Eye Focus Issues?

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H

hetmarie

Well-known member
Joined
Jun 12, 2011
Messages
68
Location
Wisconsin
Hi all,
I had OHS March 7. I had an aortic valve replacement (St. Jude's) and they also replaced my ascending aorta (all the way up to the neck). Within the past month, I've had three instances of my eyes going out of focus for 2 to 3 minutes. I start to feel like I'm going to pass out, I have to close my eyes until it passes. It comes on very suddenly and then is gone just as quick with no residual effects. I've also had a couple incidents of my tongue and lip going numb (like if the dentist shoots you up with novocaine) and one where I just couldn't swallow for a few minutes.

My dad had the same OHS in 1983 and he told me he's had the eye focus thing ever since. It's lessened over the years but he still has it a couple times a year. The doctors were never able to figure it out for him.

Has anyone else experienced this post-op, especially the eye focus thing? My INR has been too low the majority of the time since my surgery. I had an MRI done yesterday to check for blood clots in my head but don't have the results yet.
 
Well now, Just to let you know I had my AVR three weeks ago, and from reading many post over the last two years I think it is pretty common, you should discuss it with your Dr. My openion is it is nothing to wory about. Mine never last more than a few minutes. In fact I can remember it happening to me even prior to surgery a few years ago. Im sure someone knows the answer.
 
I, too, had the same thing happen to me. I had cataract surgery about 15 years ago and thought that might have something to do with it, but apparently not according to the card and my eye doc. I had 3 episodes of 2-3 minutes each in the first 2 weeks and have had 1 or 2 in the past 10 weeks. Keep a log of dates, intensity, and duration so you can see how they are trending. For me, it is just one more little side effect of getting to live longer :)
 
I've had a few optical "things" happening since my AVR last Dec., and I'm still having them checked out. One of my "things" is a bit like yours, though it's usually only long enough for a few blinks, then my vision is clear again. Another one -- a "golden crescent" of light at my left periphery, usually seen in the dark just before bed when turning my head near "limit left" -- is probably the first sign of a slightly separating aqueous humor, the precursor to a separated retina. My ophthalmologist couldn't see it, and has sent me for a Carotid Doppler to rule out a neurological-circulatory explanation. No test yet, much less results.

He also said it would either (a) get better, or (b) get worse, or (c) stay the same. (I said "For THIS you went to Med School?" He said "Yes." I said "Can you at least say it in Latin?" He said "Not since a few years after Med School.") If it gets worse, and the Carotid scan is clear, then he said he'd "dilate the hell out of me" and search until he finds it. I forget what the treatment is, maybe lasers to re-attach?

So far it's not getting any worse, since it appeared. I have no idea if it's connected to "that truck" or not; I've never been 66yo before!
 
I am 6 months post op for ascending aortic repair and I get the out of focus thing, the "rainbow horse shoe" ocular migraines maybe once every two weeks or so. Been to the eye doctor, they saw nothing, generally speaking, lots of folks after OHS say they get the same thing.

One thing I am also getting is the occasional light case of vertigo and I have had at lest one severe sudden onset of vertigo after taking some baking soda for heartburn. I also have the tinitis (buzzing/ringing in ears) going pretty much all the time to varying degrees.

All of this stuff except for the occular migraines seem to happen mostly in the evening hours.

I tend to "hit the wall" energy wise between 11:30 and 1:00 pm. A quick nap and Im right back in the game.

I’m heading to the ENT next week to see what’s the deal! More later
 
I had a scary bout of double vision 3 days post op. Told nothing to worry about. This has occurred again at 3 weeks. Also, and this was fun, attempted to ask my wife for a glass of water after a coughing fit, but what I actually said was total gibberish (I realised that and eventually stopped talking until my brain focussed). In the Uk we are advised that optical problems can occur for up to about 3 months, and not to have any eye tests until things have settled down. Good luck - David.
 
Thanks for all the replies! Not that I'm glad others are having the same issues but at least it's not all in my head. :) I heard back from the nurse today and my MRI was "unremarkable" and there are no clots or aneurysms which is great news. (I have Loeys-Dietz Syndrome and part of the disorder is that you can have aneurysms show up in any of your arteries or aorta.) I guess I'll just go with it and pray it doesn't happen while I'm driving! On the downside my INR is still sitting at 1.9 but that's a rant on a different post for another day.
 
Hi, this sounds a little outside your symptoms, but when I was taking Amioderone (anti-Afib) for the first couple weeks (I'm at 8wks now, AVR), I noticed my eyes crossing or double vision when I was reading, I think if I was a little tired (a LITTLE tired?? I mean, more tired than usual, like before night bedtime). It was pretty consistent, and was glad when I could get off it.
Other than that I'm glad to see (well you know what I mean) that you found you were not at all alone with something nobody was able to relate to! Awesome site for that. Michellemar
 
normofthenorth said:
I forget what the treatment is, maybe lasers to re-attach?
Click to expand...

I have also had a detached retina and they do, indeed, use a laser to reattach it. Sort of like a tack welding job. Procedure lasts about 10 minutes and basically can be described as feeling like a tiny bee is stinging the back of your eye about 150 times in succession. Nothing to lose sleep over if that turns out to be the case, but get it 'fixed' as soon as possible. In my case, I have permanent loss of sight in the region that detached because I didn't get to the opthalmologist soon enough. HTH.
 
