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This Is An Ophthalmology/Neurology Question: I Have Recently Had Two
Question: This is an Ophthalmology/Neurology question: I have recently had two Ocular Migraine events in my left eye. Symptoms: Spontaneously I experienced "wavy" lines in the left field of vision of my left eye, similar to looking through an old pane of glass, i.e. distorted vision. In both instances the distorted vision resolved itself in about 20 minutes. Three hours prior to this event, I had been working out in the gym, when all of a sudden I began to sweat profusely and feel dizzy. I stopped working out and lay down for 30 minutes. I felt better, but then the ocular migraine occurred 2.5 hours later. Two additional data points: (1) two years ago I experienced a NAION (Non-Arteritic, Anterior Ischemic Optic Neuropathy) event in my right eye, which resulted in the loss of central vision in that eye. It was probably due to Nocturnal Hypotension as a result of blood-pressure lowering drugs; and (2) I have been suffering from intermittent Neuropathic Pains (Polyneuropathy) over the last ten years. I take Lyrica, 150mg 2x/day for the Neuropathy, 10mg/day of Rosuvastatin for cholesterol; and .4mg/day of Tamsulosin. Regarding the Ocular Migraines: While there is no clear cause of, or cure for such events, it is my understanding that Ocular Migraines may lead to blindness. I have had an MRI of the brain, but it did not show any tumor or blockage. Nonetheless, I am concerned that the Ocular Migraines may be due to blockage in the arteries leading to my left eye or my head. I am 75 years old, and am recovering from 43 IMRT Treatments, and six months of Lupron injections, for Prostate Cancer, which treatments ended February 7, 2019. Not an easy case, I know.. Can you shed any light on treatments, drugs, or diagnostic tools (if any) that you might recommend to better understand and/or stave off more Ocular Migraine events? Thank you.
This is an Ophthalmology/Neurology question: I have recently had two Ocular Migraine events in my left eye. Symptoms: Spontaneously I experienced "wavy" lines in the left field of vision of my left eye, similar to looking through an old pane of glass, i.e. distorted vision. In both instances the distorted vision resolved itself in about 20 minutes. Three hours prior to this event, I had been working out in the gym, when all of a sudden I began to sweat profusely and feel dizzy. I stopped working out and lay down for 30 minutes. I felt better, but then the ocular migraine occurred 2.5 hours later. Two additional data points: (1) two years ago I experienced a NAION (Non-Arteritic, Anterior Ischemic Optic Neuropathy) event in my right eye, which resulted in the loss of central vision in that eye. It was probably due to Nocturnal Hypotension as a result of blood-pressure lowering drugs; and (2) I have been suffering from intermittent Neuropathic Pains (Polyneuropathy) over the last ten years. I take Lyrica, 150mg 2x/day for the Neuropathy, 10mg/day of Rosuvastatin for cholesterol; and .4mg/day of Tamsulosin. Regarding the Ocular Migraines: While there is no clear cause of, or cure for such events, it is my understanding that Ocular Migraines may lead to blindness. I have had an MRI of the brain, but it did not show any tumor or blockage. Nonetheless, I am concerned that the Ocular Migraines may be due to blockage in the arteries leading to my left eye or my head. I am 75 years old, and am recovering from 43 IMRT Treatments, and six months of Lupron injections, for Prostate Cancer, which treatments ended February 7, 2019. Not an easy case, I know.. Can you shed any light on treatments, drugs, or diagnostic tools (if any) that you might recommend to better understand and/or stave off more Ocular Migraine events? Thank you.
I have uploaded the radiologist's report following an MRI (w/ and w/out contrast) of my brain.
I have uploaded the radiologist's report following an MRI (w/ and w/out contrast) of my brain.
Brief Answer:
Ocular migraine
Detailed Answer:
Hi.
Welcome to "Ask a Doctor" service.
I am Dr Ajeet XXXXXXX
I have gone through your history and reports and here is my opinion.
