Eliquis, known as apixaban, is a prescription anticoagulant, or blood thinner. Its primary role is to treat and prevent blood clots associated with conditions like deep vein thrombosis (DVT), pulmonary embolism (PE), and nonvalvular atrial fibrillation (AFib). By interfering with the body’s clotting process, it reduces the risk of stroke. People taking this medication may have questions about side effects, particularly how it might affect eye health.
The Connection Between Blood Thinners and Eye Health
Eliquis functions as a direct inhibitor of Factor Xa, a protein involved in blood clot formation. By targeting this factor, the medication reduces the blood’s ability to coagulate, which is beneficial for preventing strokes and systemic embolisms. This same mechanism, however, introduces a potential risk for bleeding throughout the body, including within the structures of the eye.
The eye contains a dense network of small blood vessels, which are fragile, particularly in the retina and on the eye’s surface. The anticoagulant effect of Eliquis means that minor trauma or spontaneous breaks in these vessels can lead to more significant bleeding. The primary concern is not that the medication causes a specific eye disease, but that it can amplify the severity of a bleed if one happens.
This increased risk is a trade-off for the medication’s protective benefits against serious clots. While bleeding is a known side effect with any anticoagulant, bleeding within the eye can be concerning due to the potential for vision changes. The FDA label for apixaban notes that various forms of eye hemorrhage have been reported by patients.
Specific Eye Conditions Linked to Eliquis Use
The most frequently reported eye-related issue for people on blood thinners is a subconjunctival hemorrhage. This occurs when a tiny blood vessel breaks beneath the conjunctiva, the clear surface covering the white part of the eye. The result is a bright red patch that can look alarming but is often painless and does not affect vision. While this can be caused by simple actions like coughing, the use of anticoagulants is a known risk factor.
A more serious complication is a retinal hemorrhage, which involves bleeding directly into the retina, the light-sensitive layer of cells at the back of the eye. Unlike a surface hemorrhage, bleeding in the retina can directly interfere with vision. Retinal hemorrhages are often associated with underlying conditions like diabetes or high blood pressure, but anticoagulant use can increase the risk.
Bleeding can also occur in the vitreous, the clear, gel-like substance that fills the eyeball. A vitreous hemorrhage can cause symptoms like a sudden increase in floaters, haziness, or shadows in the field of vision. This type of bleeding can be linked to trauma or other retinal diseases. Studies show that patients on anticoagulants are more likely to have a vitreous hemorrhage during common age-related events where the vitreous gel pulls away from the retina.
Recognizing Symptoms and When to Seek Medical Attention
Anyone taking Eliquis should be aware of eye-related symptoms that warrant medical evaluation. The appearance of a new, bright red spot on the white of the eye, even without pain, is a reason to consult with a doctor. This is likely a subconjunctival hemorrhage, which is often harmless but should be monitored.
More urgent symptoms require immediate medical attention. Any sudden change in vision, such as blurriness, distortion, or a dark shadow across your field of vision, should be treated as an emergency. A sudden burst of new floaters or flashes of light can signal a retinal or vitreous hemorrhage and should prompt an immediate visit to an ophthalmologist or emergency room.
Never stop taking Eliquis without first speaking to the doctor who prescribed it. Abruptly discontinuing the medication increases the risk of the blood clots and strokes it is meant to prevent. If you experience any concerning eye symptoms, seek prompt medical evaluation while continuing your medication until a healthcare professional advises otherwise.