Hyperoxic myopia After a week of diving

[cholla11]

Hey Everyone: first let me say thanks, and that I appreciate the advice. I have been seeing medical professionals, and just wanted to seek some opinions on here, as this seems to be a rare-ish condition.



After diving roughly 5 weeks ago, I noticed blurred distance vision in the airport while returning home. I had equalization issues and a fast assent while diving, and believe that I may have suffered from hyperoxic myopia, in addition to barotrauma/ DCS. After returning home, I had two US Navy Table 5 treatments for DCS.



Now 5 weeks out, my visual symptoms do not seem to be completely back to normal. I got refracted (which produced a notable myopic change from last July), and the medical experts weren't really able to give me concrete advice on when this may go back to normal. From what I can find online, similar findings have been reported, but most seem to disappear within the first few weeks. Anyone have insight on this?

Hyperoxic myopia: a case series of four divers - PubMed

Diver Loses Distance Vision After Innocuous Dive - Divers Alert Network

some literature I have found very useful

 

[nickbutcher]

I first suffered from this after a trip to Bikini in 2012 (I was 54 at the time). There was a lot of deco at 6m, often 2+ hours at a time and I was using a CCR with a setpoint of 1.2-1.4. I wrote about it here.

@Dr Simon Mitchell was on the trip and we discussed it. I don't think he'll object to me mentioning that he had also experienced a similar thing.

At the time, I was long-sighted with age-related presbyopia so my distance vision improved somewhat as a result of this. I was told that my vision would revert after about 6 week but it never fully went back.

2 years later I had another trip to Bikini and this compounded the matter further. Shortly after, I was diagnosed with the early onset of cataracts and 2 years later I had cataract surgery and tri-focal intraocular lenses were fitted.

I've done a couple of long trips with extended deco since but the phenomenon has not manifested itself again.

 

[cholla11]

I first suffered from this after a trip to Bikini in 2012 (I was 54 at the time). There was a lot of deco at 6m, often 2+ hours at a time and I was using a CCR with a setpoint of 1.2-1.4. I wrote about it here.

@Dr Simon Mitchell was on the trip and we discussed it. I don't think he'll object to me mentioning that he had also experienced a similar thing.

At the time, I was long-sighted with age-related presbyopia so my distance vision improved somewhat as a result of this. I was told that my vision would revert after about 6 week but it never fully went back.

2 years later I had another trip to Bikini and this compounded the matter further. Shortly after, I was diagnosed with the early onset of cataracts and 2 years later I had cataract surgery and tri-focal intraocular lenses were fitted.

I've done a couple of long trips with extended deco since but the phenomenon has not manifested itself again.

Thanks so much for the fast reply. Were you able to get new contacts/ glasses that were able to fix the problem then? Any long term after-effects from the shift? Did the dizziness gradually go away?

 

[Pedro Burrito]

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[Duke Dive Medicine]

What is it that makes you think this is hyperbaric myopia? Asking because it's relatively unusual, or at least quite under-reported, in divers. Equalization issues and DCS are certainly confounding factors here.

Best regards,
DDM

 

[nickbutcher]

Thanks so much for the fast reply. Were you able to get new contacts/ glasses that were able to fix the problem then? Any long term after-effects from the shift? Did the dizziness gradually go away?

I never suffered from dizziness, just a change in my visual acuity.

For a period I didn't require assistance for my distance vision but as the effect declined I needed new varifocal specs as my old ones were too strong.

 

[JonG1]

I've had this after a week of rebreather diving, it takes a while but gradually stabilises. I wear monthly disposable lenses, so I am guessing this possibly makes things worse, but not really certain on the mechanics of it all.

 

[cholla11]

What is it that makes you think this is hyperbaric myopia? Asking because it's relatively unusual, or at least quite under-reported, in divers. Equalization issues and DCS are certainly confounding factors here.

Best regards,
DDM

So I saw another hyperbaric specialist this AM and they say I may have a perilymph fistula that would explain my recurrent dizziness and balance issues still persisting, and that my myopic change would be more likely from prescription changes instead of potential hyperoxic myopia. Thoughts?

 

[68raggtop]

I've had this after a week of rebreather diving, it takes a while but gradually stabilises. I wear monthly disposable lenses, so I am guessing this possibly makes things worse, but not really certain on the mechanics of it all.

Like JonG1, I get hyperoxic myopia after 5 days or more of rebreather diving. It will continue to worsen for a week or so after the dive trip has ended. It typically takes two months to completely resolve. It is very consistent for me, to the point I have a pair of glasses that are my post-dive trip glasses.