Purpose To describe ocular findings in patients with established obstructive sleep apnoea hypopnoea syndrome (OSAHS) using continuous positive airway pressure (CPAP). Methods One hundred and fifteen referrals investigated for OSAHS were included. Patients with OSAHS were compared with those with normal sleep study controls. Subgroup analysis for CPAP users and nonusers was also carried out. Results OSAHS patients (n ¼ 89) compared with the controls (n ¼ 26) had higher ocular irritation symptoms (Po0.001), abnormal tear break-up time (Po0.05) with increased upper (Po0.001) and lower (Po0.001) lid laxity. Floppy eyelid syndrome (FES) was noted in 31.5% (28/89) OSAHS patients vs 3.8% (1/26) controls (P ¼ 0.005). Open angle glaucoma prevalence in OSAHS patients (3/89, 3.4%) was similar to the controls (1/26, 3.8%) (P ¼ 0.92). Sixty-seven (75.3%) OSAHS patients were using CPAP (average duration: 19.6 ± 15.3 months). All CPAP users maintained a supine sleep posture to prevent mask edge leaks. A fifth of CPAP users (14/67) had experienced earlier episodes of conjunctivitis secondary to leaks. CPAP users had similar upper and lower lid laxity (P ¼ 0.746 and 0.633) to non-CPAP users, but a better tear film (P ¼ 0.029) and less ocular irritation (P ¼ 0.134). Conclusion OSAHS patients showed increased ocular irritation, abnormal tear film, lid laxity, and FES. The prevalence of glaucoma in our series was similar to normal population data of 2%, P ¼ 0.429, and may relate to use of CPAP in majority of the patients. More stable tear film in CPAP users was probably secondary to the supine sleep postures necessarily adopted with CPAP use.

Although growing rods have efficacy in the control of deformity within the growing spine, they also have adverse effects on the spine. Immature spines treated with a growing rod have high rates of unintended autofusion which can possibly lead to difficult and only moderate correction at the time of definitive fusion.

Level II.

Finite element modeling suggests that the pathomechanics at the proximal end of a scoliosis construct may be diminished by preserving the ISL/SSL complex and possibly completely eliminated with the use of rods with a diameter transition at the most proximal level.

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.