الفهرس 
CHRONIC OBSTRUCTIVE PULMONARY DISEASEOnly 14 pages are availabe for public view
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Abstract
COPD as a disease had many effects on eye structures and cause increase in IOP which will lead to Glaucoma.
The more the severity of COPD the more the increase in IOP.
Follow up IOP in COPD patients and make them familiar of the possible Ophthalmological complications especially the increase in IOP will help for early recognition and management of these complications.
RECOMMENDATIONS
1. It is better in future studies to increase the sample size and duration of the study.
2. It is better in future studies to use OCT as an accurate tool.
3. Most COPD cases were category E according to GOLD 2023 so it is better in future studies to use different categories of COPD.
4. A Multidisciplinary team are needed to manage patients with COPD complications.
5. We should work on developing clinical guidance and other educational materials for healthcare providers, patients, and the public of ophthalmological complications of COPD.
6. Further studies are needed to better understand how many people are affected by COPD with ophthalmological complications.
7. People who had COPD must do regular Follow up on IOP.
SUMMARY
A
t the forefront of clinical care for COPD are multiple guidelines, recommendations, and best practices that have been promulgated and prioritized for prevention and management of its complications especially Ophthalmological complications.
Chronic obstructive pulmonary disease is a major cause of chronic morbidity and mortality. It is a chronic, progressive disease with pulmonary and extra-pulmonary manifestations and is a leading cause of death in the world. An increase in its prevalence and mortality has been predicted in the coming decades (Lowe et al., 2019).
Intraocular pressure (IOP) is an important risk factor for developing glaucoma. Glaucoma is a disease characterized by visual field defects and optic nerve damage. Glaucoma ranks second among the causes of blindness and is a preventable cause of blindness with early diagnosis (Erhan et al., 2018).
Hypoxia and systemic inflammation have a major effect on ocular structures. They are thought to involve fine ocular structures, such as choroid, macula, retinal nerve fiber layer (RNFL), and retinal vascular vessels (Fabri et al., 2003).
The effects of smoking on the eye can be summarized as decreased blood flow in the ocular and retinal vessels, impaired autoregulation, increased vascular resistance in the chorioretinal and optic nerve circulation and abnormal choroidal vascular activity (Saber et al., 2021).
Ocular manifestations of pulmonary hypertension secondary to chronic obstructive pulmonary disease develop as a result of reduced venous outflow due to increased systemic venous pressure (Zhang et al., 2021).
The aim of this work is to assess the effect of COPD on intraocular pressure in Ain Shams University Hospitals patients.
The study was done during the period from Septemper 2022 to April 2023who were admitted to our chest department or outpatient clinics visitors, to Ain Sham University Hospitals.
On 50 diagnosed chronic obstructive pulmonary disease with age more than 40 years old included in the study diagnosed using standard clinical and diagnostic criteria to assess intra ocular pressure and 50 age and sex matched healthy control subjects included in the study. After consent achievement and fully explained about the steps of research.
Exclusion criteria:
None of cases in both COPD group and control group had history of glaucoma, history of eye surgery, history of congenital eye anomalies, history of glaucoma medication or history of anticholinergic drugs and all of them are exclusion criteria to rule out any cause of increase in intra ocular pressure.
The subjects of both groups subjected to:
Full history taking with special stress on occupational history and smoking as a special habit.
Full clinical examination divided into general and local chest examination.
Spirometry test with reversibility to ensure the diagnosis of COPD.
The intra ocular pressure was measured using applanation tonometery under topical corneal anathesia using 0.5% propracaine hydrochloride after tear film staining with the help of a moistened fluoroscine strip. All the recordings will be done between 10AM and 1 PM (Aziz and Friedman, 2018).
Fundus examination and visual acuity.
By comparison of the two groups, we found that IOP in right and left eye showed significant elevation in COPD group compared to control group.
There was a statistically significant Relation between severity of COPD and IOP measurement in right and left eye and also there was significant positive correlation between IOP in right and left eye with smoke pack and duration of smoking.
The conclusion is COPD as a disease had many effects on eye structures and cause increase in IOP which will lead to Glaucoma. The more the severity of COPD the more the increase in IOP.