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Dr. Dan B.
Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3147
Experience:  Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
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Chronic Migraines and now.. severe right eye issue

Customer Question

I have had migraines accompanied with vision flashes and darkening and spots for the past 6 years, almost daily and in Dec my right eye had a seizure during a migraine after waking one morning. I went to the ER, told them my history with migraines and was given Hydrocodone pain medicine and sent home. Now 5 months almost to the day, my right eye just had another and the pain of my migraine and the eye itself is causing me concern.

Are my migraines causing damage to my eyes? Are these the onset of epileptic seizures?
Submitted: 3 years ago.
Category: Eye
Expert:  Dr. Dan B. replied 3 years ago.

Hello and thanks for your question. Please allow me to ask you a few questions so I can get a better idea of your circumstances.

 

Please describe for me in detail what you mean when you said you had a seizure in your right eye, during a migraine. If you would please describe everything about that episode (duration, manner of onset and resolution [slow or sudden onset/resolution], other associated symptoms, and in what way this seizure episode has been different from a regular migraine.

 

 

Customer: replied 3 years ago.
The 1st time (eye issue) was early morning, woke once briefly with a migraine, went back to sleep.. woke a few hours later and my migraine flared sharply and my right eye suddenly burned and ached. Over the next hour it went red all around on the white part and had such a terrible distracting pain of it's own not to mention I could not see out of it at all because it was watering and couldn't open. I went to the ER but had no insurance (my Medicare was 1 month from kicking in) so the doc put drops in my eye to see if it was lacerated but it was not. He said it had seizured from eye strain (I do use computer every day) and that it was eyeritis and prescribed hydrocodone.. but I had never had this happen before.. Now today after five months, for the second time, my eye has gone red and swollen and I notice it has happened again with a migraine. The two seem related and I have had migraines for so many years now with no real answers why... that same eye has had a black dot stationary in the vision for almost a year..
Expert:  Dr. Dan B. replied 3 years ago.

How long did that pain last? How long did the redness last? Were you light sensitive out of that eye when this happened (if so, was it more than you may have with a normal migraine)?

 

Has your eye ever gotten red and painful like this without a migraine?

 

Do you get skin rashes, joint pains or ulcers (maybe considered cold sores) in your mouth, nose, or genitalia?

Customer: replied 3 years ago.
The severe eye pain the first time lasted for three hours, that is from waking until getting a shot in the ER of painkiller but the redness and aching and burning actually lasted about four days, slowly fading as I took the hydrocodone and slept a lot during that time.
That eye was lightsensitive and couldn't focus or open much for the first day, but slowly got better.
My migraines themselves can go anywhere from 2 hrs to 3 days from experience. They are debilitating, making me unable to even rise from bed usually. I get nauseus and dizzy and my entire face seems to pulse and ache throbbingly. Sometimes it feels like the pain is in my skull, sometimes the front of my face or behind my eyes.
I have never had my eyes turn red or swell before the first time 5 months ago.. with or without a migraine. Never.
I have very sensitive skin on my face, once in awhile I feel like I have a sunburn and go a little pink across my cheeks and nose but no rashes.
No joint pain, no ulcers anywhere.

I should mention three things..
1) I have never had epilepsy nor anyone in my family -that I know of.
2) I have assumed my migraines have been partially due to a sensory sensitivity because I have high functioning autism and light and sound and movement are extra stimulating for me.
Customer: replied 3 years ago.
clicked reply before I could add 3.

3) My mother has a cataract forming in one eye and diagnosed with lupus. Am I genetically at risk for an eye problem from her?
Customer: replied 3 years ago.
Maybe my eye issue today can also help shed some light..

I woke up with a splitting migraine and my right eye burning and aching. I went and looked at it, and it was 'pink'.. lots of tiny red speckles across the white. I immediately went and took 1 whole hydrocodone (I took only halves the first time months ago) and went to sleep again. Woke up two hours later with a little less migraine pain and my eye thankfully less pink. Still both ache though... eye and head. This migraine feels like it is in the front of my face.. mainly eyes, temples and forehead area. Does this mean taking the hydrocodone may have lessened the pain of the migraine AND lessened the eye pink because the two are related somehow?
Expert:  Dr. Dan B. replied 3 years ago.

I apologize for all the questions, but your constellation of symptoms are a bit unusual.

 

When you get this redness and pain, does the vision actually worsen, or do you think it's just tears flooding your eye that cause the vision to worsen?

 

Do you see halos around lights and/or get nauseous when this happens?

 

Is it always the same side of the head and the same eye that have this happen?

Customer: replied 3 years ago.
I don't mind the questions, I just hope I can answer helpfully enough. I'd love to know what is going on with my own head and eye!

