Visual problems following cardiac surgery

[Paleowoman]

I keep getting what might be called migraines without headache or ocular migraines ever since surgery, and I found a really good thread on the forum which started 2009 and went on till 2012 in which many people describe exactly the same thing, some with and some without headaches. I wrote a reply to the thread but keep getting an error when I try to post, maybe it's because it's such an old thread ? Here is a link to the thread: http://www.valvereplacement.org/foru...lowing-surgery And here is my post:

I am really pleased to have found this thread. So many people on it with "ocular migraines" or migraine without headache, just the auras. I somtimes get the typical zigzagging pattern of light which starts in the centre of vision and expands outwards over a period of about 15 minutes, sometimes just bright 'blobs' of light moving around my visual field, and sometimes double vision. These started on the second day after surgery and I'm continuing to get these things several times a week, now seven months post op. There don't seem to be any triggers. The other night I woke in the middle of the night to go to the loo (I always do this, it's not related) and I disovered I was about half way through one of the zigzagging pattern of light sequences - that means the aura had started while I was asleep. I'm glad to say I don't get any headaches. I would love to know why these things happen to quite a few of us after cardiac surgery. I may see a neurologist next month but I doubt he'll find anything.

 

[elirn]

I also experienced this phenomena after my first OHS. It was so bad that I couldn't even read my cell phone!

It has passed now, but is disconcerting at the time. I spoke to a perfusionist that said this was fairly common.

All the best

 

[Ryan CA]

For the first few weeks post-op, I couldn't read books or magazines. My vision blurred when I tired to focus. Not sure if it is similar, but my vision issues have pretty much resolved themselves. Hope you find an answer.

 

[epstns]

Well, Anne, I can't add much. I can say, though, that I still occasionally have visual disturbances such as the "areas of light" within my vision, or double vision - and I'm now about 3 1/2 years out. They have been diminishing, and are never serious enough to be a safety issue, but annoying nonetheless.

At least, from what I've learned here, they seem to be harmless.

 

[Paleowoman]

3 1/2 years out and still occasionally getting them Steve ! My cardiologist says I shouldn't be getting them now (seven months post op) but I've a feeling they are definitely to do with a side effect of the heart lung machine. They are harmless, yes, unless I was driving....I can't drive so that's that out of the way ! But the double vision is sometimes tricky to deal with, makes me feel like I am going to fall over. I doubt a neurologist would find anything amiss with me, and I don't want any medication since I don't drive. But why isn't this phenomenon documented ? Why, when so many valvers get it aren't we told that it's a 'normal' effect of the heart lung machine ? And can last a long time.

 

[mcsf]

I'm six months out and I definitely get vision problems like you describe. In fact I'm at work this morning and an episode is starting to creep up in my left eye. I get the zig-zaggy type pattern in my field of vision. It's a prism type of pattern. I do not get a headache with it but it can be real annoying when I am at work.

 

[clay_from_nj]

I'm six months out and I definitely get vision problems like you describe. In fact I'm at work this morning and an episode is starting to creep up in my left eye. I get the zig-zaggy type pattern in my field of vision. It's a prism type of pattern. I do not get a headache with it but it can be real annoying when I am at work.

Silent migraine, meaning you get the aura without the pain. I've had them for years. In my teens I had "real" migraines with pain that would totally disable me. As my condition worsened before surgery, I got the silent migraines more frequently, some with scarier symptoms like confusion, dizziness, and aphasia. Now they are rare, benign, and much shorter-lived.

 

[Protimenow]

I used to get these pre-op, and I get them post-op. Sometimes sudden exposure to bright light seems to trigger them, and it certainly seems to make them worse. I sometimes just work through them, and other times, when I can, I'll put something over my eyes and relax for the 30 minutes or so that it takes for the aura to clear up. Sometimes a chocolate bar or caffeinated drink seems to end the episode.

One thing that you may consider regarding the double vision --- one of the less known side effects from Lanoxin/digoxin overdose can be double vision. I stopped taking digoxin many years ago, and the issue went away. Another thing to consider -- if you have a cataract forming on one or both eyes, you may also see double. Neither is directly related to the valve or to warfarin.

If you take lanoxin, you may want to ask your doctor about this as a possible side-effect. You may also consider an eye exam to rule out cataracts.

 

[Paleowoman]

mcsf - One of the things I get is that zigging, prism type pattern. I found a YouTube video where someone has shown it speeded up, mine is very similar: https://www.youtube.com/watch?v=G8P_ZTJqv8g

Clay - I used to get proper migraines with aura in my mid 40's (related to my menstrual cycle). The aura was always the one above, the ziagging thing for about 20 minutes followed by the headache. No headaches now. Do you mean you had yours pre surgery as your valve got worse ?