Ocular migraine or Retinal migraine is a temporary condition caused by disruption of blood supply to eyes,may be by spasm.
It usually recovers by itself (in 20 to 30 minutes) and there is no residual visual deficit.
It does not cause blindness,nor it is a sign of stroke.
Diagnosis is usually done by-
History,
Physical examination,
Fundoscopy,
MRI Brain,
MRI-Angio.
(You can go for MRI- Angiography, as it will reveal the status of complete vasculature of eye)
There are no other advanced techniques of diagnosis.
Most people don’t need any treatment for it.
They need to just stop what they are doing and rest take rest untill the vision is normal.
Better to raise legs (by 35 degree) to increase blood supply and venous return to brain.
It always has an aura (patient can make out that he is about to have an attack) so patient can always position himself in time.
Better to apply pressure on head while laying down in a supine position.
If there is associated headache, pain relievers like Advil can be taken
If there is associated nausea,anti emetics like Domperidone can be taken.
Some clinicians use Pentoxifylline to improve blood flow in patients with circulation problems in any part of the body.
Avoid processed and smoked and junk food.
Avoid alcohol,smoking,tobacco.
Avoid intense exercise.
Keep yourself well hydrated as dehydration is a known trigger.
Avoid long periods of fasting as low Blood sugar is a known trigger.
Keep your blood pressure under control.
Limit caffeine intake.
Hope that I have answered your query.
Happy living.
Regards.
Ocular migraine
Detailed Answer:
Hi.
Welcome to "Ask a Doctor" service.
I am Dr Ajeet XXXXXXX
I have gone through your history and reports and here is my opinion.
Ocular migraine or Retinal migraine is a temporary condition caused by disruption of blood supply to eyes,may be by spasm.
It usually recovers by itself (in 20 to 30 minutes) and there is no residual visual deficit.
It does not cause blindness,nor it is a sign of stroke.
Diagnosis is usually done by-
History,
Physical examination,
Fundoscopy,
MRI Brain,
MRI-Angio.
(You can go for MRI- Angiography, as it will reveal the status of complete vasculature of eye)
There are no other advanced techniques of diagnosis.
Most people don’t need any treatment for it.
They need to just stop what they are doing and rest take rest untill the vision is normal.
Better to raise legs (by 35 degree) to increase blood supply and venous return to brain.
It always has an aura (patient can make out that he is about to have an attack) so patient can always position himself in time.
Better to apply pressure on head while laying down in a supine position.
If there is associated headache, pain relievers like Advil can be taken
If there is associated nausea,anti emetics like Domperidone can be taken.
Some clinicians use Pentoxifylline to improve blood flow in patients with circulation problems in any part of the body.
Avoid processed and smoked and junk food.
Avoid alcohol,smoking,tobacco.
Avoid intense exercise.
Keep yourself well hydrated as dehydration is a known trigger.
Avoid long periods of fasting as low Blood sugar is a known trigger.
Keep your blood pressure under control.
Limit caffeine intake.
Hope that I have answered your query.
Happy living.
Regards.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Brief Answer:
Ocular migraine
Detailed Answer:
Hi.
Welcome to "Ask a Doctor" service.
I am Dr Ajeet XXXXXXX
I have gone through your history and reports and here is my opinion.
Ocular migraine or Retinal migraine is a temporary condition caused by disruption of blood supply to eyes,may be by spasm.
It usually recovers by itself (in 20 to 30 minutes) and there is no residual visual deficit.
It does not cause blindness,nor it is a sign of stroke.
Diagnosis is usually done by-
History,
Physical examination,
Fundoscopy,
MRI Brain,
MRI-Angio.
(You can go for MRI- Angiography, as it will reveal the status of complete vasculature of eye)
There are no other advanced techniques of diagnosis.
Most people don’t need any treatment for it.
They need to just stop what they are doing and rest take rest untill the vision is normal.
Better to raise legs (by 35 degree) to increase blood supply and venous return to brain.
It always has an aura (patient can make out that he is about to have an attack) so patient can always position himself in time.
