Eye Problems on Expeditions – Recommendation of the Medical Commission of the Union Internationale des Associations d’Alpinisme (UIAA)

D.S. Morris; J. Potts; S. Mella; D. Depla

doi:10.55225/hppa.172

Autor

D.S. Morris University of Cardiff Medical School, Cardiff, UK
J. Potts University of Cardiff Medical School, Cardiff, UK
S. Mella University of Bristol, UK
D. Depla North Cumbria NHS Trust, UK

DOI:

https://doi.org/10.55225/hppa.172

Słowa kluczowe:

wyprawa, duża wysokość, wzrok, ślepota śnieżna, cukrzyca, jaskra, retinopatia

Abstrakt

Visual loss in the wilderness setting is potentially fatal. Firstly it may be a warning sign of a serious systemic problem and secondly the patient may lose their functional independence and ability to respond to objective danger. The issues discussed in this paper fall broadly into two categories, those that are unique to the high altitude setting and those that could happen anywhere but require treatment to protect vision then standard ophthalmological care is unavailable. The aims are to provide practical knowledge on how to manage simple eye problems and also how to recognize the warning signs when evacuation may be required. In keeping with all wilderness medicine, preparation and prevention are essential to avoid eye problems in the mountains. This paper is intended for physicians, interested non-medical people and expedition operators as a practical guide to the treatment and prevention of eye problems on expeditions.

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Bibliografia

Polk JD, Rugaber C, Kohn G, Arenstein R, Fallon WF. Central retinal artery occlusion by proxy: a cause for sudden blindness in an airline passenger. Aviat Space Environ Med. 2002;73(4):385-387. http://www.ncbi.nlm.nih.gov/pubmed/11952061. Google Scholar

Ersanli, D., Yildiz, S., Sonmez, M., Akin, A., Sen, A., & Uzun G. ntraocular pressure at a simulated altitude of 9000 m with and without 100% oxygen. Aviat Space Environ Med. 2006;77(7):704-706. Google Scholar

Bosch MM, Barthelmes D, Merz TM, et al. Intraocular Pressure during a Very High Altitude Climb. Investig Opthalmology Vis Sci. 2010;51(3):1609. doi: 10.1167/iovs.09-4306. DOI: https://doi.org/10.1167/iovs.09-4306 Google Scholar

Morris DS, Somner JEA, Scott KM, McCormick IJC, Aspinall P, Dhillon B. Corneal Thickness at High Altitude. Cornea. 2007;26(3):308-311. doi:10.1097/ICO.0b013e31802e63c8. DOI: https://doi.org/10.1097/ICO.0b013e31802e63c8 Google Scholar

Somner JEA, Morris DS, Scott KM, MacCormick IJC, Aspinall P, Dhillon B. What Happens to Intraocular Pressure at High Altitude? Investig Opthalmology Vis Sci. 2007;48(4):1622. doi:10.1167/iovs.06-1238. DOI: https://doi.org/10.1167/iovs.06-1238 Google Scholar

Willmann G, Schommer K, Schultheiss M, et al. Effect of High Altitude Exposure on Intraocular Pressure Using Goldmann Applanation Tonometry. High Alt Med Biol. 2017;18(2):114-120. doi:10.1089/ham.2016.0115. DOI: https://doi.org/10.1089/ham.2016.0115 Google Scholar

Fujiwara K, Yasuda M, Hata J, et al. Long-term regular exercise and intraocular pressure: the Hisayama Study. Graefe’s Arch Clin Exp Ophthalmol. 2019;257(11):2461-2469. doi:10.1007/s00417-019-04441-9. DOI: https://doi.org/10.1007/s00417-019-04441-9 Google Scholar

Leal C, Admetlla J, Viscor G, Ricart A. Diabetic Retinopathy at High Altitude. High Alt Med Biol. 2008;9(1):24-27. doi:10.1089/ham.2008.0125. DOI: https://doi.org/10.1089/ham.2008.0125 Google Scholar

Morris DS, Severn PS, Smith J, Somner JEA, StannardKP, Cottrell DG. High Altitude and Retinal Detachment. High Alt Med Biol. 2007;8(4):337-339. doi:10.1089/ham.2007.1026. DOI: https://doi.org/10.1089/ham.2007.1026 Google Scholar

