Eye pressure and full face masks

[tattoohead]

PsychoMike...

I'm looking to get me one of these. My doc had said something about possible eye pressure problems. I'm at 17/21 on my ResMed machine using a Quattro FX mask for now. Was using a Mirage Quattro for years but both full face masks keep leaking and making the raspberries.

Have you heard anything about pressure to the eyes with higher BiPAP pressures?

Thanks..

[PaulaO2]

I moved Tattoohead's post from the Review Forum to here which is why his post may seem a little odd.

[justMongo]

There is a necro-thread on eye pressure somewhere.
Paula -- do you recall it?

[PsychoMike]

From my reading, there are some potential issues with OSA and eye pressure....some related to untreated OSA and some to CPAP treatment in general (not specific to the FitLife). There may be some additional information in the threads that Mongo refers to, but I don't have a link to them. The general impression I get is that untreated OSA has far more health risks associated with it than treated OSA, including when it comes to the eyes and eye pressure.

Regarding something like the FitLife, I haven't heard of issues with folks "on air" (i.e. SCBA or SABA) for a lot of their working lives being more prone to eye health issues other than dryness due to the compressed air used and because their eyes are open. With something like the FitLife, your eyes should be closed most of the time you are using it

I'll try to do a bit more digging to see what I come up with, but if you're concerned about things like glaucoma to begin with, then it is something you will probably need to keep an eye on with your eye health professional, regardless of your mask choice.

[archangle]

There are several issues that often get confused together as "eye pressure." Let's get the terminology right first.

Full Face Mask (FFM) - Covers the nose and mouth.
Total Face Mask - Covers the nose, mouth and eyes - example Fitlife.
Oral Mask - Fits into the mouth, optional nose plug.
Nasolacrimal Duct - a tube that runs from the eye socket to the nasal cavity. Sometimes called the tear duct. Full Face Mask (FFM) - Covers the nose and mouth.

There are different "eye pressure" problems.

A Full Face Mask may cause problems from pressure in the nose causing air to flow up the nasolacrimal duct. I guess there may be some other eye problems caused by pressure of the mask on the face near the eyes.

A total face mask puts physical air pressure on the eyelids, and from there onto the eyeballs. The air pressure under a CPAP mask is roughly equivalent to the pressure inside the eyeball. A total face mask will solve nasolacrimal duct problems because the pressure inside the nose is equal to the pressure in the eye socket.

FFM's may leak an air stream that blows on the eye socket. Some people call this eye pressure.

Which problem is the OP talking about?

An oral mask goes into the mouth like a SCUBA mouthpiece. You can learn to close off the soft palate at the back of your nose and not use the nose plugs. It's the same physical action you do when you blow up a balloon. You have pressure in your mouth and your windpipe, but no pressure in your nose.

An oral mask eliminates any problems with nasolacrimal ducts and doesn't put any pressure near your eyes, as long as you don't use the nose plugs or clips.

I found I could learn to not let air leak out of my mouth with an oral mask, but it was uncomfortable. My mouth and throat got very dry, even with humidification. The lack of airflow in my nose was uncomfortable and has some side effects.

They have some drawbacks, but an oral mask does pretty much solve all CPAP related eye problems if you can live with it and learn to not use nose plugs or clips.

[archangle]

OK, I see this thread was split from a "Fitlife" thread, so the OP is talking about a Total Face Mask, not a Full Face Mask.

[PaulaO2]

I believe the OP is referring to external pressure to the eyes vs internal such as ocular hypertension.

The internal eye pressure thread, or at least one of them, was one I started a long time ago. Increased ocular pressure is possible with CPAP but the benefits of CPAP far outweigh the slight risk, even for those already at risk. My ocular pressure has steadily increased but has not changed in that speed since I started CPAP. If that makes sense...

[PsychoMike]

Makes sense, Paula....and it's what I think tattoohead is getting at. Some of the main concerns people have voiced about total face masks (not just the oro-nasal masks that the CPAP community calls a full face mask or ffm) are: drying of the eyes and pressure under the mask pressing on the eyeballs and causing issues.

The dryness shouldn't be an issue with a total face mask (TFM) unless you've had one too many facelifts or have some other issue that doesn't let you eyelids close. If that is the case, it will be a chronic problem whether you are using a TFM, FFM or nothing at all. Most people get sufficient closure of the eyelids to prevent drying and the TFMs (or at least the FitLife from my experience) don't blast air at your eyes. My use of SCBA and SABA systems says that they are more prone to dryness because of the use of an oro-nasal cup and routing of the super dry airflow (needed to prevent oxidation in the tank and to prevent icing which could result from cooling with reducing the pressure from the tank down to what you can actually breathe) through the mask to prevent fogging.

When it comes to pressure "on" the eyes, that's a little different. I'm also assuming that tattoohead is asking about possible issues with the eyes related to the pressure under a tfm being applied to the eyeballs. If you've had recent eye surgery or are dealing with (or at high risk of developing) glaucoma, I can see folks wanting to avoid a TFM...those are two of the listed contraindications (reason not to use) for the FitLife. Outside of those two circumstances, I can't see where there would be an issue.

[Lukie]

My eye pressures have gone up on cpap from 22/23 to 26/28 borderline glaucoma.

[justMongo]

I have a comprehensive eye exam by an ophthalmologist two or 3 times per year.
My IOPs are always in the teens.

The nasolacrimal duct is actually a tear drain. Some people with dry eyes have them plugged.
One thing I'm noticed with regard to the nasolacrimal duct -- since xPAP pressurizes my sinuses, it blows crud into my eyes.
ergo: morning ritual is to wash out my eyes with eye drops.