Dr. ML - headaches and eye issues?

[sterl724]

I'm not a super frequent poster but have a "Dr. ML" question.

I am a chronic migraine sufferer. 90% of the time, it is connected to hormones. (I always get at least 1 in the days prior to my period.) I may get more than one the week before my cycle, but not usually back to back. The other 10% or stress or related to alcohol consumption.

I woke up with a migraine on Tuesday morning. Took prescription meds, mostly better. I always have a few hohrs of "headache hangover" after meds kick in, but for the most part felt ok. I was working on my computer a mid-morning and felt like one of my contacts was cloudy I guess? I felt like the vision in my left eye was weird - not quit "foggy" but off. My migraines always involves severe pain and pressure behind my left eye. I figured it was connected, swapped my contact and was fine.

Yesterday I woke up with another migraine. I rarely get them two days in a row. Took meds, was okay most of the day.

Today I woke up with yet another one, and it was rough. (FWIW, I don't think I've ever had migraines 3 days in a row in 20 years of getting them.) Meds finally kicked in and felt ok. But most of today I feel like my eyes are wierd. I have no idea how to describe it. My vision isn't blurry, no auras, no spots, no lack of vision, no redness or pain, none of the common eye issues. But my actual eyeballs just don't feel the same. Like one feels bigger maybe? Maybe different eye pressure? They both look normal, they don't hurt. I juat feel like when I look at something, my eyeballs feel different from each other.

I scheduled an appointment with ny doc but it isn't until next week. While I wait,anyone experience headaches and vision issues? I'm trying not to go down the rabbit hole on Google, but am over feeling like shit every morning.

[mcsangel2]

Do you have any thyroid issues you are aware of? I would encourage you to see an endocrinologist as soon as you can and get some bloodwork done and check your antibodies. And then I would go see a thyroid eye disease specialist (you can find one at thyroideyes.com), not the same as a regular opthamologist.

[picksthemusic]

Yeah, I'd see your provider about this to see if you need an endo, neuro, or ophthalmology referral.

Have you looked into Botox for your migraines?

Good luck!

[sterl724]

Apr 18, 2024 17:42:27 GMT -5 mcsangel2 said:

Do you have any thyroid issues you are aware of? I would encourage you to see an endocrinologist as soon as you can and get some bloodwork done and check your antibodies. And then I would go see a thyroid eye disease specialist (you can find one at thyroideyes.com), not the same as a regular opthamologist.

No known issues and no family history.
Thyroid issues were one of the common things Dr. Google was telling me. Any other common symptoms connected to thyroid? (Also, I'm almost 40. Don't know if age matters in connection to certain conditions.)

Anything specific I should ask or push my doc for, other than a blood work-up?

[timorousbeastie]

Can you get in with an eye doctor sooner than your other doctor (is that with your PCP or a neurologist?) appointment next week? I have chronic migraines as well, and both my neuro and my ophthalmologist have said that if I ever have vision changes with a migraine, they want to see me right away.

Hopefully it’s just a random new migraine symptom, but personally I’d want to get a doctor’s opinion ASAP.

[sterl724]

Apr 18, 2024 17:46:32 GMT -5 timorousbeastie said:

Can you get in with an eye doctor sooner than your other doctor (is that with your PCP or a neurologist?) appointment next week? I have chronic migraines as well, and both my neuro and my ophthalmologist have said that if I ever have vision changes with a migraine, they want to see me right away.

Hopefully it’s just a random new migraine symptom, but personally I’d want to get a doctor’s opinion ASAP.

My appt is with my primary - I've never seen a neuro. My eye doc is closed on Fridays, so I can call Monday. Not sure if they can get me in before Wedn.

[rubytue]

I’d try to get in with an ophthalmologist quickly. I’ve had a couple episodes of weird eye issues, and both times, there was a day or two of weird seeming eyes before I finally figured out it was full out double vision. The second time, I thought it was a second orbital pseudotumor (which is just benign swelling) but turned out to be a nerve palsy. FWIW, both had no known cause, and easily treated. Pseudo tumor had headaches for a few days. I thought it was a sinus infection.

[sterl724]

Is double vision hereditary? My dad has a history of double vision. (And migraines as well.)

[DotAndBuzz]

Are your pupils the same size and equally reactive to light? Like, when you shine a light in them one at a time, do they contract equally. Can you track someone's finger going up/down and side to side without moving your head (both eyes moving equally/in sync)? You'll need someone else to evaluate this for you, but if the answer to any of these is no, go to an ER.

If the eye pain gets worse, I'd definitely call the doctor and try to go to an urgent care affiliated with your office/hospital (not a random freestanding one). Or even call and see if they have any openings from cancellations in the morning if you want to be seen sooner. It may be worth doing that regardless, since this is an aberration from your "normal" migraine experience. It could be nothing, and just a change in how they impact you, but for neuro and eye stuff, I tend to err on the side of being seen instead of trying to wait it out.

Also, migraines can come in clusters. Mine do, and it SUCKS. I get them for up to 4 days in a row, and wake up with them. The eye thing could be an aura of sorts still linked to the migraine that hasn't quite gone away. Like, the meds are keeping it at bay, but they haven't totally kicked it. If it gets really bad and the meds don't work, you can go to the ER for an IV cocktail that will knock it out, but fair warning, it includes Benadryl, and IV Benadryl is a wild ride for about 15 seconds. 0 stars, do not recommend unless absolutely necessary, speaking from experience.

