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Share your eyesight troubles
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I am an ophthalmologist and PAH caregiver.
Changes in prescription are not caused by using your eyes. The link between reading and myopia (nearsightedness) progression has been talked about for decades but no study exists that proves there is a link. Likewise, medications would not cause this change except for the rare medication (not PH meds) that can change the lens inside the eye and its ability to change shape to “focus”. Increases in nearsightedness generally occur because of lengthening of the eye which is due to natural growth. Some older people will have a smaller increase during the initial stages of cataract formation.
Sildenafil can have vision side-effects. The most worrisome is something that affects the optic nerve and is thought to occur due to decreased blood flow in people who have a very typical appearance optic nerve appearance on clinical exam. This has been reported in a single PH patient and most cases occur in people with other diseases which lead to decreased blood flow such as atherosclerotic heart disease. Men with ED often have these other risk factors which explains why this more serious side-effect is seen in this population.
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@scott thank you for that information and for sharing with us that you are an ophthalmologist. My son’s eyesight has gotten progressively worse since transplant but it hasn’t been linked to any medications. He does take Topamax (Topiramate) but so far hasn’t experienced the specific eye problems that it can cause. When he had PH he was taking Sildenafil but again…his vision changes were not linked to that. It’s just natural sight changes that he has been experiencing.
Thank you for taking the time to explain some of this to us.
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Yes, Topamax can cause swelling of the ciliary body inside the eye and lead to an acute change in vision and more importantly angle closure glaucoma where the pressure inside the eye goes up very quickly. Fortunately this is not common but is also well known and can be correctly addressed if it were to occur.
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@scott wow! Thank you for sharing such valuable information with us. I know it is greatly appreciated. I honestly thought that there must have been some connection with straining my eyes, reading, looking at a computer screen etc that caused more stress on the eyes and therefore my eyesight. But, as my own eye doctor says, he thinks that it has a lot to do with my underlying heart conditions and when my heart has been worse or when I have been going through a lot with my circulation and bloodflow, me eyes are usually worse too. I wasn’t able to physically get to the eye doctor but I have a scheduled appt in the summertime when hopefully the worst of COVID19 is behind us.
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@scott I also experience changes in eye pressure and some broken blood vessels. My younger sister has signs of glaucoma and like I said before in a post, I have macular degeneration in my left eye. Something that they are looking out for.
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Hi @scott, thanks for your excellent information here. We appreciate your education on these matters. Vision issues, I know, are age-related, too. But because I have taken sildenafil(Revatio) for over 15 years and at the highest dosage possible, my eye doctors did say that this was part of my vision issues. But, with me being “40ish”, age certainly plays a role as well.
We are appreciative of such great information. I have an appointment scheduled next month, which looks like it may be changed.
I hope that you and your family are staying safe during this pandemic.
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Hi Everyone,
I’m new here, and find this discussion absolutely fascinating. Approximately 5 years ago I went for an eye test and was told by the optometrist that I needed to see an Ophthalmologist, who diagnosed me with cataracts. I went on to have cataract removal surgery, but really have not been able to see any better since the surgery. I have been back to the Ophthalmologist a number of times and have spent a fortune on spectacles that have done nothing to help. I have eventually given up on trying to find an answer.
I was only diagnosed with PAH 6 months ago, together with mitral valve stenosis, mitral valve regurgitation and right heart failure, was well as having systemic lupus (an autoimmune disease).
In South Africa we have to undergo an eye test every 5 years to renew our drivers’ licence and I am now due to renew my licence again. I’m beginning to think that I never had cataracts and in fact my eye problems are being caused by my circulatory problems?
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@traceyaustralianmigration-co-zaey I don’t have an answer regarding the circulatory problems but hopefully one of our members can jump in with a response.
I’m so sorry to hear that the cataract surgery did not help. In most cases that I have heard of, including my dad’s, it usually helps, so I wonder if something is triggering these eye issues in you. Do you see a PH specialist or talked to a doctor other than the Ophthalmologist about it?
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Hi @traceyaustralianmigration-co-za, I am not sure if your circulatory caused your cataracts or not. It is often difficult to distinguish which came first. I am sorry to hear about your frustrations with your Ophthalmologist. I would see if you could get another opinion f you are not satisfied with the first one.
You are newly diagnosed with PH. How long have you had lupus?
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Problems with circulation can cause certain issues with your eyes but this is often seen in people with significant carotid artery disease. Cataract surgery is generally very successful if the issue was the cataract alone. There are times that a cataract looks “mature” or “dense” enough to be causing the decrease in vision that is recorded but there ends up being something else that was equally limiting. This should be something that should be able to be diagnosed. Assuming all of the “focusing” issues are taken care of with a proper pair of glasses, there are other things that should be looked into as a cause. The most common is a problem with the retina. With modern day technology special pictures of the retina can be taken which basically show every single layer of the retina in fine detail. Any problems should be seen this way. Optic nerve problems can also cause poor vision and can usually be seen on exam or with testing. Occasionally other testing needs to be done such as looking at the “electrical current” of the retina. These tests are usually available at tertiary care clinics but are less likely to be the cause of the problem.
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Thank you so much, @scott, for sharing your knowledge. I am sure that @traceyaustralianmigration-co-za will appreciate the feedback, too.
I am interested in the depth that you shared because my hubby has cataracts. He is in his 40s and was borderline diabetic once. They want him to rush into surgery, but I was not sure they completed enough tests first. Are these tests something you would suggest before cataract surgery? No matter what eye doctor he visits, his glasses are not helping him. Thanks again.
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Thank you so much for the information @scott. Your knowledge as an ophthalmologist is greatly appreciated and I hope it helps @traceyaustralianmigration-co-za.
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@jenc the things that might limit visual recovery after cataract surgery are almost always able to be seen on a good exam by an ophthalmologist. It is not usually considered necessary to do these other tests if the clinical exam is otherwise normal and the “density” of the cataract appears to be consistent with the vision that is obtained.
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@jenc I currently take Adcirca and am on a Remodulin pump. But I take all of the heart medications. Most of them say may cause blurred vision. Some days my sight is fine. I do wear glasses. But many times I notice that by the end of the day things are starting to blur.
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Thanks again, @scott, for sharing your knowledge. We all appreciate it much.
@jenniferbeaty, so many medications can affect our vision. But as Scott mentions, so does our circulatory system. My vision also gets worse as it gets later. I contributed that to age. Maybe @scott can shed some light on this, too. I am only in my 40s, FYI, hehe.
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Thank you all, I am new to the Forum and this is fascinating.. I have been on 4 pills a day of 40mg Sildenafil. My eyes are terrible, I also have Cataracts, but my eye Doc says not to get surgery. and have to keep getting new RX’s for glasses, near-sight and far-sight.
but the worst reaction i have had with the Sildenafil is that it makes the capillaries open so we can get more Oxygen, but the capillaries are what hold your hair in your scalp, my hair comes out by the ton, all of it with the bulb still on the end so I know it is not breaking off, but coming out of mu scalp, there is lots of regrowth. I am on so many meds for all my ailments , all of them so many side effects, i don’t want to complain. I am still kicking , thank you all
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