SALINE NASAL SPRAY AND INTRAOCULAR PRESSUREDr. Carolina Valdivia discusses whether there is a connection between saline nasal spray and increased intraocular pressure.  A woman from New Jersey, USA writes about her 87 year-old mother with glaucoma and elevated intraocular pressure:Dear Dr. Valdivia, My question concerns my 87 year-old mother. She has been a glaucoma patient for about 32 years. She currently uses Timolol eye drops twice per day and also takes Asacol for mild ulcerative colitis. Her eye pressure has varied throughout the years from 19 to 26. She suffered a retinal detachment in one of her eyes about 15 years ago that left her without sight in that eye. A recent visit to her ophthalmologist found that the pressure in her sighted eye is 25. I am worried. My mother has been using a saline nasal spray for several weeks to treat a mild sinus infection. Is it possible that this could be causing the increase in her eye pressure? Thanks for your help.
Tears produced by the lacrimal gland form the tear film that lubricates the eye. They eventually drain into the nasolacrimal duct. When we cry, there is an overproduction of tears. This volume overwhelms the nasolacrimal duct and the excess tears stream down our face. The nasolacrimal duct is a one-way system that is ensured by the continuous down flow of tears through it. However, the most important thing to understand is that the lacrimal apparatus is a system that is external to the eyeball. In contrast, eye pressure is a characteristic that is internal to the eyeball. Thus, introducing saline nasal spray into the nasal cavity will not cause the saline solution to migrate up through the nasolacrimal duct and enter into the eyeball to increase eye pressure. In medicine, it is common to recommend preparations or solutions containing 0.9% saline to patients for treatment of nasal congestion from colds, sinus infections, and seasonal allergies. This concentration mimics the salinity of our cells and therefore poses no danger. The solution softens mucus secretions and facilitates drainage, which in turn moisturizes the surface of the mucosa of the nose. There are several advantages to using saline nasal spray as a decongestant.
Solutions containing 0.9% saline sometimes also may contain steroid medications to reduce inflammation. In some individuals, the prolonged use of steroid medications can cause elevations in intraocular pressure and lead to a condition called drug-induced glaucoma. However, from your description it does not appear that the solution that your mother is using contains steroid medications. Check with your doctor or pharmacist to be sure. If the intraocular pressure in your mother's eye remains elevated, it may require the addition of a second medication to her regimen in order to bring it down. There are two medications that combine Timolol with a second glaucoma medication into one eye drop. These are Cosopt and Combigan. You might consider mentioning these to your ophthalmologist to see if they might be an option for better control of your mother's eye pressure. Carolina Valdivia, MD
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Return from Saline Nasal Spray to Answer My Health Question
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Let me address your concern from the outset. There is no relationship between the use of saline nasal spray and increased
