Ocular migraine leading to glaucoma?

[benjamin916]

Hello,

I've been posting in the migraine forum about this, since each episode starts with what appears to be an ocular migraine, but I've not been able to find an answer on this dull, lingering eye pain, so I thought I'd see if I can find answers here.

I've had 3 ocular migraines in the last 7 months, at around 3 month intervals.  These migraines start with a blind spot in the central vision of only my right eye, followed by jagged shapes of brightly colored lights, and flashing lights in my peripheral vision.  These symptoms are only in the right eye (left remains fine), and last around 40 minutes.  After the migraine, I generally have a full-on headache for several hours, but this fades by the next morning.

What really concerns me though is that the right eye feels pain and pressure for months following these migraines.  For the first 36-48 hours following the migraine, the entire right eye feels tender, sore, and tired.  After the 48-hour mark, the pain dulls quite a bit, but remains present.  It's been a week since my last ocular migraine, and my right eye still feels this soreness and pressure, and if this is anything like the last one it won't start to clear up for another three months.  Also, not as prevalent, but still something I notice, is that the vision in my right eye seems slightly degraded - a strange mixture of mild blurryness and a bit of tunnel vision (almost like my right eye is not taking in the same amount of light as my left eye).  The eye-pain also generally gets worse at night, and feels best in the middle of the day (between 3-7pm).

The ocular migraine symptoms are very consistant with a typical ocular migraine, but this lingering eye pain lasting a long amount of time after the ocular migraine doesn't seem to fit.  No one seems to have this same symptom, and no one has been able to give me a good answer.

My question is, can an ocular migraine cause or enhance the symptoms of acute angle-closure glaucoma?  I've been doing research online and it seems the eye pain and blurry vision could be caused by acute angle-closure glaucoma.  Does acute angle-closure glaucoma pain last months?  Would there be any other symptoms that could distinguish this?

I've been to a retinal specialist opthomologist twice for other issues (once in January, once in March), but they checked my eye pressure both times and it was normal.  They also didn't see anything unusual about the retina or the optic nerve at the retina.  Is acute angle-closure glaucoma something they would have found easily?  Is it pretty obvious if someone has it, or could it be missed?

My regular doctor originally thought I had sinusitis, so he gave me anti-biotics and Flonase (which didn't really help much).  After my most recent ocular migraine, he gave me Imitrex to take at the onset of the next ocular migraine I have, but unfortunately it does nothing for the eye pain I'm experiencing now (and there's no guarantee it will prevent the eye pain from happening when I have my next ocular migraine...).

Do these symptoms sound familiar to anyone?  Has anyone experienced anything similar, or have any advice on what I can do to remedy this?  It's really worrying me...

Thanks so much for your help.
Ben

[John C Hagan III, MD, FACS]

Migraine could theoretically cause an angle closure attack in an eye that is predisposed to the problem by having occlucable angles. I have never read about that happening.

Suggest seeing a neuro ophthalmologist.

JCH MD