Do you have a problem seeing zig zag lines? This can be an alarming symptom. Sometimes, they are described as jagged or resembling a heat wave coming off of a hot asphalt road. Others describe the symptom as looking like a kaleidoscope. The zig zag lines usually come on without warning and may slowly increase in size and intensity over several minutes. They often interfere with vision by blocking out part of the vision. For example, you may only be able to see part of a person’s face or part of a printed word. After 15–20 minutes or so, they disappear without any permanent vision loss.
What causes this symptom?
There are many causes of zig zag lines in the vision. However, the most common cause is a migraine phenomenon, called a visual aura. Migraines with visual aura may occur with or without a headache. Often, they often follow stress by several weeks. Migraine is a diagnosis of exclusion. That means it is necessary to exclude or rule out other more serious causes of zig zag lines before settling with the diagnosis of migraine.
What are more serous causes of zig zag lines in the vision?
Serious causes of may include problems in the eyes, the brain, the heart, and other medical problems. Eye problems include retinal breaks, retinal detachment, and inflammation in the eyes. Brain problems include bleeding, aneurysm, seizure, and tumors. Sometimes, zigzag lines are associated with a heart problem, such as patent foramen ovale. In this case, a cardiologist assesses and provides treatment as needed. Rarely, blood clot problems and connective tissue disease are implicated.
Who should I see about this problem?
The ophthalmologist (Eye MD) is equipped with the knowledge, skill, and equipment to diagnose the cause of your zig zag lines. Sometimes, you may need to see a retinal specialist (a type of ophthalmologist with specialty education in retinal disease). In some cases, the ophthalmologist will send you for a brain scan or to a neurologist for further care.
What is the treatment for zig zag lines?
The treatment of zig zag lines depends on the cause. Once the doctor excludes serious diseases, he may diagnosis migraine. In that case, no treatment is usually necessary. However, if the symptoms are recurrent and bothersome, the ophthalmologist will usually send you to a neurologist for assessment and possible medication.
For a telemedicine consultation with Dr Pautler, please send email request to spautler@rvaf.com. We accept Medicare and most insurances in Florida.Please include contact information (including phone number) in the email. We are unable to provide consultation for those living outside the state of Florida with the exception of limited one-time consultations with residents of the following states: Alabama, Arkansas, Connecticut, Georgia, Minnesota, and Washington.
Scleral buckle surgery is an advanced form of eye surgery for the repair of retinal detachment that is performed in the operating room under a microscope. Scleral buckle surgery may take thirty minutes to several hours to perform depending upon what task is being accomplished. Despite common tales, the eye is not taken out and placed on the cheek. It remains in its normal position throughout the surgery. During scleral buckle surgery a silicone band or sponge is sutured to the external eye wall (the sclera) behind the eye muscles and hidden by the covering of the eye (the conjunctiva). The surgery creates an indentation (buckle) in the sclera that offers a ledge of support for the retina inside the eye and offsets traction on the retina from the vitreous gel (a major cause of retinal break and retinal detachment).
Artistic rendition of scleral indentation (click on image to enlarge)
Below is an example of scleral buckle surgery. If you are uncomfortable watching surgery, please do not click on this video.
What type of anesthesia is available?
Although some surgeons and patients choose local anesthesia, general anesthesia is also available. With local anesthesia the patient is sedated with IV medication so there is no memory of the anesthetic injection around the eye. Surgical drapes are placed over the face leaving plenty of breathing room. During surgery the patient is awake, but generally does not feel pain. It is important to lie still on the operating room table as movement during surgery may result in damage to the eye and affect the final visual result.
General anesthesia offers some advantages over local anesthesia. With general anesthesia the patient is motionless and remembers nothing of the surgery. The anesthesiologist places a tube to hold the airway open. Which type of anesthesia is best for a patient may be determined by the health of the patient, so you may wish to ask your internist for advice. If a person cannot lie still for the surgery or if claustrophobia is a problem, general anesthesia is preferred. Although there are risks with any type of anesthesia, modern techniques offer a high degree of safety for the patient.
How can I prepare for scleral buckle surgery?
Your EyeMD will schedule an appointment with your primary care doctor if evaluation is needed prior to surgery. Please inform your doctor of any chest pain/pressure, fever, productive cough, or shortness of breath. Unless otherwise notified by your doctor, do not take aspirin-containing products or any herbal supplements for two weeks prior to surgery. Coumadin should be stopped four days prior to surgery. On the morning of surgery, take no medications for diabetes unless instructed differently by your doctor, but please do take all of your other medications with a sip of water. Otherwise, do not eat or drink anything after midnight the day before surgery. If you usually use eye drops in the morning, they may be taken on the morning of surgery. Please click on this link for further information on how to prepare for surgery.
What are the risks of scleral buckle surgery?
Although uncommon, problems such as bleeding and infection may arise from any surgery. Retinal detachment or abnormal scar tissue formation may require additional surgery. Rarely, there may be loss of vision/loss of the eye from surgery. Although serious problems are not encountered often, the risks and benefits must be weighed for each individual prior to surgery. In retinal detachment, surgery is the only way to improve vision and prevent blindness.
What can I expect after scleral buckle surgery?
A soft eye patch and a hard eye shield are placed on the eye at the end of surgery. Leave these in place until your exam on the day after surgery. You may use Tylenol or Advil for aching pain, but call the doctor for a prescription if your pain is not relieved.
Over-The-Counter Pain Medication Schedule for Maximum Effect
Dosing Schedule:
8AM
2PM
8PM
2AM
Maximum
Ipubrofen
800mg
800mg
800mg
800mg
3200mg
(200mg tablets)
4 tablets
4 tablets
4 tablets
4 tablets
Dosing Schedule:
11AM
5PM
11PM
Maximum
Tylenol Extra-Strength
1000mg
1000mg
1000mg
3,000mg
(500mg acetaminophen)
2 caplets
2 caplets
2 caplets
Note: This schedule may need to be altered if you have kidney or liver disease.
This schedule is designed not to exceed maximum dosages of these medications.
Do not take addiitonal medications that also contain ibuprofen or acetaminophen.
It is common to have moderate discomfort after scleral buckle surgery. A scratchy feeling may result from sutures on the white of the eye. These sutures dissolve in about a month. At your exam after surgery, you will be given eye drops and/or an ointment to keep the eye comfortable, to prevent infection, and to promote healing. Wearing the eye patch is optional after you are seen in the office. Be sure you understand any positioning requirements given by your surgeon and feel free to ask about special pillows and equipment available to help maintain head position. If a gas bubble is placed in your eye at the time of surgery, you may not fly on a plane or undergo nitrous oxide anesthesia until the gas has dissolved, or you could risk severe pain and blindness. You may see the gas bubble as a horizontal, dark, curved line or as a dark ball in the vision. If a gas bubble is used during surgery, please keep a MedicAlert bracelet on your wrist until the gas has disappeared. The swelling and redness slowly disappear over weeks to months. The vision usually returns slowly after surgery and may take months to years for final recovery. Sometimes, the vision does not recover completely to normal. If the center of the retina was detached, there is usually some degree of permanent blurring of vision or distortion.
For a telemedicine consultation with Dr Pautler, please send email request to spautler@rvaf.com. We accept Medicare and most insurances in Florida.Please include contact information (including phone number) in the email. We are unable to provide consultation for those living outside the state of Florida with the exception of limited one-time consultations with residents of the following states: Alabama, Arkansas, Connecticut, Georgia, Minnesota, and Washington.
