Thanks for writing! Yes, that's about how I saw it at first (choose blindness or stroke).

However, we are speaking of probabilities and in that regard we are all different. I.e., taking anti-coagulants "only" increases the likelihood - not certainty - of leakage into the retinas. Furthermore, the risk of strokes caused by AFib are "only" about 5 % without treatment and what's more that is only the figure without antVEGF treatment.

Besides that fine tuning of ones situation, there is a range of risk even with the same scores per the CHAD2VASC2 (just a broad prediction for a large demographic). My CHAD2VASC2 score is about 2 at present based on age (76) and 3, adding a point for my gender, female.

I don't have high blood pressure, though (yet!), nor am I overweight nor do I smoke. I also exercise regularly (mostly in a gym) . There are SO many variables, though, to do with depression, abnormal sleep, and hereditary factors (we three siblings have a severe inherited lipid disorder aggravated by lifestyle factors - one, younger, has already succumbed to a CV event two years ago .)

One example, even though I've managed to reduce my lipid profile to fairly normal results per lab, that's only part of the picture. For instance, for all I know I have plaque build-up in my aorta and other key anatomic parts from all the years when I left my lipids untreated - very elevated since from mid-20s. So complicated!

Why I want advice about the desirability of the Watchman, to be based on a careful cardiological analysis of my total risk factors based on more than lab numbers (for example, calcium and stress tests - possible also an arteriogram.

It doesn't help that I've only met a single retinologist so far (they are VERY back-booked) who's even thought of the risk to my eyes of taking blood thinners! (It's highly specialized research.) Apart from my preferences, Cardiac interventional specialists (doctors who perform the Watchman - not risk-free) need to justify the procedure to an approval board. They need to present medical reasons a blood thinner - otherwise, the most desirable treatment for AFIB - is unsuitable for any given patient.

And there are other considerations for a cardiological surgeon to weigh. Whereas the CHAD score raises the stroke risk score significantly by age, its also true that:
with age, FALL RISK is greatly increased. With that, so is the risk of hemorrhagic stroke. (Some doctors discontinue blood thinners because of age, and 15% of all strokes (all ages) are hemorrhagic stroke. If someone taking an anticoagulant has a hemorrhagic stroke, they can only survive if the anticoagulant effect is blocked by special agents (depends on ones hospital being able to give a accurate differential diagnostic lickety split - and having the proper agents on hand. For the record, my local rural hospital is NOT the best equipped nor are our doctors the best, by any means.)

The only consolation in trying to make the best medical decision (too bad wet macular degeneration is incurable!),
is that many strokes lead to blindness anyhow.

Might as well flip a coin! 🙁

Such a mess.