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Migraine-Related Eye Problems
Brenda wrote:
Hi, have a question.. I've been having a reoccurring problem with my eyes, been on and off for about 2+ years now. I've been to the dr, he seen nothing physically wrong, said I could see an optometrist if I wished. Just called them, they are just going to do the normal exam, not sure if they can figure out what's wrong with just the exam?! My symptoms start like this.. Sudden blur, almost as if someone throws a bottle of black ink in my eyes, then just all over blur like I'm looking through a kaleidoscope almost. Then it is almost like my eyes fill up with water, like from the bottom up, it's just the sensation I feel warmth and then the vision slowly blurs from bottom of eyes up. These are sudden and random things.. My eyes continue to be completely blurry and I can hardly see for at least 20-40 minutes each time this happens? Please help, because the drs have no idea!! Thank you :(
Dr Langis Michaud's response:
Dear Brenda
You describe the visual aura linked with the classic migraine syndrome very accurately. This is just like in the textbooks. Having this problem myself I certainly understand how confusing this occurrence could be. First of all, I have to say that this is a very benign, but spectacular, phenomenon that happens usually under certain circumstances. Stress and fatigue are the main triggering factors associated with visual aura. This could happen also around menstrual cycle on women, some being affected before their menopause, some being impacted only after their menopause. Smoking is also a factor to consider, because the phenomenon is related to a short-term constriction of small blood vessels at the base of the neck, at the back of the head. Our visual cortex (where our brain interprets what eyes are seeing) is located just above this area. When vessels are restricted, there is a temporary lack of regular blood supply in the area. It triggers a kind of short-circuits neurologically speaking and the kaleidoscope images appear. It last for 10-15 up to 45 minutes. After that, there is an automatic release of chemical mediators, naturally produced by our system, that allows the vessels to dilate in order to restore the blood flow in the visual cortex. Images are fading away but vessel dilation is at that time related to the occurrence of a malaise and/or a migraine that can last for 24 up to 48 hours. Some patients are not feeling any headache at all — this is possible but most of the time there is certainly some nausea or malaise that follows such episode.
One thing to investigate, when this occurs on a frequent basis, is some misalignment of superior vertebrae of the spin. Some patients who are doing computer work for many hours every day, or patients who had sports minor injury around the neck can have a misalignment of the vertebrae. Blood vessels traveling there can be easily compressed leading to the visual aura phenomenon. In this case, headaches are rare.
Consequently, I would consult a physiotherapist or a chiropractor to make sure that everything is ok around the neck area and if this is the case, when the episodes are coming, take 1-2 Tylenol tabs to reduce the symptoms and the intensity of the following headaches. Alleviate stress and fatigue is easy to say but never easy task to do… but this can help. If you are smoking, please cease to smoke… this affects blood vessels and supply and could favour such occurrences.
Again, this is very spectacular but very benign. Your vision will never be permanently affected by this neither your neurological functions. Nothing wrong can happen from this anomaly. However, as I say to my patients, this is a warning sign of your nervous system telling you that it is time to relax a bit…
Be Zen!
Dr Langis Michaud, OD, MSc, FAAO (Dipl)
Associate Professor – U de M
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Right Eye is Blurry Even With New Prescription
Mike wrote:
I went to see an optometrist she gave me prescription-od.+2.50 cyl-0.75 axis055 os+2.50 cyl-1.00 axis 115 but only the right eye is very blurry I went back to tell her that, she said there nothing she can do and that she gave me the best prescription. It’s like walking with one eye. What can I do???? TKS
Dr Langis Michaud's response:
Dear Mike
If this is the first time that you notice this blurry vision on just one side this is certainly not usual. Your optometrist has to give you the reason why this eye is blurry. When someone is complaining about such an issue, it is ethically and professionally required to take all the steps necessary to find the exact cause of reduced visual acuity, especially when this is monocular. This could be related to a benign pathology but also to a not so benign cause. Your optometrist (or any other one) has to make a thorough assessment of the ocular health, including color vision testing, ocular motilities, visual fields, Amsler grid, intra-ocular pressure and fundus assessment under dilation (using drops to dilate the pupil in order to see all the retinal area). If these test were not all done, please consult again and ask for this. Or ask to be referred to someone who will be able to ass your condition and find a cause to your reduced visual acuity.
Good luck
Dr Langis Michaud, OD, MSc, FAAO (Dipl)
Associate Professor – U de M
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RGP Contact Lenses
Mihaela wrote:
Hi, I am interested in RGP lenses. Is it true that they provide crisp vision only when you look straight ahead? Is the vision blurred when you look in other directions or after you blink? Thank you.
Dr Langis Michaud's response:
Dear Mihaela
You are right to say that RGP provides a very crisp and sharp vision, especially if your refractive error is high or if you have a significant amount of astigmatism. If RGP lenses are fitted well, you will be able to see clearly everywhere because the lenses follow your eyes. There is a new generation of RGP lenses, called mini-scleral. They are as large as a soft lens, as comfortable as a soft lens but provides this crisp and clear visual acuity given by RGP ones. They do not move on the eye so there is no visual fluctuation. The problem is that not so many practitioners can handle these lenses and the learning curve to fit them is certainly there. If you are living near Waterloo, ask to have an appointment at University School of Optometry clinic. The same for Montreal in Quebec. Outside of that you can ask your optometrist if he or she is able to fit these lenses or if he knows who can do it in your area. As a last resource, email me and I’ll try to find someone reliable in your area.
Good luck
Dr Langis Michaud, OD, MSc, FAAO (Dipl)
Associate Professor – U de M
langis.michaud@umontreal.ca
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