Migraine Waves in Vision

What are Waves in the vision?

Some people experience episodes of wave-like motion in their vision that last several minutes, typically 20-30 minutes, up to an hour.  Usually, the waves interfere with the vision in the form of missing vision off to the side, but often cutting off some of the central vision.  The visual symptoms are sometimes described as resembling “heat waves.”  After the symptoms disappear, the vision returns to normal.  This phenomenon frequently is part of migraine.  

What is migraine?

Migraine is a common cause of headache that affects at least 10% of the population. Migraine may also cause unusual visual symptoms that occur with or without a headache.  It is usually benign and resolves without after-effects.  However, migraine must be distinguished from more serious causes of headache and visual symptoms.

What causes migraine?

The cause of migraine is unknown, but heredity may play a role. Many people with migraines have family members who also have had migraine and often report a tendency of light-sensitivity and motion-sickness. Migraine may be caused by abnormal episodes of blood vessel constriction within the brain. A number of events may trigger a migraine: stress, hormonal changes (puberty, menopause, and hormone pills), bright lights, loud noises, a change in altitude, and certain foods (including caffeine, chocolate, alcohol, and red wine). Sometimes eye problems can worsen or bring on migraine. Such problems include improper eyeglasses, eye dryness, double vision, past eye injury or eye surgery. 

What are the symptoms of a migraine?

Migraine is associated with a great number of symptoms. Hours or days before a migraine episode occurs, subtle symptoms may be noticed. These symptoms include depression, fluid retention, and stomach disturbances. Visual symptoms can occur before a headache or be the sole symptom of a migraine. These visual symptoms occur without warning when the vision is impaired just off to the side of central vision. A jagged light (“like cracked glass”), which appears to shimmer or repeatedly flash, borders the area of impaired vision. The jagged light causes a missing area of vision and gradually works away from the center to the peripheral vision, taking on a C-shape over a period of 15 to 30 minutes. It sometimes is described as heat waves, bubbles, tunnel vision, or a kaleidoscope, and it may be silver and white or in color. Objects may appear too small or too big (This is called the Alice in Wonderland Syndrome). In middle-aged patients a brief loss of vision may occur in one eye resembling a stroke-like symptom. It usually involves both eyes but may appear more prominently in one eye. In younger patients, nausea and a throbbing headache often follow the light flashes. In older patients, the visual symptoms may occur without headaches. 

Migraine may also cause other symptoms that do not involve the eyes. Such symptoms include tingling of the face and hands, weakness, or trouble with speech. If this occurs, seek urgent evaluation in the emergency department with follow up by a neurologist.

The headache may be described as a deep, penetrating pain or a painful stretching sensation. The headache often begins on one side of the head, but it may spread over the entire head. It may be throbbing nor non-throbbing.

What treatment is available?

Making the correct diagnosis is the most important step. Light flashes may be caused by other problems such as retinal detachment. Therefore, the eye doctor is often called on to make this important distinction. If migraine symptoms occur infrequently, no treatment is needed.  Establishing regular sleep, meal, and exercise programs may help. Try to avoid known triggers. Riboflavin and magnesium supplements may benefit some patients. Prescription medication is available from a neurologist if headaches are severe or frequent.  

If there is any significant change in symptoms or if permanent loss of function occurs, please contact your doctor without delay. In rare instances, a stroke, aneurysm, or tumor may cause unusual light flashes and headache. Your doctor will decide whether further examination or testing is required.

By Scott E. Pautler, MD

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.

Copyright  © 2024 Designs Unlimited of Florida.  All Rights Reserved.

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Burning Eyes

What is the symptom of burning eyes?

Burning eyes is a common problem.  Sometimes, you can feel burning isolated to the eyelids.  At other times, the entire eye may seem to burn.  The burning may be low-grade or severe and it may come and go.  In addition, there may be associated symptoms such as redness, itchiness, crusting, and dry eye.  But usually there is no loss of vision.    

What are the causes of burning eyes?

There are many causes of a burning sensation.  First, make sure you don’t have a sensitivity to make-up or eye drops that you place in your eyes.  One clue is that the burning comes on right after you are exposed to the offending agent.  However, a very common cause of burning is blepharitis.    

What is blepharitis?

Blepharitis is an inflammation of the eyelid border where the lashes emerge.  With blepharitis, the edge of the lid is usually red.  Sometimes, seborrhea or rosacea is the cause of blepharitis.  At other times, blepharitis is an isolated problem.  Regardless, the symptoms are the same.  Frequently, infection from bacteria or skin mites cause or aggravate blepharitis.  Blepharitis is diagnosed by the eye doctor.       

What treatment is available?

There are a host of treatments available.  Warm compresses often help.  Although a warm wet washcloth may help, it cools down rapidly.  Therefore, warming masks may work better.  Artificial tears help symptoms of dry eyes.  They may be used 3-4 times a day.  Sometimes, antibiotic drops, ointments, and/or pills are used.    

Can tea tree oil help?

Tea tree oil provides rapid improvement in symptoms.  It not only rapidly soothes the eyes, but it also works against infection by bacteria and mites.  However, pharmacists must prepare tea tree oil for use around the eye to avoid irritation and complications.  Various preparations include drops, washes, and lid wipes.  Daily use of tea tree oil helps keep the eyes healthy and comfortable.  

Where do I go for diagnosis and treatment?

A general ophthalmologist, trained to diagnose and treat burning eyes, is the doctor to see.  Further consultation is available with an ophthalmologist specializing in cornea and external disease.  In Tampa, I recommend Dr Mark Arey, Dr Allen Pusateri, and Dr Edgar Espana, among others.  

By Scott E Pautler, MD

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.

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Copyright  © 2023 Designs Unlimited of Florida.  All Rights Reserved.