I hope you get some relief and some answers soon

[rubytue]

Apr 18, 2024 17:50:42 GMT -5 sterl724 said:

Apr 18, 2024 17:46:32 GMT -5 timorousbeastie said:

Can you get in with an eye doctor sooner than your other doctor (is that with your PCP or a neurologist?) appointment next week? I have chronic migraines as well, and both my neuro and my ophthalmologist have said that if I ever have vision changes with a migraine, they want to see me right away.

Hopefully it’s just a random new migraine symptom, but personally I’d want to get a doctor’s opinion ASAP.

My appt is with my primary - I've never seen a neuro. My eye doc is closed on Fridays, so I can call Monday. Not sure if they can get me in before Wedn.

I’d honestly call and see what the recording says to do. And over the weekend, if you start seeing vision changes, please go to the ER. I hate going to the ER (always feel I’m abusing it) but I’ve been chastised by doctors, on the double vision issues I’ve had in particular. 

[rubytue]

Apr 18, 2024 17:53:33 GMT -5 sterl724 said:

Is double vision hereditary? My dad has a history of double vision. (And migraines as well.)

Do you have double vision? That is ER worthy. 

Based on what I was told the times it happened, double vision is usually from a temporary nerve paralysis. Sometimes it’s congenital and sometimes not. 

im gonna post this, as it’s when the first issue happened. Turned out to be orbital pseudotumor. Was a pain in the ass to get diagnosed, because the urgent care place I went to sucked. pandce.proboards.com/thread/58675/when-er-followup-wednesday

[rubytue]

sterl724, any updates?

[lo]

Apr 18, 2024 17:54:50 GMT -5 DotAndBuzz said:

Are your pupils the same size and equally reactive to light? Like, when you shine a light in them one at a time, do they contract equally. Can you track someone's finger going up/down and side to side without moving your head (both eyes moving equally/in sync)? You'll need someone else to evaluate this for you, but if the answer to any of these is no, go to an ER.

If the eye pain gets worse, I'd definitely call the doctor and try to go to an urgent care affiliated with your office/hospital (not a random freestanding one). Or even call and see if they have any openings from cancellations in the morning if you want to be seen sooner. It may be worth doing that regardless, since this is an aberration from your "normal" migraine experience. It could be nothing, and just a change in how they impact you, but for neuro and eye stuff, I tend to err on the side of being seen instead of trying to wait it out.

Also, migraines can come in clusters. Mine do, and it SUCKS. I get them for up to 4 days in a row, and wake up with them. The eye thing could be an aura of sorts still linked to the migraine that hasn't quite gone away. Like, the meds are keeping it at bay, but they haven't totally kicked it. If it gets really bad and the meds don't work, you can go to the ER for an IV cocktail that will knock it out, but fair warning, it includes Benadryl, and IV Benadryl is a wild ride for about 15 seconds. 0 stars, do not recommend unless absolutely necessary, speaking from experience.

I hope you get some relief and some answers soon

Curious what you mean about a a wild ride with IV Benadryl? I had it once and it made me severely nauseous and I was dry heaving. I also get horrible cluster migraines, but have never had to go to hospital for one (knock on wood).

[DotAndBuzz]

Apr 22, 2024 9:50:56 GMT -5 lo said:

Apr 18, 2024 17:54:50 GMT -5 DotAndBuzz said:

Are your pupils the same size and equally reactive to light? Like, when you shine a light in them one at a time, do they contract equally. Can you track someone's finger going up/down and side to side without moving your head (both eyes moving equally/in sync)? You'll need someone else to evaluate this for you, but if the answer to any of these is no, go to an ER.

If the eye pain gets worse, I'd definitely call the doctor and try to go to an urgent care affiliated with your office/hospital (not a random freestanding one). Or even call and see if they have any openings from cancellations in the morning if you want to be seen sooner. It may be worth doing that regardless, since this is an aberration from your "normal" migraine experience. It could be nothing, and just a change in how they impact you, but for neuro and eye stuff, I tend to err on the side of being seen instead of trying to wait it out.

Also, migraines can come in clusters. Mine do, and it SUCKS. I get them for up to 4 days in a row, and wake up with them. The eye thing could be an aura of sorts still linked to the migraine that hasn't quite gone away. Like, the meds are keeping it at bay, but they haven't totally kicked it. If it gets really bad and the meds don't work, you can go to the ER for an IV cocktail that will knock it out, but fair warning, it includes Benadryl, and IV Benadryl is a wild ride for about 15 seconds. 0 stars, do not recommend unless absolutely necessary, speaking from experience.

I hope you get some relief and some answers soon

Curious what you mean about a a wild ride with IV Benadryl? I had it once and it made me severely nauseous and I was dry heaving. I also get horrible cluster migraines, but have never had to go to hospital for one (knock on wood).

It made me feel like I was going to die for about 15 seconds. Like, severe panic, nausea, heart pounding. It hit me super fast, and I wasn't prepared for any of it. Like, out of nowhere it hit, then felt like I was going to die, then I felt fine, exhausted, and basically passed out for 12 hours.