World Health Organisation. Ultraviolet Radiation and the INTERSUN Programme. World Meteorological Organization.1992. Available from: http://Www.Who.Int/Uv/Uv_and_health/En/. Google Scholar

Gnyawali S, Shrestha GS, Khanal S, Dennis T, SpencerJC. Ocular morbidity among porters at high altitudes. Nepal J Ophthalmol. 2017;9(1):30-36. doi:10.3126/nepjoph.v9i1.17529. DOI: https://doi.org/10.3126/nepjoph.v9i1.17529 Google Scholar

Singh I, Khanna PK, Srivastava MC, Lal M, Roy SB, Subramanyam CS V. Acute Mountain Sickness. N Engl J Med. 1969;280(4):175-184. doi:10.1056/NEJM196901232800402. DOI: https://doi.org/10.1056/NEJM196901232800402 Google Scholar

Clarke C, Duff J. Mountain sickness, retinal haemorrhages, and acclimatisation on Mount Everest in 1975. BMJ. 1976;2(6034):495-497. doi:10.1136/bmj.2.6034.495. DOI: https://doi.org/10.1136/bmj.2.6034.495 Google Scholar

Wiedman M, Tabin GC. High-altitude retinopathy and altitude illness. Ophthalmology. 1999;106(10):1924-1927. doi:10.1016/S0161-6420(99)90402-5. DOI: https://doi.org/10.1016/S0161-6420(99)90402-5 Google Scholar

Zhao X, Yang Y ZWF. Pathogenesis research progress of high altitude retinopathy. Int Eye Sci. 2018;18(3):461-465. Google Scholar

Morris DS, Somner J, Donald MJ, McCormick IJ, Bourne RR, Huang SS, Aspinall P DB. The eye at altitude. Adv Exp Med. Biol. 2006;588:249-270. doi: 10.1007/978-0-387-34817-9_21. DOI: https://doi.org/10.1007/978-0-387-34817-9_21 Google Scholar

Clarke AK, Cozzi M, Imray CHE, Wright A, Pagliarini S. Analysis of Retinal Segmentation Changes at High Altitude With and Without Acetazolamide. Investig Opthalmology Vis Sci. 2019;60(1):36. doi: 10.1167/iovs.18-24966. DOI: https://doi.org/10.1167/iovs.18-24966 Google Scholar

Tian X, Zhang B, Jia Y, Wang C, Li Q. Retinal changes following rapid ascent to a high-altitude environment. Eye. 2018;32(2):370-374. doi:10.1038/eye.2017.195. DOI: https://doi.org/10.1038/eye.2017.195 Google Scholar

Mukhtar A, Khan MS, Habib A, Ishaq M FO. Visual outcome of retinal vein occlusion in patients residing at high altitude. J Pak Med Assoc. 2017;67(5):735-738. Google Scholar

Flynn, W. J., Miller, R. E., Tredici, T. J., & Block MG. Soft contact lens wear at altitude: effects of hypoxia. Aviat Sp Env Med. 1988;59(1):44-48. Google Scholar

Krakauer J. Personal Account of the Mount Everest Disaster. London: Random House; 1998. Google Scholar

Mader TH, White LJ. Refractive Changes at Extreme Altitude After Radial Keratotomy. Am J Ophthalmol. 1995;119(6):733-737. doi:10.1016/S0002-9394(14)72777-1. DOI: https://doi.org/10.1016/S0002-9394(14)72777-1 Google Scholar

White LJ, Mader TH. Refractive changes at high altitude after LASIK. Ophthalmology. 2000;107(12):2118. doi:10.1016/S0161-6420(00)00276-1. DOI: https://doi.org/10.1016/S0161-6420(00)00276-1 Google Scholar

Dimmig JW, Tabin G. The Ascent of Mount Everest Following Laser in situ Keratomileusis. J Refract Surg. 2003;19(1):48-51. doi:10.3928/1081-597X-20030101-10. DOI: https://doi.org/10.3928/1081-597X-20030101-10 Google Scholar

Gupta N, Prasad I, Himashree G, D’Souza P. Prevalence of Dry Eye at High Altitude: A Case Controlled Comparative Study. High Alt Med Biol. 2008;9(4):327-334. doi:10.1089/ham.2007.1055. DOI: https://doi.org/10.1089/ham.2007.1055 Google Scholar