Most patients think it’s just a bit of snoring, the main consequence of which is some bruised ribs courtesy of sleep deprived and frustrated partners.However, sleep apnoea brings with it much higher risks of stroke, heart attack, diabetes and early death.It also provides us an opportunity as eyecare professionals to provide a more holistic approach to patient care.Now, I know what you’re probably thinking – we already have 101 things on our ‘to-do’ list without adding another. However, the seriousness of this condition cannot be ignored.Evidence gathered from multiple studies conducted over the past 15 years has shown a definite link between a variety of eye-related ailments and obstructive sleep apnoea (OSA).Patients with OSA have an increased rate of floppy eyelid syndrome, they’ll often have difficulties with dry and irritated eyes, ptosis, and are at a higher risk of developing more serious diseases like glaucoma, central serous retinopathy and non-arteric anterior ischic optic neuropathy (NAION).All of these symptoms are signs of potentially greater probls, which if not addressed, could have severe or even fatal health implications for the patient.{{quote-A:R-W:450-Q:These symptoms are signs of potentially greater probls, which if not addressed, could have severe or even fatal health implications for the patient.}}Just last month a newly released study found people with type 2 diabetes and OSA were three times more likely than those who just had diabetes to develop moderate to severe diabetic retinopathy within four years.That example is just one reason why it is so important for us as ophthalmologists and optometrists to be aware of the potential signs of OSA.Yet so often when I see letters sent to GPs from eyecare professionals, they very much focus on “here’s what we’ve found is wrong with the eyes today.”But, do you honestly think a GP will know the link between these eye complications and OSA?Of course not. It’s not their job.It’s the same as someone presenting with AV nipping and retinal flame haorrhages – we should refer th back to their physician for blood pressure managent.Likewise if there is evidence of the capillaries in the retina leaking and deteriorating we will order a blood test for diabetes.For years we have learned the obvious markers of ill-health elsewhere in the body – so why should OSA be treated any differently?We need to ask the right questions and really encourage the patient to report back to their GP that what they have is potentially a sign of OSA and needs further investigation.Yes patients might laugh it off and try and dismiss it, but it is up to us as health advocates to ensure they realise fully the potential risks they are taking with their health.Otherwise, we have missed an opportunity for an early intervention that could have had a massive impact on the patient’s quality of life, and overall health and wellbeing.As I alluded to earlier, it’s not like there’s no information out there about this. Studies have shown that patients with OSA are more likely to have a subsequent diagnosis of glaucoma and NAION.We’ve also shown in our research that patients with OSA have vascular changes in the retina.So we have proof that OSA is causing blood vessel damage, and this same damage will be occurring in their brain, heart and kidneys.It’s about being responsible for the whole patient, not just their eyes. Otherwise, we risk letting our patients sleep their way into a future of blindness, ill health and prature death.
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Name: Clare FraserQualifications: MBBS, MMed, FRANZCOOrganisation: Save Sight Institute, University of SydneyPosition: Associate ProfessorLocation: Sydney, NSWYears in the profession: Consultant for 6 years |
