Surgery for Sleep Apnea Could Slow Glaucoma Damage

HOT TOPIC

Surgery Could Improve OSA, and in Turn, Reduce Glaucoma Risk

A recent study found that a significant improvement in optic nerve microcirculation occurs after surgical intervention for obstructive sleep apnea (OSA) is performed. Thus, OSA surgery could reduce the risk of glaucoma or slow down its damage. (As eye doctors, we are very much aware that OSA can cause oxidative stress in the eye that can ultimately lead to vascular dysregulation, endothelial dysfunction, and glaucomatous optic neuropathy.)

The prospective, single-masked study was performed in Taiwan and included 29 patients 20 to 70 years of age with moderate to severe OSA. Interestingly, the study group consisted of 25 males and four females with an average age of 36 years. The researchers analyzed optic nerve head microcirculation in patients before and after upper airway surgery performed both before and 3 months after the surgical procedure, where the patients underwent overnight polysomnography. (This test aims to provide an apnea-hypopnea index score.) Additionally, patients underwent ophthalmological assessments, including laser speckle flowgraphy, which assesses the microcirculation of the optic nerve head.

The results were impressive, to put it mildly. The surgery was highly effective in reducing the severity of OSA, with a substantial decrease in the apnea-hypopnea index score (which is beneficial) and an impressive reduction in Epworth Sleepiness Scale scores. Notably, we have observed a significant improvement in ocular blood flow parameters.

According to the researchers, “treatment of OSA to increase oxygen supply during sleep can reduce oxidative stress, vascular inflammation, endothelial damage, and sympathetic activation, which could be the possible mechanism for improving ocular blood flow and avoiding subsequent damage to optic nerve and macular function.”

My Two Cents

By now, you know that if it involves sleep, I’m likely to profile it here. This is yet more ammunition in your quiver as a primary care eye doctor, reminding us of the need to discuss the importance of sleep with each of our patients. It’s that important. (Yet not important enough for the Academy to approve my lecture on sleep.) Wink wink, hint hint. To the members of the American Academy of Optometry: I know you turned me down for this year’s meeting, but you can bet I’ll apply again next year!

OUTSIDE THE LANE

App Takes Aim at Food Waste

Food markdown apps like Too Good To Go are gaining traction as innovative solutions to combat food waste while offering consumers affordable meals. In 2023, the United States wasted approximately 73.9 million tons of food—nearly one-third of its total food supply—with retailers and restaurants contributing 17.2 million tons, according to ReFED, a nonprofit focused on food system reform. These apps allow grocery stores and restaurants to sell surplus food at discounted rates, preventing it from ending up in landfills.

ReFED estimates these apps could save up to 881,000 tons of food waste annually as they expand across US cities. However, challenges persist, including limited awareness among vendors and consumers, as well as an overly cautious food culture, notes Jackie Suggitt of ReFED.

The apps are taking some safety steps to ensure they enforce compliance with local food safety regulations, which many require vendors to discard cooked food after 7 days to prevent risks from pathogens such as Listeria. Users can report spoiled food for refunds, and noncompliant businesses are removed from the app. Despite concerns about whether purchased food is consumed or wasted, mindful use enhances the apps' effectiveness. By offering economic benefits and reducing environmental impact, these apps represent a promising step toward addressing the global food waste crisis.

My Two Cents

What a genius idea! This is one of those rare instances that benefits both consumer and business. Of course, you never know when bad actors may turn up, so vigilance from the apps will need to be constant.

CAN YOU RELATE

Last year, I made my first trip to Vision Expo West after regularly attending Vision Expo East the past few years. To say that I was thoroughly impressed would be a massive understatement. It was an incredible convention! From the ODs on Facebook rooftop party to the excellent education and shockingly large exhibit hall, to the ODs on Finance party, it was a great time with great friends. Not to mention the fact that Las Vegas seems to be a city built for large conventions, with plenty to do for everyone and no shortage of hotel rooms, ranging from the most affordable to the most extravagant.

Now, to the point of my rambling: If you haven’t heard, Vision Expo is combining its East and West meetings into one large convention. At first blush, many are probably upset about this. After all, a yearly trip to Las Vegas in the fall and/or New York (now Orlando) in the spring may have come to be a bit of a tradition, and I can fully understand that. However, this consolidation makes sense to me, and it probably marks the start of a trend that will take years to play out. That trend, in my opinion, is that of meetings combining with each other to help sustain their base and grow.

In-person continuing education (CE), although one of my absolute favorite things to do, is a hassle for many doctors. The appeal of online CE is easy to see, and with much of it being free (or nearly free) and taught by world-class doctors and instructors, why wouldn’t more doctors opt to earn their CE online? This question leads us to the elephant in the room: If an increasing number of doctors are getting more of their CE online, then the need for in-person events must not be as great (despite the growing number of optometrists).

I applaud The Vision Council for taking this step. I absolutely love the fact that it is rotating the Vision Expos each year. As the dad of a 7-year-old son, I will be in Orlando March 12-14 to check out the new Universal Epic Universe and all the usual Disney Park magic. I’m also excited that Vision Expo will be in Las Vegas in 2027 and then in New York in 2028. Great job, Vision Council, for making the move. Now, if you’re interested in having me give a CE lecture on the importance of sleep and the eye, let me know.

QUOTE OF THE WEEK

“Many lack the originality to lack originality, but nobody lacks sweat in this summer heat.”

— Oscar Wilde