Better to apply pressure on head while laying down in a supine position.
If there is associated headache, pain relievers like Advil can be taken
If there is associated nausea,anti emetics like Domperidone can be taken.
Some clinicians use Pentoxifylline to improve blood flow in patients with circulation problems in any part of the body.
Avoid processed and smoked and junk food.
Avoid alcohol,smoking,tobacco.
Avoid intense exercise.
Keep yourself well hydrated as dehydration is a known trigger.
Avoid long periods of fasting as low Blood sugar is a known trigger.
Keep your blood pressure under control.
Limit caffeine intake.
Hope that I have answered your query.
Happy living.
Regards.
Ocular migraine
Detailed Answer:
Hi.
Welcome to "Ask a Doctor" service.
I am Dr Ajeet XXXXXXX
I have gone through your history and reports and here is my opinion.
Ocular migraine or Retinal migraine is a temporary condition caused by disruption of blood supply to eyes,may be by spasm.
It usually recovers by itself (in 20 to 30 minutes) and there is no residual visual deficit.
It does not cause blindness,nor it is a sign of stroke.
Diagnosis is usually done by-
History,
Physical examination,
Fundoscopy,
MRI Brain,
MRI-Angio.
(You can go for MRI- Angiography, as it will reveal the status of complete vasculature of eye)
There are no other advanced techniques of diagnosis.
Most people don’t need any treatment for it.
They need to just stop what they are doing and rest take rest untill the vision is normal.
Better to raise legs (by 35 degree) to increase blood supply and venous return to brain.
It always has an aura (patient can make out that he is about to have an attack) so patient can always position himself in time.
Better to apply pressure on head while laying down in a supine position.
If there is associated headache, pain relievers like Advil can be taken
If there is associated nausea,anti emetics like Domperidone can be taken.
Some clinicians use Pentoxifylline to improve blood flow in patients with circulation problems in any part of the body.
Avoid processed and smoked and junk food.
Avoid alcohol,smoking,tobacco.
Avoid intense exercise.
Keep yourself well hydrated as dehydration is a known trigger.
Avoid long periods of fasting as low Blood sugar is a known trigger.
Keep your blood pressure under control.
Limit caffeine intake.
Hope that I have answered your query.
Happy living.
Regards.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
I though that your answer was concise, incisive and informative regarding the causes and effects of Ocular Migraine events. For that I thank you very much.
Strangely, I had another Ocular Migraine attack today--one week after the last attack. The sequence of the attack was similar to the last: First, I noticed on the "right field of my left eye," I noticed some wavy lines, and some inability to see writing or object to the right of my central vision of my left eye. The last attack affected the "left field" of my left eye.
I re-read your recommendations of things to avoid, and one of them was caffeine. Indeed, within an hour or so of having my morning coffee (and nothing else), the Ocular Migraine attack occurred. Henceforth, I will know to avoid caffeine.
But, I'm concerned that the second attack happened within one week of the first Ocular Migraine.
Does that second attack of an Ocular Migraine presage a worsening of the problem? If the problem is a spasming artery or vessel that feeds my optic nerve or retina, is there anything that I can/should do to prevent further attacks or, God forbid, blindness in my left eye? What about a blood thinner? Would that help in any way prophylactically?
Please let me know. Thank you.
Strangely, I had another Ocular Migraine attack today--one week after the last attack. The sequence of the attack was similar to the last: First, I noticed on the "right field of my left eye," I noticed some wavy lines, and some inability to see writing or object to the right of my central vision of my left eye. The last attack affected the "left field" of my left eye.
I re-read your recommendations of things to avoid, and one of them was caffeine. Indeed, within an hour or so of having my morning coffee (and nothing else), the Ocular Migraine attack occurred. Henceforth, I will know to avoid caffeine.
But, I'm concerned that the second attack happened within one week of the first Ocular Migraine.
