Visual Disturbances: Causes and Recommended Tests

Q: Visual Disturbances: Causes and Recommended Tests

Hello Mr. <br>Egg： Your condition may be a precursor symptom of a migraine, starting with visual disturbances. <br>The visual anomalies can vary from person to person and typically resolve on their own after about half an hour. <br>Following this, you may experience headaches or

Visual impairment

Hello Doctor, I first experienced symptoms around the second year of junior high school, and it has been nearly ten years now.
The frequency of episodes is not high, approximately seven times over the past decade.
Initially, I noticed black spots in my vision that would gradually expand, and after a few seconds, I would completely lose sight.
After about thirty minutes, my vision would return to normal, and I could move around normally.
Since I was abroad for a long time, there were no abnormalities found during examinations.
What could this issue be, and what direction should I take for further evaluation? Thank you for your response.

Dan Dan, 20~29 year old female. Ask Date: 2023/04/16

Dr. He Jianxian reply Ophthalmology

Hello Mr.
Egg: Your condition may be a precursor symptom of a migraine, starting with visual disturbances.
The visual anomalies can vary from person to person and typically resolve on their own after about half an hour.
Following this, you may experience headaches or nausea, although some individuals may not have any further symptoms at all.
This could be due to abnormal electrical conduction in the brain.
Generally, there are no abnormalities in the eyes.
If you wish to have an examination, you may need to consult a neurologist.
Director He Jianxian, Department of Ophthalmology, Nantou Hospital.

Reply Date: 2023/04/16

More Info

Visual disturbances, such as the symptoms you describe, can be concerning and may arise from various underlying causes. Given your history of experiencing black spots in your vision that expand and then resolve after a period, it's essential to consider several potential explanations and the appropriate diagnostic steps.

Possible Causes of Visual Disturbances
1. Vitreous Detachment: As we age, the vitreous gel inside the eye can shrink and pull away from the retina, leading to symptoms like floaters or flashes of light. This condition is usually benign but can sometimes lead to more serious issues like retinal tears.

2. Retinal Issues: Conditions such as retinal tears or detachments can cause sudden changes in vision, including the appearance of black spots or shadows. These require immediate medical attention.

3. Migraine Aura: Some individuals experience visual disturbances as part of a migraine aura, which can include temporary vision loss or the appearance of zigzag patterns and spots. This typically resolves within an hour.

4. Transient Ischemic Attacks (TIAs): These are temporary episodes of neurological dysfunction caused by a lack of blood flow to the brain. They can manifest as visual disturbances, among other symptoms. TIAs are serious and warrant immediate medical evaluation.

5. Ocular Migraines: Similar to migraine auras, ocular migraines can cause temporary visual disturbances, including blind spots or flashes of light. These usually resolve quickly.

6. Other Neurological Conditions: Conditions affecting the central nervous system (CNS) can also lead to visual disturbances. This includes multiple sclerosis or other demyelinating diseases.

Recommended Tests and Evaluations
Given your symptoms and their episodic nature, here are some recommended steps for evaluation:
1. Comprehensive Eye Examination: Schedule an appointment with an ophthalmologist for a thorough eye exam. This should include a dilated fundus examination to assess the retina and vitreous for any abnormalities.

2. Visual Field Testing: This test can help determine if there are any blind spots or areas of vision loss that may indicate a retinal or neurological issue.

3. Optical Coherence Tomography (OCT): This imaging test provides detailed images of the retina and can help identify issues like macular degeneration or retinal tears.

4. Neurological Evaluation: If your eye exam does not reveal any ocular issues, consider consulting a neurologist. They may recommend imaging studies such as an MRI or CT scan to rule out any CNS-related problems.

5. Blood Tests: Depending on your medical history and symptoms, your doctor may recommend blood tests to check for conditions like diabetes, thyroid issues, or other metabolic disorders that could contribute to visual disturbances.

Conclusion
While the episodes you describe may not be frequent, they are significant enough to warrant a thorough investigation. It's crucial to address any potential underlying conditions early to prevent complications. Make sure to document your symptoms, including their duration, frequency, and any associated factors (like headaches or visual triggers), as this information can be invaluable during your evaluations. Seeking prompt medical attention will help ensure that you receive the appropriate care and peace of mind regarding your visual health.

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