Visual Disturbances/photophobia

[kaysus]

I have been diagnosed with pseudotumore cerebri.  I am on zonegran and lasix.  I think that the swelling in my optic nerve has gone down.  I used to just have visual disturbances (auras) right before migraines.  For the past 3 months I have had to wear sunglasses almost constantly because I am very photophobic even without a headache.  And for 3 months I have had all kinds of visual disturbances.   They are happening all the time even in the absence of a headache/migraine. The opthamologist doesn't think that they are floaters.  He doesn't know what to think.  They are all different kinds of colors and shapes.  The one that is most prominent that is there all the time in both eyes is like tv snow.  It is not white though.  It is just the black squiggly lines constantly moving.  I don't think that I have decreased vision.  I am having some blurred and double vision.  For a while they thought that maybe I had MS due to symptoms.  MRIs just show some abnormal white brain matter which they tell me is common in people who have migraines.  Within the past 3 months as well I have begun to have incredible joint and muscle pain and weakness.  I have been breaking out in cold sweats. I am sceduled to see a neuro-opthamologist on the 31st.  I am just wondering what your thoughts might be.  Thanks.

[kaysus]

Hi!  I saw the neuro-ophthamologist yesterday.  I was diagnosed with pseudotumor (IIH) in March.  The doc yesterday feels that was a misdiagnosis.  He said that I was born with small optic nerves and the fibers are very dense (or something) and that can be mistaken for swelling.  He says there is no papilledema.  He said that although my pressure was elevated twice on spinal taps (33 and 34) he said that because it was done at bedside instead of in radiology that could have been a false reading.  He said that without any evidence of swelling in the optic nerve there is a 1% chance that I have IIH.  As for the double vision.  He said that although I only notice it in one eye, it is actually happening in both eyes.  Apparently, there are some muscles that are stronger than others and that I was born that way.  He said that it gets more prominent as we age.  He also said that there is surgery to correct it but at this point there is no reason to do it as it is not that bad.  The visual disturbance is persistant visual aura.  He said that it is because my migraines aren't under good control.  The usual treatment for this is Depakote.  I am allergic to this.  He feels that if my doc gets them better under control this will subside.  I am glad for the answers!

[DrNoopurMD]

Hi,

Thanks for writing in.
Persisting visual snow is one of the common symptoms of a migraine variant termed as persistent aura without infarction. Visual snow is also a feature of autoimmune conditions, optic neuritis and lyme disease and also MS although it has been ruled out in your case. Your symptoms warrant a complete neurological and ophthalmic examination. It is therefore good that you will be undergoing a neuro-opthalmological exam. Do keep us posted on the results and further questions if any. Take care!

[meyan]

Hi, I hope you finally got some answers on the 31st. I also have had migraines for at least 20 years now, some years are more or less frequent the kind with visual disturbance, mine are often geometric and neon coloured. Just in the past 3 wks daily a headache will start and increase w/ time. In my pereferial vision I see colours and shapes and circles of lights. I also know what you mean about the black snow. Last summer I was surprised when looking at the sky outside that was what I saw, squiggly lines, thick, thin, no real design but moving. Back to the present though the brightness of the sun and it's reflection is driving me crazy. Headlights are now limiting my times when I can drive in the dark. The MRI showed an anomaly in my brain??? I don't know.  Please post your results. Is it MS?