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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7745
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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Hi, I just ran on the elliptical for forty minutes. I have

Resolved Question:

Hi, I just ran on the elliptical for forty minutes. I have done this in the past without any complications but not regularly. I am now experiencing an intermittent flashing light in the top of my right eye. It is distressing. Some background: I am a migraine sufferer of five years, but I have NEVER gotten a visual aura before. Two years ago, I received PRK laser eye surgery on both eyes to correct my vision. My eyesight is 20/20, although I've always considered my right eye to be weaker than my left. My doctors said this is because it's dryer/still has more astigmatism than the other. Should I seek medical attention now? It's almost 11pm on a Saturday. Or would I be okay to wait until Monday? Thanks.
Submitted: 10 months ago.
Category: Eye
Expert:  Dr. Rick replied 10 months ago.

Dr. Rick :

Hi. I'm Dr. Rick and I have two decades of ophthalmology experience. I'm online and happy to answer your question today.

Dr. Rick :

There is no need to worry. You will be OK.

Dr. Rick :

Are you available to chat?

Customer:

Yes, hello, Dr. Rick

Dr. Rick :

Hi.

Dr. Rick :

What's going on now...how have things changed?

Customer:

I've never had this happen to my eye before. I began reading online, which is probably bad, and became afraid that it was a detached retina or something.

Customer:

No, it's still happening but less frequently

Dr. Rick :

I am a retina surgeon....and I do not believe you are having a retinal detachment.

Dr. Rick :

Were you seeing a shimmering light or flashes of light like a thunder storm?

Dr. Rick :

Also, have you noticed any floaters?

Customer:

It's more like I'm seeing a light out of the corner of my eye in places where there aren't any lights -- like on walls. And then it's gone.

Dr. Rick :

Are you still there?

Customer:

I'm not clear on what floaters are

Customer:

Also, I believe my eye is twitching a little

Dr. Rick :

looks like little bugs moving around in your vision...

Customer:

No, I don't have those

Dr. Rick :

twitching is nothing to worry about.

Dr. Rick :

Ok.

Customer:

There is blackness around the light

Dr. Rick :

Do not believe what Dr. Google told you: You are not having a retinal detachment.

Dr. Rick :

From what you have posted I am pretty sure you are experiencing your first visual migraine aura :(

Customer:

Oh, good, that makes me feel better. I've always been a little worried about this eye since it was weaker than the other one after PRK.

Dr. Rick :

Let me tell you a little bit about this:

Customer:

Oh no :(

Dr. Rick :

 


What you are describing is consistent with ocular migraines, a condition that I not only treat in my office but that I have been dealing with personally for decades.


A typical migraine headache starts with shimmering lights, often times they surround a blurry area or have dots or jaggedly lines associated with them. They tend to progressively increase in intensity and sometimes march across the visual field causing difficulty with reading. Many times this is then accompanied by nausea, irritability, sensitivity to bright lights and/or loud noises. After the onset of the lights (called scintillating scotomas), the headache typically starts and the light show tends to progressively go away.


Many people can have this migraine phenomenon WITHOUT the headache; it is called an acephalgic migraine. Some people even start having these late in life, or may have had a few much earlier in life that behaved differently and haven't had any for decades and then begin to have them; this is not uncommon. A family history of migraines is often present as well.


This is nothing to worry about. It is not a sign of a more serious underlying condition, brain tumor or anything like that. If the episodes become so frequent that they are bothersome there are medicines that can be used to decrease their frequency or stop an episode once it has started.


I, personally, have been suffering from this condition for almost 30 years. I almost never got the headaches after the visual effects.


There was one time, I was in the middle of a very delicate retina operation, when an attack started. After a few moments I lost most of my central vision and the inferior part of my visual field. I, calmly, removed my surgical instruments from the patients eye and we all sat around in the OR for 15 minutes until my vision returned. Other than that my ocular migraines have not really caused me any significant problems :o)

Dr. Rick :

I get them all the time...scary but not anything to worry about.

Dr. Rick :

Does this make sense to you?

Dr. Rick :

Do you have any other questions for me?

Customer:

Oh my goodness - your story sounds scary! I usually get basilar migraines -- where I get dizzy beforehand

Customer:

One more--

Dr. Rick :

sure...

Customer:

so it is possible that I may not get a headache following this episode?

Customer:

That it may just be the visual part?

Dr. Rick :

You might....or you might not. I used to get a headache a lot after the visual aura's when I was in my 20's, less so in my 30's and almost never now.

Dr. Rick :

Pregnancy and menopause tend to make the headaches less frequent in females.....

Customer:

Got it.

Dr. Rick :

Ok

Customer:

Thank you so much for your help!

Dr. Rick :

Have a good evening.

Dr. Rick :

I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. You may also receive an email survey after our chat, if you don’t feel that I have earned a “10” rating in all areas, please let me know what I can do to meet your expectations.

Thanks in advance,

Dr. Rick MD FACS

Dr. Rick :

My pleasure.

Customer:

You too -- take care

Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7745
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Dr. Rick and other Eye Specialists are ready to help you
Expert:  Dr. Rick replied 10 months ago.
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