Protimenow - I'm not on any of the medications you mention, or any other that could lead to double vision, no cataracts either, I had an eye exam a couple of months ago, so definitely part of the migraine aura package that I've been getting since surgery. Although I had proper migraines in my mid 40s that was some 15 years ago. These 'auras' started right after cardiac surgery.

 

[Protimenow]

Oddly enough, I started getting the migraines when I was in my mid-teens. Lots of pain, some auras.
They settled down in my early 20s (I think I can remember that far back), and I've been getting the auras, with occasional speech disturbances, and occasional numbness in tongue, lips, or fingers. Usually, it's only the visual auras -- the others are much more worrisome.

 

[mcsf]

@clay_from_nj - Thanks. I did not know what the weird vision problem was. Thanks for the information.

@Paleogitl - The video you linked shows what I experience. Thanks.

 

[clay_from_nj]

Paleogirl - Yes, I've always had them, but they seemed to occur more often and more disturbing (could be having a stroke and wouldn't realize it) as my valve got worse. I had crippling pain in my teens, and into my twenties that part dwindled away. Like Protimenow, mine are sometimes triggered by bright light, enough that I ALWAYS wear sunglasses outdoors during the day and even had one of the ceiling lights at my office turned off so as to cut down on the direct glare. Auras are interesting and somewhat varied. I often get the "zig-zig" type as described by others but also get what I think of as "looking through stained glass" or the top half of one eye totally "whiting out". That last type is what I have gotten after surgery, and thankfully they last only a few minutes, though sometimes come with some confusion and difficulty concentrating.

 

[epstns]

Wow - That video is really freaky! I do get the grey blob action, with more of a Technicolor sparkly blob near or around it. I can still see "through" it, but it is definitely disconcerting.

 

[Paleowoman]

Wow - That video is really freaky! I do get the grey blob action, with more of a Technicolor sparkly blob near or around it. I can still see "through" it, but it is definitely disconcerting.

Here's one that has technicolour on it: https://www.youtube.com/watch?v=qVFIcF9lyk8 Hey, you'll make us jealous Steve !

 

[mcsf]

Yes, I get the technicolor version! The ole internet is full of great stuff. https://www.youtube.com/watch?v=qVFIcF9lyk8

 

[Mooney]

I had mitral valve repair on Feb 28, 2014. No pre-surgery vision problems, but post surgery I have had the following:

1) little sparks of intense white light flashing and darting across my field of vision. Rare, probably once a week or once every two weeks. It only lasts a microsecond and is gone. Does not really bother me, but I noticed it first a couple of days after getting home from the hospital.

2) I have now had two episodes of those jagged line/blurring events. VERY bizarre, never before had anything like that in my life. Both of these episodes had some similar characteristics - each occurred after periods of high stress at work, each occurred about 2-3 hours after vigorous exercise (cycling), and each started while watching TV with me feeling light the lights were too bright.

Is this something related to the heart/lung machine and "pumphead"?

 

[Paleowoman]

Hi Mooney,

I've been getting the "little sparks of intense light darting" (really good description that) across my vision since the day after surgery. I get it daily and I'm now nine months post op. I also get those migraine auras, zigzagging patterns of light in vision, sequence lasting about 20 minutes but no headache, and I also get double vision for a very short while when it happens - those two once every couple of weeks. I found an article here which says visual disturbances are a possible side effect of being on the heart lung machine: http://www.sciencedaily.com/releases/2009/08/090813142455.htm It would appear to be benign and, judging from what peeps here say, a relatively common side effect. I should imagine if I were driving the double vision would be a real problem, but I can't drive so that's okay.

There are no triggers for any of those visual disturbances for me - I once woke up in the middle of the night and was halfway through the zigzag sequence ! They are bizarre. I wonder why the heart lung machine causes this ? I'm a very curious person and when science/medicine doesn't have an answer I get even more curious !

 

[Mooney]

Hi Paleogirl,

Thank you for your response. I have now had a third episode of that aural migraine, this time in the morning while driving in very bright sunlight. I was able to remain calm, keep driving, pay my tolls, but it was very strange. It lasted about 30 minutes. I went to an opthamologist and saw my cardiologist - both said everything looked fine. I guess I will wait and see if I have more, not sure what to do from here.

 

[Dan Zulu]

I started getting the auras 2 weeks after surgery, sort of Aztec symbols in my peripheral vision. I see a neuro-ophthalmologist in a week.

 

[Paleowoman]

I started getting the auras 2 weeks after surgery, sort of Aztec symbols in my peripheral vision. I see a neuro-ophthalmologist in a week.

Hi Dan - it would be great if you could give a report here after your see the neuro-opthalmologist !