Every once in a while, I get the dizzy, hold onto something, lightheaded vision wonky nauseated feeling. Lasts about 30 sec. to 2 min, over with and shake myself, and get on with what I was doing at a slower rate. Usually happens a/when I havn't eaten, b/stressed out, c/tired or d/feeling miserable. I have to keep HALT in my mind, hungry, angry lonley or tired as any of those things can have an adverse effect on me. For what it is, I don't know what causes it, I see an opomologist in August so for sure asking him about it plus my GP if I remember. I see him about every 2 weeks it seems, don't want to but something in the new normal needs explanation at that interval. Used to get these things prior to surgery as well. Floaters of bright dots moving from left to right in my left eye is another concern of mine-thats new-first noticed waking up from surgery and happens 3-6 times a day, usually when I havn't eaten or stressed.

Bob
 
UPDATE - So, I heard from my doctor today to get the official results of the MRI they did last week. My cardiologist and the doc decided that in order to rule all clots out completely, they want to do a trans-esophageal echo. (They're going to put a camera down my throat so they can get a really good look at my heart and valve. Good times!) I'm scheduled for next week Tuesday. The only good news that came out of that phone call was my cardiologist told my doctor's office that they need to manage my INR better. It's been pretty much in the "ones" for weeks. It's supposed to be 2.5 to 3.5 but my doctor's nurse is fairly blase about the fact that it's been 1.6 to 1.9 for weeks.
 
Hmmm....

Momentary loss of focus, lip going numb.... sounds like a tiny clot temporarily blocking blood to some areas which would not be out of the question, especially if your INR is below your target range.

MANY members have had various types of 'visual disturbances' following surgery that typically disappears in less than an hour, more like 15-20 minutes most of the time. When these patient go to Doctors (PCP, Cardio, Eye, Neuro) universally nothing is ever found. Just a suggestion that it could be a TIA (Transcient Ischemic Attack).

FWIW, whenever I have a 'visual disturbance', I chew half (sometimes a full 325 mg) Aspirin with my Cardio's approval. You might want to ask your Cardio before following suit.

The BIG Question to ask and resolve is WHY is you INR Too Low most of the time?

Who is managing you anticoagulation? FYI, INR mismanagement is often a key contributor to clotting (or bleeding) issues. I'm betting that if you get your INR in range, these problems will either disappear or occur much less frequently.

'AL Capshaw'
 
Yes Al, that is the big question of the day. My surgeon told me that it was my PCP's job to monitor my INR. I had several doses of antibiotics after surgery due to my incision becoming infected and it messed with my INR quite a bit. A few weeks ago my surgeon's P.A. told me I needed to get after my PCP about managing my INR better and if they weren't going to stay on top of it to find a different doctor. I relayed my surgeon's concern to the nurse and PCP to which they both responded "if your surgeon wants to monitor your INR, that's fine with us." She also commented that they monitor hundreds of patients' INRs. I was quite taken aback by their response and told them both that it's not my surgeon's job to monitor my INR, it's theirs. They relented a little and agreed that it did need to be managed better. While my PCP was discussing my current issues with my cardiologist, they discussed my INR and my cardiologist told her they need to monitor my INR and get it under control. As soon as this whole business of them ruling out any blood clots as far as my eye issue goes, I will be looking for a new PCP. One who has time for me. The biggest problem I have is there aren't a lot of internal medicine docs in my area accepting new patients. There is an anti-coagulation clinic about an hour and a half from me but realistically that's just too far to have to deal with when I've got a full time job. (One that I just started a couple weeks ago after my old job "downsized" me the week after I returned from my recovery. Yep, this has been a great year...)
 
Hether -

It sounds like you would benefit from Home Testing your INR. Note that Home Testers have the BEST control of INR, followed by dedicated AntiCoagulation Clinics. Individual practicioneers results vary all over the map, as you have experienced.

You may want to pursue this with your PCP and see if your insurance company would cover the cost of an instrument ($1000 to $2000 list) and Test Strips.

Some members whose insurance would not cover the cost have opted to buy their own monitor and supplies.

'AL Capshaw'
 
I had the same problem for the first couple months, it seems to have something to do with my blood pressure meds which seemed to be changing all the time. I'm at 11 months out now and feel better than ever. Hang in there, it gets better.
 
UPDATE 2: Finally got my results from the Transesophageal echo I had on Tuesday. (Side note: those drugs they give you really do a number on your hearing. The nurse started talking about me needing surgery because something was wrong with the valve. What she said was "IF" they found something wrong...WHEW!) The doctor called with my results today and said that my mechanical valve is working, still sewn in like it should be and my heart's beating away perfectly. They didn't find any clots or reason to explain why I've been having eye focus issues.

However, they did find that I have PFO (Patent Foramen Ovale) which means there's a hole between my right and left sides of my heart. The doctor said it's not unheard of and she couldn't say whether it had anything to do with my having LDS. She also didn't think it had anything to do with the eye focus issue. It does not require surgery to fix or anything. She did say though that because of this anomaly, we need to be very on top of my INR. They want it to be between 3.0 and 3.5 and if it gets down to 2.5 that's the bottom of where they would be comfortable with it. This is because with PFO, you can have a blood clot travel directly from one side of the heart to the other and go straight to the brain causing a stroke instead of taking the path through the lungs and getting stopped there.

So, even though the TEE didn't show the cause of the eye focus issues, at least we found this out and we know that we have to be on top of my INR even more so now. The doctor did warn me that having my INR higher means I will bruise a lot easier and have other issues but I will take that over stroke any day.
 
Thanks Lyn. At this point in time they are not looking at closing it. I understand though from what I've read on the internet, should the time come, it's a fairly non-invasive procedure to have done. I imagine if they continue to have difficulties keeping my INR above 2.5, that may become an option.
 
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