Vision Issues and Coumadin

[MaryLM]

I've been on Coumadin since 2018 and in January of this year I started to experience some vision issues in my right eye - particularly flashes in peripheral regions. Optomoligist determined it to be 'Posterior Vitreous Detachment' and told me that it should get back to normal in a month or two. It has gotten better, but hasn't fully recovered and now I'm starting to experience the same thing in my other eye. Has anyone on Coumadin or other blood thinners experienced this?

 

[pellicle]

Good morning Mary

I haven't experienced that but, to the best of my knowledge, it is neither caused by or exacerbated by warfarin.

I hope that @vitdoc may be able to share more on this.

Best Wishes

 

[tom in MO]

My eye doctor has told me that warfarin does not effect your eyes or sight.

As I get older I have gotten a variety of new eye problems including Posterior Vitreous Detachment or PVD. It went away as I was told it would but it occasionally comes back but not as bad.. Here's some info:
https://www.asrs.org/patients/retinal-diseases/9/posterior-vitreous-detachment

 

[MaryLM]

Thank you pellicle and tom for your responses. I wanted rule out the possibility of any connection of the vision issue to the meds. It does seem that its more likely than not unrelated. This is a great forum and your help is much appreciated. I will be reading and adding my two cents where I can.

Best,
Mary

 

[Paleowoman]

I've been on Coumadin since 2018 and in January of this year I started to experience some vision issues in my right eye - particularly flashes in peripheral regions. Optomoligist determined it to be 'Posterior Vitreous Detachment' and told me that it should get back to normal in a month or two. It has gotten better, but hasn't fully recovered and now I'm starting to experience the same thing in my other eye. Has anyone on Coumadin or other blood thinners experienced this?

Hi @MaryLM - I'm not on Coumadin but I've had Posterior vitreous Detachment, I've had in both eyes: flashes of light in my posterior vision. I've had it thoroughly investigated and Posterior Vitreous Detachment is apparently a normal occurrence in people above the age of 60...though why most people don't get the flashes of light I don't understand. The flashes of light are most disconcerting !

The vitreous humour in the eyes kind of dries up a bit with age (above 60) and detaches from the retina, as it detaches it kind of tugs on the retina which causes the flashes - also can cause big floaters...the floaters stay but the flashes go after several weeks.

https://my.clevelandclinic.org/heal...e gel,it doesn’t cause vision loss on its own.

 

[pellicle]

Hey Mary

will be reading and adding my two cents where I can.

you're welcome and I look forward to your contributions helping those who are coping with this "big change" in their lives.

 

[vitdoc]

The vitreous humor is a clear jelly that fills the eye and is relatively "thick" early in life. As we age it gets more liquified and large vacuoles of liquified jelly form. At birth the jelly is adherent to the back of the eye but when it gets liquified enough, suddenly the jelly may peel off the back of the eye with pure fluid forming between what is left of the jelly and the retina. The vitreous "collapses". This is a sudden spontaneous event the occurs in most people if they live long enough. Being myopic is associated with this event occurring earlier in life than those who are less myopic (nearsighted) or hyperopic (far sighted). There are fibrils of the jelly that adhere to the peripheral retina which probably by mechanical traction on the retina cause the flashes which are seen usually in dark environments. If the traction is significant the retina can tear which may lead to a retinal detachment. (relatively rare). So when these symptoms occur the retina is checked to make sure there is no tear. If there is then usually laser photocoagulation is done to "seal down" the tear. The flashes tend to be very short. Sometimes people get migraine which can cause a different type of visual effect. The migraine type is called a scintillating scotoma. These go on for 10-20 minutes and are quit different then the short quick flashes with a vitreous detachment.

There is no correlation with the use of any known drug with this process.

Increased floaters are often seen due to the vitreous collapse which sometimes increases debris within the jelly. Usually the floaters are not too bad and they tend to clear on their own with time.

