Nausea, Ringing in Ears, and Temporary Blindess at Eye Appointment

[TheWaxMan]

I experienced a very strange episode at a recent eye doctor appointment. First, the attendant placed some sort of yellow drops in my eyes that stung at first, and conducted some tests with bright yellow and blue lights. Then he placed dilation drops in my eyes and the doctor came in to conduct similar tests (with very bright lights, of course). As the tests began, I started to feel very nauseous and asked if we could pause for a moment. Then a ringing began in my ears and my body (particularly my eyes) began to feel weird. I quickly lost all vision. For about ten minutes I experienced absolute blindness. Zero sight in either eye. The physical symptoms continued, not accompanied by what I can only imagine were physiological symptoms (sweating, greater discomfort and panic). Eventually I regained sight, first of vague shapes, then of details. However, the details were all filled in with strange shapes and colors, almost like a very "trippy" kaleidoscope. The strange shapes and colors were more vivid with my eyes closed. After about five minutes of this, my eyesight returned to normal. I drank an entire bottle of water during the ordeal. The attendent was perplexed, and the doctor blamed it on an "ocular migraine." This seems incongruous to me

A. Because "ocular migraine" isn't even the correct term, or so my personal investigation revealed. Its proper name appears to be "ophthalmic migraine." It worries me that my doctor didn't know the proper name.

B. Because from what I've gathered in researching symptoms, ophthalmic/ocular migraines are typically painless and do not cause total blindness, but rather spreading visual distortion (rarely blindness) in a ring. It seems to possess the symptoms of retinal detachment, but clearly wasn't, as my vision came back independently in not much time.



So.... any thoughts?

[Uxi]

Rading various accounts, this sounds more like a Basilar-type Migraine (disclaimer: I am not a doctor) although I don't recall having the throbbing headache commonly associated with this condition.

[Uxi]

I have had identical symptoms periodcially since the age of 12.  The attacks happen no more than once every couple of years and always seem to be caused by bright light, particularly small, concentrated light sources in a darkened room.  For example, the first incident happened during a physics lesson at school when the teacher was demonstrating the use of a light box and diffraction grating.  Another incident occurred at a candlelight dinner (my sister-in-law was not impressed that I vomited a few minutes after tasting her lovingly-prepared coq au vin).  On two occasions I have had symptoms triggered merely by sitting near a window on a very sunny day though.  Occurence of this doesn't seem very predictable as I can quite comfortably watch TV in the dark, use candles or sit in the sun with no sign of any problem most of the time (except the occasional photic sneeze reflex).

Most often the symptoms stop before complete blindness and vomiting occur but I have suffered complete blindness twice and vomiting twice.  My tactile sense also seems to be diminished somewhat as well during these episodes.

Like you, the visual effect for me does not take the form of a ring.  Instead my vision becomes fuzzy (like the snow effect on an un-tuned TV but multicoloured) which gets more intense over the course of about 1-2 minutes.  Once the episode reaches its peak then the ringing sound fades within a minute and sight returns progressively over perhaps 3-4 minutes.

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

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[Nancy T]

As Dr. Hagan pointed out, "ocular migraine" is one of several correct terms (my doctor used it, too).

Perhaps the bright lights from the exam triggered the migraine. (Migraines can have many different kinds of triggers, and bright lights are a well-known trigger.)

Migraines can cause a LOT of different symptoms. It can affect the eyes, ears, head (headaches, tingling, or other pain); it can cause nausea, diarrhea, light or sound sensitivity, tingling in an arm or a whole side of the body; and other things. It's a complicated and very strange phenomenon, about which they are learning more all the time. It's a combined neurological and vascular event whose effects spread during the attack through different parts of the brain, including the brainstem.

I'm betting your doctor is correct. Your symptoms and their duration really do sound like migraine is the most likely possibility.

Nancy T.

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

1. Ophthalmic or eye or ocular" combined with migraine are all acceptable and commonly used synonyms.

2. I suggest you see a neuro-ophthalmologist and find out if you had a medication reaction, TIA or other serious cause of your symptoms or if it was a ophthalmic-eye-ocular migraine.

JCH MD