Optic Nerve damaged by migraines?

I am a 56 year old overweight female.  I have been diagnosed with Fibromyalgia and Migraines. My migraines are worse on the left side of my head with alot of pressure behind my left eye and painful itching over the whole scalp.  The vision in my left eye blurs during the migraines.  I have just found out from my Opthamologist that the optic nerve in my left eye is damaged and he believes that my migraines are causing this damage.  I am concerned, since all medications for migraines have not worked and my Neurologist prescribes Norco for the pain but hasn't even ordered any new scans or tests to see what might be causing these headaches, so if the headaches are not stopped will my vision just continue to decline?  My Neurologist is supposedly one of the best headache doctors in the area but even he suggested going to a headache clinic like "Diamond or Cleveland".   I have a very high tolerance for prescription drugs so it is hard for a doctor to figure out anything to help me.

[John C Hagan III, MD, FACS, FAAO]

It is very unusual for migraine to damage the optic nerve. It is true that are visual field exams (peripheral vision testing) in migraine patients that there is an definite number of unsuspected loss of visual field (especially in smokers) compared with a like number of testing on people without migraines. The mechanism however is felt to be "mini-strokes rather than optic nerve damage.

I would suggest you see a neuro-ophthalmologist for a formal visual field, optic nerve OCT and a second opinion about "optic nerve damage" due to glaucoma.

Your ophthalmologist should be able to refer you to a neuro-ophthalmologist. You can also find the location of one near you at www.aao.org

Your second opinion will be more productive if you take your medical records from your eye MD along with the tests that document the optic nerve damage to the neuro-ophthalmologist.

JCH III MD