In occasional cases the jelly may get fairly turbid and have significant persistent clouding. If this happens it is possible to remove the vitreous and replace it with basically water. Once the human eye is developed the vitreous can be removed. This is even done in pre mature babies who may develop retinopathy of prematurity and other relatively rare conditions.

The only time anticoagulation is an issue with eye disease is when something occurs that leads to bleeding. The bleeding event is not usually generated by the anticoagulation but the duration of the bleeding and the concomitant severity may be worsened by the anticoagulation like any bleeding anywhere else in the body.

 

[Paleowoman]

I wish my floaters would clear vitdoc - when my right eye’s vitreous detached in 2021 I got a large Weiss Ring floater, and then when the left eye’s vitreous detached last summer I got one in that eye too ! I’m glad I don’t have any more eyes LOL

 

[ATHENS1964]

Το υαλοειδές υγρό είναι ένα διαυγές ζελέ που γεμίζει το μάτι και είναι σχετικά «παχύ» νωρίς στη ζωή. Καθώς γερνάμε γίνεται πιο υγρό και σχηματίζονται μεγάλα κενοτόπια υγροποιημένου ζελέ. Κατά τη γέννηση το ζελέ προσκολλάται στο πίσω μέρος του ματιού, αλλά όταν υγροποιηθεί αρκετά, ξαφνικά το ζελέ μπορεί να ξεκολλήσει από το πίσω μέρος του ματιού με καθαρό υγρό να σχηματίζεται ανάμεσα σε ό,τι έχει απομείνει από το ζελέ και τον αμφιβληστροειδή. Το υαλοειδές «καταρρέει». Αυτό είναι ένα ξαφνικό αυθόρμητο γεγονός που συμβαίνει στους περισσότερους ανθρώπους εάν ζουν αρκετά. Το να είσαι μυωπικός σχετίζεται με αυτό το συμβάν που συμβαίνει νωρίτερα στη ζωή σε σχέση με εκείνους που είναι λιγότερο μυωπικοί (μυωπικοί) ή υπερμετρωπικοί (μακρόπνοοι). Υπάρχουν ινίδια του ζελέ που προσκολλώνται στον περιφερειακό αμφιβληστροειδή χιτώνα τα οποία πιθανώς με μηχανική έλξη στον αμφιβληστροειδή προκαλούν τις λάμψεις που φαίνονται συνήθως σε σκοτεινά περιβάλλοντα. Εάν η έλξη είναι σημαντική, ο αμφιβληστροειδής μπορεί να σχιστεί, κάτι που μπορεί να οδηγήσει σε αποκόλληση του αμφιβληστροειδούς. (σχετικά σπάνιο). Έτσι, όταν εμφανιστούν αυτά τα συμπτώματα, ελέγχεται ο αμφιβληστροειδής για να βεβαιωθείτε ότι δεν υπάρχει ρήξη. Αν υπάρχει τότε συνήθως γίνεται φωτοπηξία με λέιζερ για να «σφραγιστεί» η ρήξη. Τα φλας τείνουν να είναι πολύ σύντομα. Μερικές φορές οι άνθρωποι παθαίνουν ημικρανία που μπορεί να προκαλέσει διαφορετικό είδος οπτικού εφέ. Ο τύπος της ημικρανίας ονομάζεται σπινθηροβόλο σκότωμα. Αυτά συνεχίζονται για 10-20 λεπτά και σταματούν διαφορετικά από τις σύντομες γρήγορες αναλαμπές με αποκόλληση υαλοειδούς.

Δεν υπάρχει συσχέτιση με τη χρήση οποιουδήποτε γνωστού φαρμάκου με αυτή τη διαδικασία.

Συχνά παρατηρούνται αυξημένα floaters λόγω της κατάρρευσης του υαλοειδούς που μερικές φορές αυξάνει τα υπολείμματα μέσα στο ζελέ. Συνήθως τα floaters δεν είναι πολύ κακά και τείνουν να καθαρίζουν μόνα τους με τον καιρό.

