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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7750
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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What is the difference between ocular migraines and optic neuritis

Resolved Question:

What is the difference between ocular migraines and optic neuritis? Vision in my left eye will have little glowing worms flying around then within 5 minutes I lose total vision (totally black) for 5-15 minutes then it will fade back in and be fine for a while (anywhere from a day to month) It only happens in my left eye.
Submitted: 3 years ago.
Category: Eye
Expert:  Dr. Rick replied 3 years ago.

Dr. Rick :

Hi. I'm online and happy to answer your question today.

Dr. Rick :

Optic neuritis is inflammation of the optic nerve inside or behind your eyeball

Customer:

is that something that could be seen without any kind of enhancers (gadolinium)?

Dr. Rick :

do you mean optic neuritis?

Customer:

the inflammation of the optic nerve... is it something that can be identified without any enhancing dye?

Dr. Rick :

Optic neuritis can be seen by an ophthalmologist during an eye exam. There is a form called retrobulbar optic neuritis that can't be seen by the eye doctor. Usually this is a clinical diagnosis and MRI imaging is not done.

Dr. Rick :

However, to answer your question it would show up on MRI a lot better with gadolinium enhancement.

Dr. Rick :

The symptoms you discuss in your post are more consistent with a vascular problem.

Customer:

even if it is just one eye?

Dr. Rick :

yes. It would be, usually, just in one eye. You would need a complete eye exam by an ophthalmologist. After that, depending on what is found, you may need various degrees of examination of your carotid system, heart, great vessels etc.

Dr. Rick :

Your symptoms are not consistent with ocular migraines.

Dr. Rick :

are you still there?

Dr. Rick :

I guess you have stepped away from your computer.

Dr. Rick :

 


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Expert:  Dr. Rick replied 3 years ago.
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Expert:  Dr. Rick replied 3 years ago.
Let me know if you would like to discuss this further.
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7750
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Dr. Rick and other Eye Specialists are ready to help you
Customer: replied 3 years ago.

The neurologist that diagnosed me in 2006 said that it was ocular migraines... so his diagnosis was wrong?

Expert:  Dr. Rick replied 3 years ago.
It would be very unusual for you to go "lights out blind" in one eye from ocular migraines....I've never seen it our heard of a case like that.

Now, that being said, you are very young to have blood flow problems to your eye. If you had been in a car accident or been involved in major trauma you could have a tear in your carotid artery that could cause your symptoms....

All things being equal, I would be very hesitant to blame recurrent, total, temporary blindness in one eye on ocular migraines until I had done the billion-dollar workup to rule out all other causes.

Does this make sense to you?
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7750
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Dr. Rick and other Eye Specialists are ready to help you
Customer: replied 3 years ago.

In early 2006 I was hit in the head hard enough to cause me to have a deviated septum and a black eye for 2 weeks and that was about the time that I started noticing problems with my eyes

 

Customer: replied 3 years ago.

Would a tear in my carotid artery also cause double vision?

Expert:  Dr. Rick replied 3 years ago.
That is a good question.....If you had enough vascular compromise to involve not only your eye but one or more of your extraocular muscles I would think there would be symptoms involving other organ systems (brain, vestibular system etc)

A comprehensive vascular workup would give your the answer to this question.
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7750
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Dr. Rick and other Eye Specialists are ready to help you

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