HBO Therapy and Ophthalmology
Published on Jan 1, 2017
· DOI :10.1007/978-3-319-47140-2_32
Hyperbaric oxygen therapy (HBOT) can be a useful primary or adjunctive therapy for a variety of medical disorders, many of which involve the eye. This chapter will review the effects of oxygen on eye, the literature describing use of HBOT for a variety of conditions and the potential complications of HBOT affecting the eye. The authors recommend the following as ocular indications for HBOT: decompression sickness or arterial gas embolism (AGE) with visual signs or symptoms, central retinal artery occlusion, ocular and periocular gas gangrene, cerebro-rhino-orbital mucor mycosis, periocular necrotizing fasciitis, carbonmonoxide poisoning with visual sequelae, radiation optic neuropathy, radiation or mitomycin C-induced scleral necrosis, and periorbital reconstructive surgery. Other ocular disorders that may benefit from HBOT include selected cases of ischemic optic neuropathy, ischemic central retinal vein occlusion, branch retinalartery occlusion with central vision loss, ischemic branch retinal vein occlusion, cystoid macular edema associated with retinal venous occlusion, post-surgical inflammation, or intrinsic inflammatory disorders, periocular brown recluse spider envenomation, ocular quinine toxicity, Purtscher’s retinopathy, radiation retinopathy, anterior segment ischemia, retinal detachment in sickle cell disease, refractory actinomycoticlacrimal canaliculitis, pyoderma gangrenosum of the orbit, and refractory pseudomonas keratitis. Visual function should be monitored as clinically indicated before, during, and after therapy when HBOT is undertaken to treat vision loss. Visual acuity alone is not an adequate measure of visual function to monitor the efficacy of HBOT in this setting. Because some ocular disorders require rapid administration of HBOT to restore vision, patients with acute vision loss should be considered emergent when they present and treatment with supplemental oxygen should be initiated.