Anticoagulant and small haemorrhage on optical disc.

Last week I went to the opticians after having a new, rather prominent, floater in the left eye. The optometrist noticed a small haemorrhage on the disc. This, she said, could be vitreous detachment (which is a normal part of the ageing process), a sign of incipient glaucoma (although she said the disc was otherwise fine) or “just a one off”. I was given a routine referral to the eye clinic which will involve a wait of some months. I am due to start an anticoagulant soon, and am concerned this might cause a problem. I realise this is rather an obscure and tricky question, but I wondered if anyone had had a similar experience. I rang the cardiac nurses at the hospital and they didn’t seem to know much about the situation.

[Geonome]

Hi Samazeuilh.

I also have eye issues. My vitreous has never completely detached, so is pulling on the retina, which causes me to see flashes of light, especially noticeable when I'm going to bed and the room is in darkness. I'm used to it. Also used to the floaters.

My optometrist also said that taking a "blood thinner" was risky, as I have a strong history of macular degeneration in my family. So I imagined this thin blood running around in my veins, and causing eye bleeds. I have since learned that an anticoagulant is exactly that, the blood does not coagulate quickly, and is not thinned at all. I did a lot of research on which anticoagulant was safest for my eyes, and decided on apixaban. I am now comfortable with taking apixaban, as I would rather lose my eyesight than have a stroke.

I've been taking apixaban for about 3 years, so far, no problems.

[Hidden in reply to Geonome]

Thanks for your reply. I’m not quite clear on what grounds the optometrist thought the anticoagulant was risky? Did he advise against it, or give an estimate of the risk?

[Geonome in reply to Hidden]

He thought it would increase the risks of bleeding of the macula. He didn't give specifics, just thought that generally it was not a good idea. I did a lot of research, and, yes, the risks of a major ocular bleed are increased with an anticoagulant, but I didn't think taking the risk of having a stroke was a good idea. I was having episodes of afib 2-3x/week.

I consulted an ophthalmologist as well, he thought the anticoagulant would be safe.

[Hidden in reply to Geonome]

Once again, thanks for the info.

[JaneFinn]

Hi Samazeuilh, I haven’t had your problem, but as well as hereditary eye conditions, I had several eye issues going on around the time I started anticoagulation, and I had a lot of uncertainties and questions.

And all I wanted to say was how much more knowledgable the optician was than any of the cardiac nurses or anticoagulation nurses I asked!! My optician knew all the potential effects of anticoagulation on the eye (both significant and insignificant) and she was extremely helpful and reassuring, even seeing me as a ‘drop in’ when my eye went suddenly bloody looking. So if I were you, if you haven’t already, I’d ask advice of your optician? And if they can’t help, maybe ask them to ask the eye clinic, if you haven’t yet got a number? Sorry if you’ve already tried this, but l thought it worth mentioning x

[Hidden in reply to JaneFinn]

I will have an appointment at the eye clinic in a few weeks (I hope). In the meanwhile, Barts cardio nurses have advised not taking the anticoagulant yet. Thanks for your reply.