Why Do I Have Frequent Ocular Migraines?

Question

Asked by Darklingilisten

Why Do I Have Frequent Ocular Migraines?

When I was little, I started to see bright lines intersecting one another in my field of vision. I don't know when they started really, but that I was very young. I was afraid of the dark not only because I couldn't see anything around me, but also because the bright intersecting lines and shapes became all that I could see, whether I closed my eyes or not. Sometimes I felt as though my head was a balloon, filled with helium, my skin tight around my head. Occasionally, a curtain of glittering pale green and blue would wash completely over my vision, and then my ears would ring (my sister told me it was because someone was talking about me, and I often wondered why I was the topic of conversation so much). If I stared into space for too long objects would separate into two. I always thought it was all normal, up until a few days ago.

In high school, I started getting migraines frequently. There was a period of about a year where they came, sometimes overlapping one another it seemed. During that time, I kept seeing those bright shapes, but they were brighter than ever, often obscuring my ability to see. I stopped eating most processed foods, meat and dairy, and focused on my own personal happiness and the migraines receded, only happening every few months. But I still saw the bright shapes, the grid of pale light, and my ears still rung. Still, it was, and is, normal to me. That was about 4 or 5 years ago.

A few days ago I went to my eye doctor and he asked me to read a row of letters with my left eye. I told him I couldn't see the first two letters because they were obscured by the migraine light aura thingys. When he started asking me about it, he seemed to grow concerned and asked me to take a vision test in which I had to look into a black box with a black dot in the middle, while black, vibrating lines flashed around it. I had to press a button whenever I saw them. I couldn't see the black lines very much, especially with my left eye, no matter how much I blinked. I took the test twice and my doctor told me the results were abnormal, and that he wanted me to take another test in a month, and then decide if I should see a neurologist. All throughout this I grew a bit frightened because it all seemed so normal to me, and now I might have to see a neurologist. Do other people have this sort of thing? Is this something that happens a lot to people? ...should I be worried?

I hope not :(

Answer

Hi Darlingilisten,

The test your ophthalmologist gave you sounds similar to one that is important for all Migraine patients to have done regularly. It's called a vision fields test, and it tells the doctor how well your eye is able to see. There is a normal pattern for most people, and when that normal pattern is different, it can indicate that there might be a problem he needs to look deeper into. He wants you to come back because he wants to see if it changes, and he wants to monitor the situation.

Migraine itself can result in some types of eye damage, especially something called normal pressure glaucoma, or narrow angle glaucoma. But before you get frightened this might be what's happening, there is also a condition in which auras can become persistent. This can often be treated by a doctor familiar with the condition and treatment options. You see, almost any time you are having an aura, your field of vision test will be abnormal. If your aura doesn't go away, it might be important for you to see a Migraine specialist along with your ophthalmologist. Often specialists will ask patients to see someone called a neuro-ophthalmologist who is specially trained in these types of conditions.

It sounds like your eye doctor is talking about seeing a neurologist. Unfortunately, neuros don't always have the most training in dealing with Migraine related problems. That said, it still might be a good idea to see a neurologist who might offer a 3rd opinion with a different focus.

I'd like to talk for a moment about ocular Migraine too if that's okay...

One of the most important things is to get an accurate diagnosis. To simplify matters and make it easier for people to get information and treatment, doctors usually go by the gold standard for diagnosis, the International Headache Society's International Classification of Headache Disorders, 2nd Edition (ICHD-II). Although people often ask what "ocular," "optical," or "opthalmic" Migraines are, there are no such diagnoses under ICHD-II or the brand new version just released: ICHD-III. We do see the terms used, but doctors use it differently, so it really doesn't tell anyone what type of Migraine you actually have. You can read more about this in Ocular, Optical, and Opthalmic Migraines and The Type of Migraine Does Matter.

I hope you'll come back and let us know how you're doing. Your story may be helpful to someone else who doesn't understand where they should go or what they should do.

~Ellen

Answered by Ellen Schnakenberg