Ocular Complications Resulting from the use of CPAP Hoods/Helmets

Abstract

Ocular complications resulting from the use of CPAP hoods/helmets O ver the course of the past decade, lightweight hoods/helmets have emerged as a useful tool for the delivery of CPAP to adults with acute hypoxaemic respiratory failure. When compared with tight fitting masks, hoods/helmets reduce the risk of skin necrosis, are less claustrophobic and have been shown to be well tolerated by patients for extended periods. 1-3 However, since these systems exert continuous positive pressure on all structures enclosed within the hood/helmet, we are concerned that this may elevate intraocular pressure (IOP) and potentially worsen symptoms of glaucoma in patients with pre-existing intraocular hypertension or precipitate retinal ischaemia secondary to reductions in retinal arterial flow. While long-term maskdelivered CPAP has been shown to cause an increase in IOP and reduction in ocular perfusion pressure in some patient populations, 4,5 the magnitude and clinical significance of such effects in intensive care patients receiving CPAP via a hood/helmet are unknown. We wonder whether anyone has noticed any ocular complications resulting from the use of these systems?