Harrison Wendy, Pence Neil, Kovacich Susan
Indiana University School of Optometry, Cornea and Contact Lens Research Clinic, Bloomington, Indiana 47405, USA.
Optometry. 2007 Jul;78(7):352-5. doi: 10.1016/j.optm.2006.12.015.
Obstructive sleep apnea (OSA) is a disorder that, when left untreated, can have serious complications, mainly cardiovascular. OSA is commonly treated with a continuous positive airflow pressure (CPAP) machine. Patients using CPAPs routinely complain of dryness of the nose and eyes.
Case 1: A keratoconic woman, wearing gas-permeable lenses began therapy with a CPAP, and vascularized limbal keratitis (VLK) developed. She now wears soft lenses, compromising visual acuity, but preventing the VLK. Case 2: A man with 20/20 visual acuity in the right eye (O.D.) and hand motion in the left eye (O.S.), presented with recurring corneal ulcers O.D. after starting treatment with a CPAP. Case 3: A man with pellucid degeneration started using a CPAP, which increased his complaint of dryness with his lenses. He subsequently had 2 occurrences of bacterial conjunctivitis.
It is unclear if the complications seen in these cases come from leakage of air into the eyes causing drying, from bacteria trapped under the mask being forced up into the eyes, or from air passing from the nose into the eye via the nasolacrimal duct. In the care of these patients, being aware of complications, suggesting nighttime lubricants, and knowing the alternatives to CPAP could help maintain ocular health and successful lens wear.
阻塞性睡眠呼吸暂停（OSA）是一种若不治疗会引发严重并发症（主要是心血管方面）的疾病。OSA通常采用持续气道正压通气（CPAP）机进行治疗。使用CPAP的患者经常抱怨鼻子和眼睛干燥。
病例1：一名圆锥角膜女性，佩戴透气性角膜接触镜，开始使用CPAP治疗后发生了血管化角膜缘角膜炎（VLK）。她现在佩戴软性角膜接触镜，这影响了视力，但预防了VLK。病例2：一名右眼视力20/20（OD）、左眼手动视力（OS）的男性，在开始使用CPAP治疗后右眼反复出现角膜溃疡。病例3：一名患有透明变性的男性开始使用CPAP后，他佩戴角膜接触镜时眼睛干燥的症状加重。随后他发生了2次细菌性结膜炎。
尚不清楚这些病例中出现的并发症是源于空气漏入眼睛导致干燥，源于被困在面罩下的细菌被压入眼睛，还是源于空气通过鼻泪管从鼻子进入眼睛。在护理这些患者时，意识到并发症、建议夜间使用润滑剂以及了解CPAP的替代方法有助于维持眼部健康和成功佩戴角膜接触镜。
