiness, whereas other sequelae may herald a more serious underlying condition.
It is important for optometrists, ophthalmologists, and primary care providers to be aware of these physical findings and unusual associations, because they may represent a potentially vision-threatening disorder. Routine screening for sleep-disordered breathing in these conditions is highly recommended.
Floppy Eyelid Syndrome
Floppy eyelid syndrome (FES) is the most common ocular disorder associated with OSA. FES is characterized by papillary conjunctivitis and a rubbery, redundant upper eyelid tissue. Similar to OSA, FES is more prevalent in obese, middle-aged men. Of note, FES frequently presents unilaterally, affecting the eyelid on the side the patient most often sleeps on.
FES is observed in 2%-5% of patients with OSA. However, among patients with FES, the prevalence of OSA approaches 90%. The association of OSA and FES was explored in a case/control study by Ezra and colleagues. In this study, 102 patients with FES were compared with 102 matched controls. OSA was identified in 32 of 102 patients with FES (31.4%), compared with only 9 of 102 controls (8.8%).
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