Three weeks ago I experienced an event that was worrisome. I wear contacts for mono vision and one morning on the way to work (it was still dark) I noticed I was having trouble seeing out of my left eye with large halos around everything. I had no problems seeing during the day at work and after I got home my husband and I went out and it was getting dark. I realized then that all the bright lights - street lights, traffic lights, reflections off of cars - had this huge black circle when I looked at it. I thought it was the contact, so I took it out and the vision remained the same. The further away the light, the bigger the black circle. When I looked at the dashboard and other dull objects it looked fine. My husband wanted to take me to the ER, but I insisted we wait. Over the next hour the vision changed to rings with alternating black and white rings, like a bulls-eye. The strange thing is that I only noticed it on bright objects I was looking at and I didn't notice it when I was inside our house, but only when we went outside. The next day I went to my optometrist and he ran all these tests and my eyes were normal. He suspected it was an ocular migraine, but said that my symptoms didn't exactly fit. I should mention that four days prior to that I had woke up in the night with my head hurting, but went back to sleep. When I got up to get ready for work I had the most intense headache I have ever had in my entire lifetime. It wasn't throbbing or anything like that. It felt like the muscles behind my eyes were being ripped out of my head. I could see fine, but the pain was excruciating. Light did not bother me. I've never had anything like that in my life and my husband wanted to take me to the ER (he's such a worrier.) I took some acetaminophen since I can't take aspirin with my high blood pressure. At the time it was 152/104. The pain went away after an hour. Could the two events be related and be in the migraine spectrum?
At first I thought migraine, too. The headache which you describe is worrisome. Especially night time...waking you with a headache. That's more serious and atypical. You need to be evaluated by an ophthalmologist and have a visual field test and possibly an MRI of the brain to rule out intracranial pathology. Keep us posted on your progress.
Timothy D. McGarity, M.D.
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