Sleep apnea-glaucoma correlation merits further study

Sleep apnea is associated with many eye diseases. While contradictory evidence exists of an association with glaucoma, it cannot be ruled out.

Since sleep apnea is a common condition, ophthalmologists should consider sleep evaluations in patients with normal tension glaucoma, glaucoma, pseudotumor cerebri, atypical retinal hemorrhages, and retinal vascular tortuosity, said Parag A. Gokhale, MD, assistant professor of ophthalmology, Medical College of Georgia, Augusta.

"I do believe that sleep apnea is a risk factor for glaucoma, and in my glaucoma patients I do take a brief sleep history and refer patients for sleep studies if their histories are positive," Dr. Gokhale said.

He noted that while a number of studies have found an association between sleep apnea and glaucoma, others have not. Studies have used varying definitions of sleep apnea and glaucoma and have displayed variability in their control groups. Therefore, it is difficult to reach definitive conclusions with the available evidence, Dr. Gokhale said.

He recommended clinical trials with age- and weight-matched control groups. He also suggested that, just as ophthalmologists should look for signs of sleep disorders in their glaucoma patients, clinicians should also evaluate sleep-disordered patients for signs of glaucoma.