It's hard to tell about the quality of vision the first time because the eye wouldn't stop running.. even closed, the tears were nonstop til the painkiller shot kicked in. I think the eye was just too irritated by that point. This time (today, right now) the vision seems fine at the moment. and the eye feels achy but no tears. So I think it's the tears that made the vision difficult before.
The migraine seems to have most of my attention right now.. hurting even as I type (even though I just took half of a hydrocone and 1 excedrin migraine tablet with water about an hr ago)
The eye was pink earlier bit has calmed down quite a bit, from the painkiller?
I am highly nauseaus right now and during migraines or just before (sometimes a whole day beforehand) I will see halos or my entire vision darkens whn I look at one thing. It's hard to explain the darkening but there can be a light in the room and a person facing me. As I look at the person's face, the lighting goes wrong and they get dark while the light gets brighter, more vivid.. it makes them seem like the light is shadowing them. It's disorienting and blinking does not help, it fades slowly or if I go to a different light setting room. Blood pressure maybe?
Customer: replied 3 years ago.
the migraines as I said usually feel like they emanate from on the top of my skull or the front of my face.. the bones of my face, especially around the eyes and forehead. Right now my migraine is around my forehead and the bones around my eyes. My head feels like it's 'front heavy'.

The eye that is affected is only my right eye.. both times.
Expert:  Dr. Dan B. replied 3 years ago.
I'll be typing to you what I think is going on as you read this.
Expert:  Dr. Dan B. replied 3 years ago.

I think you are experiencing cluster headaches. Cluster headaches are thought to be a neurovascular headache phenomenon which share features with migraine headaches. The intermittent, severe, unilateral eye pain with intermittent redness and tearing associated with the headaches are fairly classic. They also tend to happen more towards the end of your sleep cycle associated with REM sleep.

 

Alcohol and tobacco have been known to trigger attacks as has extreme temperatures, watching TV, glare, seasonal allergies, and ironically having sex. For many persons, though, there are no triggers and they get them because they get them.

 

I would recommend having your doctor send you to see a neurologist. Because cluster headaches (as well as migraines) can be mimickers of serious neurological disease, and also because neurologists are the best trained to treat these, I think having an evaluation by a neurologist is important. It sounds as though it has affected your life enough already.

 

There are typically two categories of treatments available: prophylactic medicines to take everyday and abortive medicines to take once you feel like it is coming on.

 

Does this help shed a little more light on things?

 

Does this information help address your concerns? Does this make sense? Do you have any other concerns that I haven't addressed?

 

I am happy to be able to help you today. I will also be happy to answer any other questions until you have the information you need.

 

If you would be so kind, please help me get credit for my efforts in answering your questions and press the ACCEPT button for this encounter; this allows part of the funds that you have deposited to the website to be released for my efforts to assist you. This does not end our conversation, however-we can continue to discuss any of your concerns without further charges until you are satisfied.

 

Any positive feedback and/or bonus you may feel prompted to provide would be welcomed and is appreciated. Thanks for your inquiry!

 

My opinion is solely informative and does not constitute a formal medical opinion or recommendation. For a formal medical opinion and/or recommendation you must see an eye doctor.

Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3147
Experience: Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
Dr. Dan B. and other Eye Specialists are ready to help you
Customer: replied 3 years ago.
Question: Cluster headaches.. are those still considered migraines?
Just as a side note, the causes were an interesting list..
I do not smoke and I only drink maybe twice a year because alcohol upsets my stomach AND gives me a headache...! So there is no pleasure in drinking. I had no alcohol in the past week or more but I did have intercourse in the past 24 hours so reading that part was surprising.
Is it the blood pressure from these activities that causes the cluster headaches?

I have taken excedrin migraine for the past six years and even though I tried a ton of other brands of aspirin and nonaspirin, only excedrin migraine specifically helped to stop my pain.
The past year, I noticed times where even the excedrin migraine did NOT stop the pain and so it went on for days. I feel like the migraines are resisting the excedrin now.
It is true that this has affected my life drastically.. I cannot work consistently because of them and it's listed on my disability claim as one reason I cannot find and keep work because every job I have had got tired of me calling out because I was 'sick' too much.
I will take the advice and get seen by a neurologist if I can.. I have no current doctor yet to send me to anyone, but hope to very soon since I now have medicare.

I am going to leave you excellent feedback for all the time you have spent with me and the advice.. I actually think you've spent more time talking with me than any doctor I've spoken with so far. Thank you!
Expert:  Dr. Dan B. replied 3 years ago.
Cluster headaches are considered by some to be cousins or variants of migraines, but unfortunately we don't understand fully the pathology behind them. I wouldn't doubt it if changes in BP played a role in this, but we just don't know for sure.

As far as the excedrin, it must have been working well for you to continue to use it. Unfortunately, with OTC analgesics such as excedrin it is easy to develop rebound headaches once it us taken chronically. By that I mean that a headache can become worse or propagated if it is not regularly chased by the excedrin. This is also a very good reason to see the neurologist so they cam help you get on alternate medicines that are effective yet don't carry this effect.

Do your best to get into see a neurologist because I think your life will be drastically improved if you can get on the proper treatment for these.

Thank you very much for the kind words, evaluation and bonus. I'll still be here to help you with other ?'s regarding this if you need to and I'd also be interested in hearing how you do.

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