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Neurology (Expert Forum)
Post Operative Vision Defects
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Post Operative Vision Defects
by gener, Apr 01, 2001 12:00AM
After routine surgery on Thursday, March 22, I woke with highly regular graphic visual artifacts in both eyes. The surgery required that my neck be hyperextened backwards so that the surgeon could sample lymph nodes in the center of my chest by going in alongside the bronchial tube.
The visual image in the right eye can be best described as a miniature old fashioned ships wheel. A central dark spot, a surrounding clear area, an outer dark ring, and short spokes radiating outward at the 12, 2, 4, 6, 8, and 10 o'clock positions. There are also what appears to be further ring structures resembling diffraction rings. The image is so regular as to appear to have been made with drafting tools. Against a light background, this computer screen for example, the main dark ring in the right eye occupies about the same area as a 1/4 inch circle at 24 inches. It apppears to shrink on closer approach and get larger if I am further away from the background. Against gray overcast clouds the size is the same as the 24 inch distance version.
That is the right eye image. The left eye image is somewhat smaller and not quite as regular although it is exactly aligned with the right eye image. It has 5 spokes instead of 6 and these are longer that those from the right eye. Both images appear to have the same size and distance relationships.
I’ve had a thorough retinal examination this past week including an angiogram with nothing unusual found. Even though the images are faded at the moment they can be refreshed by blinking or other interruptions of the visual field. The images also change from time to time; sometimes becoming less precise and sometimes acquiring additional features.
There is no doubt that I’ve lost noticeable visual acuity in both eyes compared to my pre-surgical state.
I have contacted the surgeon in this case as well as all of my regular doctors and I am waiting for replies. However, any clues you could suggest as to what has happened and how to proceed would be very helpful and greatly appreciated. If nothing else, some appropriate descriptive technical keywords for internet searching would be very useful.
Thank you.
GeneR
The visual image in the right eye can be best described as a miniature old fashioned ships wheel. A central dark spot, a surrounding clear area, an outer dark ring, and short spokes radiating outward at the 12, 2, 4, 6, 8, and 10 o'clock positions. There are also what appears to be further ring structures resembling diffraction rings. The image is so regular as to appear to have been made with drafting tools. Against a light background, this computer screen for example, the main dark ring in the right eye occupies about the same area as a 1/4 inch circle at 24 inches. It apppears to shrink on closer approach and get larger if I am further away from the background. Against gray overcast clouds the size is the same as the 24 inch distance version.
That is the right eye image. The left eye image is somewhat smaller and not quite as regular although it is exactly aligned with the right eye image. It has 5 spokes instead of 6 and these are longer that those from the right eye. Both images appear to have the same size and distance relationships.
I’ve had a thorough retinal examination this past week including an angiogram with nothing unusual found. Even though the images are faded at the moment they can be refreshed by blinking or other interruptions of the visual field. The images also change from time to time; sometimes becoming less precise and sometimes acquiring additional features.
There is no doubt that I’ve lost noticeable visual acuity in both eyes compared to my pre-surgical state.
I have contacted the surgeon in this case as well as all of my regular doctors and I am waiting for replies. However, any clues you could suggest as to what has happened and how to proceed would be very helpful and greatly appreciated. If nothing else, some appropriate descriptive technical keywords for internet searching would be very useful.
Thank you.
GeneR
Doctor's Answer
by CCF Neuro[P]-M.D.-RPS, Apr 01, 2001 12:00AM
Dear GeneR:
I am sorry to hear about your vision. It is difficult to tell you much because of what your describing from the surgery, there should be little influence from the opening of the chest or hyperextension of the neck. The vision pathways are from the eye through the optic chiasm to the lateral geniculate to the vision cortex at the back of the head. There should be no influence by neck hyperextension. The only thing that I can think of is that there might have been hypotension during the surgery and your vision function might have been compromised or other ischemic event. However, with just visual changes, this seems doubtful. I would suggest seeing a neuro-opthalmologist and see if there are other tell tale signs of visual changes. If nothing is found, then maybe a MRI of the brain to see if there were ischemic changes. I hope that your visual hallucinations are only transitory.
Sincerely,
CCF Neuro MD
I am sorry to hear about your vision. It is difficult to tell you much because of what your describing from the surgery, there should be little influence from the opening of the chest or hyperextension of the neck. The vision pathways are from the eye through the optic chiasm to the lateral geniculate to the vision cortex at the back of the head. There should be no influence by neck hyperextension. The only thing that I can think of is that there might have been hypotension during the surgery and your vision function might have been compromised or other ischemic event. However, with just visual changes, this seems doubtful. I would suggest seeing a neuro-opthalmologist and see if there are other tell tale signs of visual changes. If nothing is found, then maybe a MRI of the brain to see if there were ischemic changes. I hope that your visual hallucinations are only transitory.
Sincerely,
CCF Neuro MD
