LOST MY VISION DUE TO SEVERE PREECLAMPSIA

Posted On Thursday, December 29, 2011  by Christina

On Sunday, August 7, 2011 my son, Ryan, was born via c-section at 32 weeks and 6 days gestation weighing 3 pounds 13.6 ounces. At that point I had been on hospital bed rest for about one week due to preeclampsia. That particular day, my lab results came much worse than the previous round of labs (which were already bad) and I was diagnosed with severe preeclampsia. Immediate delivery was necessary. Ryan was born at 4:03 in the afternoon and was immediately sent to the NICU for evaluation. Thankfully, his 4-week stay in the NICU was quite uneventful; he was considered a “feeder and grower” with no serious health issues other than some lingering bradycardia. We are very lucky that his health and development are perfectly normal considering he was 7 weeks early. He’s been home with us since September 6th and is amazingly healthy, strong and so darn cute! A part of me feels sad that I wasn’t able to fully enjoy (or see) the first month or so of my son’s life due to the stress and limitations of my vision loss, however, a bigger part of me feels so incredibly fortunate to have such amazing friends, family and blog readers for their kindness during this difficult time. In my mind there is no option other than remaining positive and hoping for the best outcome for my vision.

Onto the vision loss…

In the early morning hours of August 9, 2011 – around 3 am – I was awoken by my nurse coming into the room to check my blood pressure. As I looked around I noticed that everything was a little blurry, kind of like I had something floating around in my eyes. I casually mentioned it to my nurse and then went back to sleep without giving it another thought. A few hours later it was morning and I woke up. When I opened my eyes I was shocked and completely freaked out by what I saw – absolutely nothing! Sometime between the hours of 3 am and 7 am my central vision went from blurry to completely absent. After the initial panic passed, I pressed the call button for my nurse (I had to fumble around for a few seconds to find it). When she came in I told her that I couldn’t see – can you imagine her reaction hearing that first thing in the morning right at the beginning of her shift!? LOL! Anyway, that was the start of a very chaotic, stressful and confusing day for me and my medical team.

At first, the medical team thought my vision loss could be a lingering side-effect of magnesium sulfate, a drug I had received about 36 hours earlier to prevent seizures (eclampsia). “Mag”, as it’s often referred to, can cause some visual disturbances, which it had, but completely resolved shortly after it was discontinued on August 8th (about 24 hours after delivery). That was pretty quickly ruled out as a cause. My doctor then ordered a head CT to rule out a stroke or other neurologic issues. She also ordered a consult with an Ophthalmologist. Thankfully, my head CT came back negative – I felt a huge sense of relief once those results came in. When the Ophthalmologist examined me, he could tell there was something going on with my retinas but since he was on consult he didn’t have the proper equipment to make a diagnosis (the hospital I was in, like most community hospitals, does not maintain an Ophthalmology department so Ophthalmologists need to be called in if they become necessary). At that point, it was determined that I needed to be immediately transferred to Thomas Jefferson University Hospital in Philadelphia because of their affiliation with Wills Eye Hospital (one of the top eye specialty hospitals in the country!). Upon arrival, I went to the emergency department at Wills Eye. The doctor immediately saw that both of my retinas were detached. Detached! This was the first time I heard of ‘serous retinal detachment’. He told me that I would be seen by the retinal specialists first thing in the morning (by this time it was already after 2 am!). After a short nap back at Jefferson’s High Risk Maternity Unit, I was transported back to Wills Eye (essentially, across the street). At that visit the retinal specialists confirmed that both retinas were detached due to fluid buildup resulting from preeclampsia. They seemed pretty sure my vision would get better, but couldn’t say for sure how much of an improvement I’d get or how long it would take. Not exactly what I wanted to hear. Within the next 48 hours I did have a noticable improvement, though my vision was still extremely poor. The next evening I was discharged from Jefferson (I was clear as far as my c-section went) and would be seen by Wills Eye Hospital on an out-patient basis. As it turned out, on August 12th I was readmitted to the original hospital where I delivered due to sky high blood pressures at home – even higher than my pre-delivery pressures! I was in the hospital for another 48 hours and put on Labetalol (a blood pressure medicine). There was no obvious change in my vision (better or worse) with the increased blood pressure or with the Labetalol.

Over the next few weeks there were some very subtle improvements in my vision, but nothing significant. I was only able to see my laptop screen when it was set between 200-400% zoom, and even then it was still blurry. At my two most recent visits the doctors performed an OCT scan (Optical Coherence Tomography) to determine and document exactly how much fluid remained in my eyes. The first OCT showed some fluid still visible in both eyes – a sign that I could still expect some improvement in my vision. The most recent scan showed a tiny amount of fluid in one eye and virtually none in the other (three weeks between the two scans). They also noted some pigment changes and the vision in my left eye seems worse than my right eye.

So that’s pretty much everything that has happened so far. Crazy, huh?! I’m still a little blurry and having trouble seeing things at a distance, seeing fine details and night/low light vision. People always ask me if there were any signs that this was taking place. Unfortunately there were not. Everything I experienced up until I noticed my vision loss were completely normal and expected things after a c-section and preeclampsia. I did not have any pain in my eyes whatsoever! I’m still so shocked that this happened, but I am so thankful that I can function and that my vision has greatly improved from that first day. All I can do is hope that I will get additional improvements over the next few weeks and months. Before this pregnancy, my husband and I had talked about having three kids, but after two episodes of preeclampsia (and especially after this one) I am too scared to try again. Preeclampsia can be very serious and it’s not uncommon for maternal and/or fetal death to occur. Without having any statistics in front of me, I’ve heard that maternal death is more common than vision loss – so you can see why I’m hesitant to try again! Preeclampsia is a disease that many women around the world experience but the cause is not known and the only cure is delivery (regardless of gestational age) – so much more research needs to be done for the sake of women and their babies. I am really excited that Dr. James Martin, the recently elected President of ACOG, (American Congress of Obstetricians and Gynecologists) has made preeclampsia a major area of focus during his term. I hope his dedication to this complicated disease will help spread awareness among the medical profession, researchers and the public. -Christina

P.S. I made this page for other patients experiencing vision loss in the setting of preeclampsia and HELLP syndrome (and for baffled medical professionals as well!)

You can read more about my ongoing issues with preeclampsia and vision loss on my blog: http://theloadeddiaper.wordpress.com/2011/09/12/preeclampsia-vision-loss/