Ocular manifestations of common pulmonary diseases - A narrative review

Abstract

Ocular involvement can be a comorbidity of several pulmonary disorders. A knowledge of these manifestations is essential for early diagnosis and treatment. Hence, we aimed to review the common ocular manifestations of Asthma, COPD, sarcoidosis, obstructive sleep apnea and lung cancer. The ocular manifestations of bronchial asthma include allergic keratoconjunctivitis and dry eye. The inhaled corticosteroids used in the management of asthma can lead to cataract formation. COPD is associated with ocular microvascular changes due to chronic hypoxia and spill over of systemic inflammation into the eyes. However, its clinical significance is yet to be known. Ocular involvement is very common in sarcoidosis, seen in 20% of cases of pulmonary sarcoidosis. It can involve almost any anatomical structure of the eye. Studies have shown the association of obstructive sleep apnea (OSA) with floppy eye syndrome, glaucoma, nonarteritic anterior ischemic optic neuropathy, keratoconus, retinal vein occlusion and central serous retinopathy. However, though association has been established, causality remains to be proven. The effect of positive airway pressure (PAP) therapy used in the treatment of OSA on the above ocular conditions is yet to be known.  The PAP therapy can itself lead to irritation and dry eyes. Lung cancer can involve the eyes by direct invasion of nerves, ocular metastasis or as a part of paraneoplastic syndrome. The purpose of this narrative review is to raise awareness about the association between ocular and pulmonary disorders to facilitate early detection and treatment of these conditions.