Does that second attack of an Ocular Migraine presage a worsening of the problem? If the problem is a spasming artery or vessel that feeds my optic nerve or retina, is there anything that I can/should do to prevent further attacks or, God forbid, blindness in my left eye? What about a blood thinner? Would that help in any way prophylactically?
Please let me know. Thank you.
I though that your answer was concise, incisive and informative regarding the causes and effects of Ocular Migraine events. For that I thank you very much.
Strangely, I had another Ocular Migraine attack today--one week after the last attack. The sequence of the attack was similar to the last: First, I noticed on the "right field of my left eye," I noticed some wavy lines, and some inability to see writing or object to the right of my central vision of my left eye. The last attack affected the "left field" of my left eye.
I re-read your recommendations of things to avoid, and one of them was caffeine. Indeed, within an hour or so of having my morning coffee (and nothing else), the Ocular Migraine attack occurred. Henceforth, I will know to avoid caffeine.
But, I'm concerned that the second attack happened within one week of the first Ocular Migraine.
Does that second attack of an Ocular Migraine presage a worsening of the problem? If the problem is a spasming artery or vessel that feeds my optic nerve or retina, is there anything that I can/should do to prevent further attacks or, God forbid, blindness in my left eye? What about a blood thinner? Would that help in any way prophylactically?
Please let me know. Thank you.
Strangely, I had another Ocular Migraine attack today--one week after the last attack. The sequence of the attack was similar to the last: First, I noticed on the "right field of my left eye," I noticed some wavy lines, and some inability to see writing or object to the right of my central vision of my left eye. The last attack affected the "left field" of my left eye.
I re-read your recommendations of things to avoid, and one of them was caffeine. Indeed, within an hour or so of having my morning coffee (and nothing else), the Ocular Migraine attack occurred. Henceforth, I will know to avoid caffeine.
But, I'm concerned that the second attack happened within one week of the first Ocular Migraine.
Does that second attack of an Ocular Migraine presage a worsening of the problem? If the problem is a spasming artery or vessel that feeds my optic nerve or retina, is there anything that I can/should do to prevent further attacks or, God forbid, blindness in my left eye? What about a blood thinner? Would that help in any way prophylactically?
Please let me know. Thank you.
Brief Answer:
Ocular migraine
Detailed Answer:
Hi.....
The blood thinners like aspirin have no role because there is no infarction and thrombosis(already proved by your brain scans).
It is just a reversible spasm of the ocular vessels which has no permanent harmful effects.
The episodes can happen at anytime so there is nothing like worsening of symptoms in you.
Avoid caffeine and do life style and dietary modifications as advised by me.
The episodes would wean off by themselves.
Regards.
Ocular migraine
Detailed Answer:
Hi.....
The blood thinners like aspirin have no role because there is no infarction and thrombosis(already proved by your brain scans).
It is just a reversible spasm of the ocular vessels which has no permanent harmful effects.
The episodes can happen at anytime so there is nothing like worsening of symptoms in you.
Avoid caffeine and do life style and dietary modifications as advised by me.
The episodes would wean off by themselves.
Regards.
Above answer was peer-reviewed by :
Dr. Yogesh D
Brief Answer:
Ocular migraine
Detailed Answer:
Hi.....
The blood thinners like aspirin have no role because there is no infarction and thrombosis(already proved by your brain scans).
It is just a reversible spasm of the ocular vessels which has no permanent harmful effects.
The episodes can happen at anytime so there is nothing like worsening of symptoms in you.
Avoid caffeine and do life style and dietary modifications as advised by me.
The episodes would wean off by themselves.
Regards.
Ocular migraine
Detailed Answer:
Hi.....
The blood thinners like aspirin have no role because there is no infarction and thrombosis(already proved by your brain scans).
It is just a reversible spasm of the ocular vessels which has no permanent harmful effects.
The episodes can happen at anytime so there is nothing like worsening of symptoms in you.
Avoid caffeine and do life style and dietary modifications as advised by me.
The episodes would wean off by themselves.
Regards.
Above answer was peer-reviewed by :
Dr. Yogesh D
Answered by
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