Σε περιστασιακές περιπτώσεις το ζελέ μπορεί να γίνει αρκετά θολό και να έχει σημαντική επίμονη θόλωση. Εάν συμβεί αυτό, είναι δυνατό να αφαιρέσετε το υαλοειδές και να το αντικαταστήσετε με βασικά νερό. Μόλις αναπτυχθεί το ανθρώπινο μάτι, το υαλοειδές μπορεί να αφαιρεθεί. Αυτό γίνεται ακόμη και σε προώριμα μωρά που μπορεί να αναπτύξουν αμφιβληστροειδοπάθεια της προωρότητας και άλλες σχετικά σπάνιες καταστάσεις.

Η μόνη φορά που η αντιπηκτική αγωγή είναι πρόβλημα με την οφθαλμική νόσο είναι όταν συμβαίνει κάτι που οδηγεί σε αιμορραγία. Το αιμορραγικό συμβάν συνήθως δεν δημιουργείται από την αντιπηκτική αγωγή, αλλά η διάρκεια της αιμορραγίας και η συνακόλουθη σοβαρότητα μπορεί να επιδεινωθούν από την αντιπηκτική αγωγή όπως κάθε αιμορραγία οπουδήποτε αλλού στο σώμα.

Θέλω να σας ρωτήσω αν η επέμβαση καταρράκτη αυξάνει τις πιθανότητες;

 

[MaryLM]

Vitdoc, that's the most in-depth explanation I've seen yet. Thanks so much for posting. Very helpful information to know and given what you've stated, I feel even more confident now that the blood thinner is not the cause.

 

[carolinemc]

The vitreous humor is a clear jelly that fills the eye and is relatively "thick" early in life. As we age it gets more liquified and large vacuoles of liquified jelly form. At birth the jelly is adherent to the back of the eye but when it gets liquified enough, suddenly the jelly may peel off the back of the eye with pure fluid forming between what is left of the jelly and the retina. The vitreous "collapses". This is a sudden spontaneous event the occurs in most people if they live long enough. Being myopic is associated with this event occurring earlier in life than those who are less myopic (nearsighted) or hyperopic (far sighted). There are fibrils of the jelly that adhere to the peripheral retina which probably by mechanical traction on the retina cause the flashes which are seen usually in dark environments. If the traction is significant the retina can tear which may lead to a retinal detachment. (relatively rare). So when these symptoms occur the retina is checked to make sure there is no tear. If there is then usually laser photocoagulation is done to "seal down" the tear. The flashes tend to be very short. Sometimes people get migraine which can cause a different type of visual effect. The migraine type is called a scintillating scotoma. These go on for 10-20 minutes and are quit different then the short quick flashes with a vitreous detachment.

There is no correlation with the use of any known drug with this process.

Increased floaters are often seen due to the vitreous collapse which sometimes increases debris within the jelly. Usually the floaters are not too bad and they tend to clear on their own with time.

In occasional cases the jelly may get fairly turbid and have significant persistent clouding. If this happens it is possible to remove the vitreous and replace it with basically water. Once the human eye is developed the vitreous can be removed. This is even done in pre mature babies who may develop retinopathy of prematurity and other relatively rare conditions.

The only time anticoagulation is an issue with eye disease is when something occurs that leads to bleeding. The bleeding event is not usually generated by the anticoagulation but the duration of the bleeding and the concomitant severity may be worsened by the anticoagulation like any bleeding anywhere else in the body.

My eye issues are cataracts, which is age related. Also, the Eye stroke was warfarin and Diabetes related in my case and affect my left eye. Had the cataracts removed from the right eye and replace with a lens, see better with the right. But still have the cataracts in the left eye, due to the eye stroke, it slowed the progression of the cataracts in the left eye. No jelly caused my sight problems.