Micro-emboli of the eye vasculature...

[pedimed]

Just curious if anyone has had similar experience? In my recent 'lament' I commented I had had 3 episodes of a brown circle developing in my left eye and blocking partial visual field in that eye alone.. the episode was less than a minute in length but has occured x3. So Cardiologist sent me to an opthomlogist and luckily I was put in with the extra specialized Neuro-Opthomologist!

After many tests, the visual field test came back with decreased area of peripheral vision in left eye (this is the same area I was describing to her as having the transient brown spot).. anyhow, to confirm this is not artifactual I am going for repeat visual field test on Monday, if same result back to Cardiologist, possibly for repeat Echo or more definitive testing for clots... My INR took a few weeks to get to therapeutic and then went past and most recent was 2.1.

I could not tell her if these events were when INR was within the subtherapeutic range..

Anyhow, curious if others have had symptoms no matter how mild like this while in a subtherapeutic range? OH, BTW (important info)- I have a St.Jude valve)

THanks!

Lea

 

[Nancy]

My husband had many TIAs, (microemboli, plaque--no one was able to tell exactly), perhaps 16 or so. Many of them hit his eyes.

I am glad you went to the eye doc. Although Joe's TIAs didn't affect his vision, he had a retinal artery occlusion which made him blind in one eye. He thought it was the same old, same old TIA, and didn't bother to go to the hospital, and it was Christmas Day. We found out later on that had he gone right into the ER, they could have done something that would possibly have saved his sight.

No one ever said the TIAs and the retinal artery occlusion were related, and I think they are apples and oranges.

BTW, Joe had TIAs when he was therapeutic, when he was not, didn't matter much at all.

 

[pedimed]

Nancy....

Nancy....

Thank you Nancy. The remainder of my vision exam is normal, the arteries etc. So she is thinking (if I am understanding her correctly) that if the repeat testing is the same, that perhaps there was a small clot that caused a small area of ischemia..

I am curious, when Joe had his TIAs how did they manifest themselves? Were they confirmed/identified with imaging?

"Joe had TIAs when he was therapeutic, when he was not, didn't matter much at all." -That is interesting, good to know.

Regarding Joe's occlusion of his retinal artery; This is an important lesson for us all, so easy for those who are "used to" frequent medical symptoms to dismiss sx...Always better to Ehr on side of caution and seek medical attention. I too am easy to dismiss certain symptoms as jut "the usual"..

Thank you!

Lea

 

[Nancy]

The window of opportunity to perhaps gain back some vision from a retinal artery occlusion is roughly three hours. They do some kind of massaging of the eyeball to try to get bloodflow back (I think), otherwise ischemia does its nasty damage.

It is a lesson to learn, also to go even though it is a holiday. Several doctors asked him why oh why didn't you go. He didn't even tell me until it was too late. Thought it would clear up like always.

TIAs are hard to catch on film. Even though he went to the ER with most of them, there was no trace. I think though, that with some tests there are little areas of damage that show up. That can add up over a lifetime and cause some form of dementia later in life, if there are too many of them.

In Joe's case, he had single sided eye TIAs many times, and even double sided eye ones. He had the curtain deal, and also temporary total blindness. He also had periods of weakness, spoke garbled speech, had stabbing head pains, had temporary loss of memory, forgot how to do very simple things, and lost his balance. A wonderful neurologist who did a good workup on him could pinpoint the part of the brain which the embolus traveled based on the symptoms. He was on Plavix for a while.

Another reason I'm glad you went to the eye doc is that I have had the curtain thing, many years ago. It lasted for several weeks. That was some kind of leakage in the back of the eyeball from what was so indelicately described as aging (of course it wasn't true ) That cleared up eventually, but I made sure it wasn't a retinal detachment starting.

So, a word to the wise. Don't fool around with your eyes. Go and go FAST when something happens. It might be a TIA, it might not. Hard for any of us to tell.

BTW, several docs have said that it isn't just bloodclots that might be traveling on through. plaques can break off blood vessels, valves, little pieces of cholesterol, etc. That is why Joe had TIAs sometimes when he was therapeutic.