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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 11313
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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My 16-year-old son, during school today, lost his peripheral

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My 16-year-old son, during school today, lost his peripheral vision on his right side for about 20 minutes. His vision came back, then a migraine headache ensued. He's had the migraine headache for about 6 hours now. We have tried Tylenol, migraine aspirin, and ibuprofen, and even 5mg of hydrocodone, yet his headache remained the same. He had some dinner, but after about 45 minutes he vomited. His nausea is gone now, but his migraine headache still persists.
Hi. I'm Dr. Rick and I have two decades of ophthalmology experience. I'm online and happy to answer your question today.
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)
If he has these episodes frequently you might want to have your son evaluated by a neurologist who specializes in migraines.
Does this make sense to you?
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
Customer: replied 3 years ago.

Thanks for answering! I do have a few more questions, though. How long does this headache typically last? He woke up this morning after sleeping overnight, and as soon as he tried to get out of bed, he said the headache was still there. It wasn't as strong, though, and it had moved from his left brain to the center. So how long will the headache still be hindering his ability to concentrate in school? And if the dose hydrocodone that was suitable for his weight didn't work, what might we try to help reduce the headache?

It is not uncommon for a migraine to last for days. That being said, if this is his first one, he really should be evaluated by his pediatrician.
A migraine prep with caffeine in it can be helpful, something like excedrin migraine are very good.
Does this make sense to you?
I hope your son feels better soon.
It's safe for you to press the positive feedback button now if you so desire. And, never fear, even after you press that button I don't go up in a puff of smoke -- I'll still be right here to continue helping you, but, as I do work for tips, I want to make sure you are happy before rating me.
Customer: replied 3 years ago.

This has happened before, but I don't think it has been quite as extreme. Also, one of the things we tried was that Excedrin (or at least something similar), and it didn't work. What could this mean? Thanks!

It means he has migraines :)
Sometimes OTC, even the Rx, stuff doesn't work. I've been there, done that.
No need to panic...and no need to keep your finger off of the "excellent" button ;)
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