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Temporary blindness
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Temporary blindness

I am a 36yr old female. For the past five yrs I have gone blind in my right eye most nights when I turn the light off. It also occurs if I walk from a light room into a very dark room. It has lasted between 15 seconds and 30 minutes. Whilst I can't see my eye feels strange- heavy and numb. Initially it was just a loss of central vision, now it is total loss in the R eye. I also feel aware of my R eye during the day. Medical history wise I have had pernicious anaemia for 3yrs and have B12 injections. I have had two thorough appointments with opthalmology with nothing abnormal found. There was a suggestion of occular migraine. I am concerned because it seems to be getting worse.
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Avatar_dr_f_tn
Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to examine you and obtain a history, I can not tell you what your symptoms are from. However, I will try to provide you with some possibilities.

It sounds like you have episodes of transient loss of vision associated with some eye discomfort for the past several years. While opthalmologic disorders are not within my specialty, in general, there are certain retinal disorders that manifest as vision loss predominantly in dim or dark light. However, it sounds like you have had 2 negative eye evaluations which makes this unlikely.  

Ocular migraine (also known as opthalmic migraine or ocular migraine) is thought to be a variant of migraine in which headache may not occur, but there is often a family history of migraine disorder. It is a difficult diagnosis to make as there is no specific test for it, but if other causes of vision loss are excluded, the diagnosis may be invoked. It is more commen in women, and symptoms may include transient vision loss, flashes of light in the peripheral visual field, or other similar symptoms lasting usually 30 minutes or less. Headache may or may not begin within 60 minutes and is often one-sided, throbbing, and may be associated with nausea and light-sensitivty. Ocular migraine is not necessarily triggered by entering a dark room, but different people have different migraine/migraine-variant triggers.

People with pernicious anemia, which is as you may know an autoimmune disease, may have one or more other autoimmune diseases. Autoimmune thyroid disorders can sometimes lead to eye symptoms/changes; these usually affect both eyes rather than just one, and cause abnormalities in the tissue around the eyes leading to proptosis (the eye sort of sticking out a little) but in more advanced cases eye muscle and vision problems as well. Evaluation of your thryoid with simple blood tests may be beneficial to you, I recommend you discuss this further with your regular/primary doctor.

Optic neuritis is painful inflammation of the optic nerve and is associated with vision loss that slowly (sometimes incompletely) recovers. If your vision recovers to normal in between episodes, and since this seems to have been going on off-and-on for several years, combined with normal opthalmologic examinations, optic neuritis is highly unlikely. However, in uncommon cases of optic neuritis the eye exam can be completely normal; this is termed retro-bulbar optic neuritis (the portion of the nerve that is behind the eye is inflamed so it can not be visualized on dilated eye exam). However, if you have had normal vision and visual field testing, this is again unlikely.  

I understand you have been evaluated by 2 opthalmologists but if you have continued concerns and symptoms, evaluation by a neuro-opthalmologist and/or a neurologist may be beneficial to you. A neurologist may be able to answer your questions regarding optic migraine as well as rule out a neurologic cause to your symptoms.

Thank you for using the forum I hope you find this information useful good luck.
3 Comments
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Avatar_m_tn
I know there are things like optic neuritis out there but let me tell you one morning I had a severe optic migraine...no head pain,  I was just 80% blind in my left eye.   Very frightening.   Have you had a brain MRI with contrast and a dilated eye exam performed by an MD opthamologist (not an optometrist)
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Avatar_m_tn
a benign tumor is not inconceivable so you should have your head scanned
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