Ocular Migraine - Vision Migraine

Ocular Migraines

A really interesting and concerning visual phenomenon that I see in my office is the manifestations of a vision migraine. Patient s typically present with a complaint of zig zag, prismatic, kaleidoscope vision lasting from 5-20 minutes. The rainbow pattern typically starts as a small zone and grows then breaks up. Usually no other symptoms occur. Patients deny head pain, nausea, and loss of memory, numbness, and speech problems. Commonly there is a bit of feeling washed out or a little bit confused right afterwards.

The cause is a migraine process that occurs in the back half of the brain where the vision center is located. In a typical (painful) migraine blood vessels that course up the neck into the front part of the brain are wrapped with nerve endings like a fish net stocking on a leg. When the blood vessels undergo a spasm, the nerve endings are stimulated and the pounding pain results. In the vision area, the blood vessels are not wrapped by nerves therefore, when they spasm, an equivalent occurs – the visual phenomenon (a pain substitute).

The cause of migraines (regular and visual type) may be stress, medications, and certain foods. There is treatment: avoiding the offending substance, and stress reduction.

Evaluation is very important. Similar symptoms could also occur in a stroke, detached retina, or aneurysm. My best advice is to seek professional help. Start at your eye doctor’s office for a good eye exam to look for any problems. If the eyes are OK then I recommend a neurology consultation for further evaluation and treatment options.

We can answer further questions at http://myneweyes.com/55901/index.html

Eyelid twitching "myokymia"

We have all had an episode of a jumping or twitching eyelid. It happens at the most unexpected moment. It can last minutes to hours. What can be done? Let's review some eye lid anatomy and function to help clarifty the issue. The eyelid is composed of three layers. The outer layer is the skin, the next inner layer is the muscle and the most inner layer against the eyeball is the conjunctiva. The eye muscle is a thin sheet of tissue which has fast fibers. This means with stimulation the muscle contracts very fast, hence it can produce a fast blink. The blink can occur involunatry or when you purposely close your eye. The nerve connetion from the brain to your eyelids is by cranial nerve number 7 (CN 7) Eyelids protect the eye and spead tears over the surface. Twitching occurs when the nerve signals to the eyelid muscles are disturbed. Usually the nerve muscle complex is over excited. To much rubbing or pulling of the eye lid, stimulants(coffee, Coke, no-dose, appetite suppresants) eyelid disesase, and allergies can all contribute. Rarely,other neurological problems start as twitching lids and can progress to severe facila spasms. For severe cases, I have been treating twitching lids in my office withsmall amounts of Botox. The results a fantastic, effective, and last 3-4 months. The prcedure takes about 5-10 minutes with no recovery time. Treatment costs range from 125-165. For more information visit www.myneweyes.com

Flashes and Floaters

Very common visual problems that people experience are flashes, floaters or a combination of each. To explain these issues in better detail, I first need to review eye anatomy. The eye is a hollow structure filled with fluids. The front part of the eye has aqueous fliuid. It reside behind the cornea and in front of the colored iris tissue in a space called the anterior chamber. The majority of the eye is filled with a thick protein fluid called vitreous. It reside behind the iris in the vitreous cavity. Vitreous is like "raw egg whites." Lining the internal vitreous cavity is the retina vision tissue, which is like wallpaper. Over time, the jello vitreous fluid begins to undergo chages - mostly shrinking and denaturaization. Small clumps of proten form. thse clumps cast a shadow obn the retina. Most apparent in bright light, agaist a plain background such as a white wall or blue sky. The floater shapes are varous: strings, strands, aomebas, bugs, nats, webs etc. These are usually benign but defintely pesky. Floaters which are big, very dark grey, or block a large portion of your vision or occur with flashes ( "arcs / sparks" ) require immediate attention! Why? Well it may indicate a tear or detachment to the retinal tissue. The floaters here may be from a bleed or loose retinal tissue. A dilated exam with a good search of the retina by a qualified eye doctor is the best course of action. If there is a small tear, a outpatient laser procedure can "spot weld" the loose retina back into place. A large tear or detachment may require major surgery. For more information please visit www.myneweyes.com

LASIK

Hello everyone! I would like to share some information about Custom LASIK. It seems to cause confusion so let me explain: Standard LASIK treatment for myopia, hyperopia, or astigmatism is based only on the prescription. For example if your eyeglass prescription is -2.00, the laser is set for and delivers -2.00. If you have an eyeglass prescription of +1.50, the laser is set and delivers +1.50. It’s that simple. Now a custom LASIK treatment starts with a custom “wavefront” scan. This eye scanning device will look for any odd or unique focusing abnormalities beyond a simple focus error. These odd or unique errors (high order aberrations) create optical distortion which if significant t enough and left uncorrected could detract from the final outcome. Not everyone has optical distortions of a significant magnitude, but the scan can find them and then reveal their % and hence give the surgeon the information to offer this custom treatment. So custom scans and custom treatments can out-perform the standard way and give you high definition vision. It can be worth the extra investment. To learn more about these procedures feel free to contact our practice at www.myneweyes.com or email me at myneweyes@hotmail.com

Dry eyes

Hey everyone! We just got a new device in the office for testing dry eye problems. Its a Tearlab analyzer. It samples a tiny amount of your tear fluid and a read out says if you have a dry eye problem. Its great! Easy and with accurate results. How do I know if I need testing? Well, the common complaints for dry eye disease or tear deficiency disease are: Gritty Scratchy Aches Fluctuation vision Vision that improves with forced blinking Spontaneous tearing especially in windy conditions. We also do other tests to work up dry eye problems along with the Tearlab device. Consider visiting my website for more information: www.myneweyes.com Sincerely, Dr. Chris Gualtieri