Ocular Migraines

[Hoshi]

I'm currently seeing a doctor for Alternating Exotropia. (I have corrective sugery later this year for it). I mentioned to him that I had been a bit worried because there had been a few occurances of vision in one eye going blurry and foggy. He just said it was probably ocular migraines and changed the subject.

I was ok with that. Untill they started happening more and more. At first it was rare, maybe once or twice a week. Then it was every other day. Then it was every day. Now it's multiple times a day. I -rarely- have headaches, and have never had a real migraine. But more than that, even, I've noticed some other things: I used to have great night vision. I'd have very few lights on and I'd be walking up the  stairs - I could see fine. Now I can't.  Going out in the sun really hurts some days. The light hurts my eyes - sometimes even if the sun is behind clouds or is facing to my back. It's not just when it's in my eyes.

Now I've stared seeing halos around lights (mostly at night) and extreme glare. Nothing like I used to have. On some lights, I see triple. Last night, I was walking home from work - I looked up at the moon and saw 3 of them overlapping. It's like I saw the top 1/3 of it sticking up above it, then the -real- moon, then the bottom 1/3 sticking off the bottom of it. Or when I was driving home one night, I saw a green light - I saw 3 verticle green lights when there was only supposed to be 1. I know this is the patient to patient forum, but does anyone recognize these symptoms? I'm pretty young (18), so I don't know why my eyes are weird like this.

P.S. When I'm seeing the glare/triple images/etc, it's not because my eyes are deveated due to the exotropia. I don't like it when my eye moves outward (because I see 2 different overlapping images if I do), so I try to keep it pulled in as much as possible.

Thanks in advance.

[JohnHaganMD]

Hello Hoshi,  I'm the ophthalmology forum EyeMD.

You have two troublesome group of symptoms which may be, but more likely are not related.

Ocular migraine is an exclusionary diagnosis. That means that there are some very serious health problems that can simulate ocular migraine (especially as people get older or in high risk groups like smokers) such as seizure disorders, heart problems, blockage of blood vessels in the neck and brain, even brain tumors or brain blood vessel problems. The general description of these symptoms is visual obscuration or possibly TIA (transient ischemic attack) Only after these more serious problems are excluded is ocular migraine diagnosed. Sometime people come in to see me and tell me they have had blurred vision, blind spots, pulsating lights, geometric patterns lasting 5-45 minutes and sometimes with and sometimes without headache. If they have had these problems 20 years and have 1or 2 of them per year its not necessary to start an extensive or expensive work-up. But, as in your case, if they're of recent oset and getting worse you need to pull out the stops.

That would mean seeing a neurologist and if possible a neuro-ophthalmologist. You will likely need some special studies that might include MRI and poss MRA, carotid doppler, sometimes a echocardiogram.

Your other symptoms of the triple images could be checked by the neuro-ophthalmologist. Causes can include corneal problems (scars, astigmatism, keratoconus), cataracts, and refractive errors such as near sighted, far sighted astigmatism.

Hope you found this helpful.

JCH MD

[Hoshi]

I really appriciate the reply. I've been putting off going to the doctor about this, but I guess it's time for me to bite the bullet and go.

Thanks!