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 disturbances can vary from person to person and typically resolve on their own after about half an hour. <br>Following this, you may experience a headache

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 within a few seconds, I would lose my vision completely.
After about thirty minutes, my vision would return to normal, and I could move around without any issues.
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 testing? Thank you for your response.

Dan Dan, 20~29 year old female. Ask Date: 2023/04/17

Dr. He Jianxian reply Ophthalmology

Hello Mr.
Egg: Your condition may be a precursor symptom of a migraine, starting with visual disturbances.
The visual disturbances can vary from person to person and typically resolve on their own after about half an hour.
Following this, you may experience a headache 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 get checked, you may need to consult a neurologist.
Dr.
He Jianxian, Department of Ophthalmology, Nantou Hospital.

Reply Date: 2023/04/17

More Info

Visual disturbances, such as the symptoms you described, can be concerning and warrant a thorough evaluation. Based on your history of experiencing black spots in your vision that expand and then resolve after a period, it is essential to consider several potential causes and the appropriate tests to investigate these symptoms further.

Possible Causes of Visual Disturbances
1. Ocular Migraines: One common cause of transient visual disturbances is ocular migraines. These can manifest as temporary visual loss or disturbances, such as seeing black spots or zigzag patterns. They typically resolve within 30 minutes to an hour and are often accompanied by a headache, although not always.

2. Retinal Issues: Conditions such as retinal detachment or retinal tears can cause sudden changes in vision, including the appearance of black spots or floaters. While you mentioned that previous examinations did not reveal any abnormalities, it is crucial to ensure that these conditions are ruled out, especially if the symptoms persist or worsen.

3. Vitreous Detachment: As we age, the vitreous gel in the eye can shrink and pull away from the retina, leading to floaters or flashes of light. This can sometimes be mistaken for more serious conditions, but it is often benign.

4. Neurological Causes: Given the recurrent nature of your symptoms, it is also important to consider central nervous system (CNS) issues. Conditions such as transient ischemic attacks (TIAs) or other neurological disorders can lead to visual disturbances. If there are any accompanying symptoms, such as headaches, dizziness, or changes in coordination, this would necessitate further investigation.

5. Systemic Conditions: Conditions such as hypertension, diabetes, or autoimmune diseases can also affect vision. If you have any risk factors for these conditions, it may be worth discussing them with your healthcare provider.

Recommended Tests
To further investigate your symptoms, the following tests may be recommended:
1. Comprehensive Eye Examination: A thorough eye exam by an ophthalmologist, including dilated fundus examination, can help assess the health of your retina and optic nerve.

2. Visual Field Testing: This test can help determine if there are any areas of vision loss that may indicate a more significant issue.

3. Optical Coherence Tomography (OCT): This imaging test provides detailed images of the retina and can help identify any structural changes that may be causing your symptoms.

4. Fluorescein Angiography: This test involves injecting a dye into your bloodstream to visualize the blood vessels in the retina, helping to identify any abnormalities.

5. Neurological Evaluation: If your eye examinations are normal, a referral to a neurologist may be warranted to rule out any CNS issues. This could include imaging studies like an MRI or CT scan of the brain.

Conclusion
Given your history of visual disturbances over the past ten years, it is essential to pursue a comprehensive evaluation to determine the underlying cause. While some causes may be benign, others could require prompt attention. It is advisable to consult with an ophthalmologist who can guide you through the necessary tests and evaluations based on your specific symptoms and history. Additionally, keeping a record of when these episodes occur, their duration, and any associated symptoms can be helpful for your healthcare provider in making a diagnosis.

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