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The Eye at Altitude

  • Conference paper
Hypoxia and Exercise

Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 588))

Abstract

High altitude retinopathy (HAR) was first described in 1969 as engorgement of retinal veins with occasional papilloedema and vitreous hemorrhage. Since then various studies have attempted to define the incidence, etiology and significance of this phenomenon, usually with small numbers of subjects. Recently studies on relatively large groups of subjects in Nepal, Bolivia and Tibet have confirmed that the retinal vasculature becomes engorged and tortuous in all lowlanders ascending above 2500m. Sometimes this leads to hemorrhages, cotton wool spots and papilloedema, which is the pathological state better known as high altitude retinopathy. These studies have also shown a significant change in both corneal thickness and intraocular pressure at altitude. The retinal blood vessels are the only directly observable vascular system in the human body and also supply some of the most oxygen-demanding tissue, the photoreceptors of the retina. New techniques are being applied in both hypobaric chamber and field expeditions to observe changes in retinal function during conditions of hypobaric hypoxia. This work allows better advice to be given to lowlanders traveling to altitude either if they have pre-existing ocular conditions or if they suffer from visual problems whilst at altitude. This especially applies to the effect of altitude on refractive eye surgery and results of recent studies will be discussed so that physicians can advise their patients using the latest evidence. Retinal hypoxia at sea level accounts for the developed world’s largest cause of blindness, diabetic retinopathy. The investigation of retinal response to hypobaric hypoxia in healthy subjects may open new avenues for treatment of this debilitating disease.

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Authors and Affiliations

  1. Royal Victoria Infirmary, Newcastle-upon-Tyne, UK

    Daniel S Morris

  2. Royal Infirmary of Edinburgh, Edinburgh, UK

    John Somner & Ian J C McCormick

  3. Royal North Shore Hospital, Sydney, Australia

    Michael J Donald

  4. Moorfields Eye Hospital, London, UK

    Rupert R A Bourne

  5. Retinal Diseases Image Analysis Reading Center, Cleveland, Ohio, USA

    Suber S Huang

  6. Heriot-Watt University, Edinburgh, UK

    Peter Aspinall

  7. Princess Alexandra Eye Pavilion, Edinburgh, UK

    Baljean Dhillon

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  1. Daniel S Morris
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  2. John Somner
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  8. Baljean Dhillon
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Editor information

Editors and Affiliations

  1. Altitude Research Center, University of Colorado Health Sciences Center, Mail Stop F524, PO Box 6508, Aurora, Colorado, 80045-0508

    Robert C. Roach Ph.D. (Research Director) (Research Director)

  2. UCSD Dept Medicine, 0623 9500 Gilman Avenue, La Jolla, CA, 92093-0623

    Peter D. Wagner

  3. Telluride Medical Center, 500 W. Pacific, Telluride, Colorado, 81435

    Peter H. Hackett

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Morris, D.S. et al. (2006). The Eye at Altitude. In: Roach, R.C., Wagner, P.D., Hackett, P.H. (eds) Hypoxia and Exercise. Advances in Experimental Medicine and Biology, vol 588. Springer, Boston, MA. https://doi.org/10.1007/978-0-387-34817-9_21

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