Published: 28 July 2020

Have you ever seen a temporary black spot in your vision? How about jagged white lines? Something that looks like heat waves shimmering in your peripheral vision? If you have, you may have been experiencing what is known as an ocular migraine. Ocular migraines occur when blood vessels spasm in the visual center of the brain (the occipital lobe) or the retina. They can take on several different symptoms but typically last from a few minutes to an hour. They can take on either positive or negative visual symptoms, meaning they can produce what looks like a black blocked-out area in your vision (negative symptom), or they can produce visual symptoms that you see but know aren’t really there, like heat waves or jagged white lines that look almost like lightning streaks (positive symptoms). Some people do get a headache after the visual symptoms but most do not. They get the visual symptoms, which resolve on their own in under an hour, and then generally just feel slightly out of sorts after the episode but don’t get a significant headache. The majority of episodes last about 20 minutes but can go on for an hour. The hallmark of this problem is that once the visual phenomenon resolves the vision returns completely back to normal with no residual change or defect. If you have this happen for the first time it can be scary and it is a good idea to have a thorough eye exam by your eye doctor soon after the episode to be sure there is nothing else causing the problem. Many people who get ocular migraines tend to have them occur in clusters. They will have three or four episodes within a week and then may not have another one for several months or even years. There are some characteristics that raise your risk for ocular migraines. The biggest one is a personal history of having migraine headaches. Having a family history of migraines also raises your risk, as does a history of motion sickness. Although the symptoms can cause a great deal of anxiety, especially on the first occurrence, ocular migraines rarely cause any long-term problems and almost never require treatment as long as they are not accompanied by significant headaches. So if symptoms like this suddenly occur in your vision, try to remain calm, pull over if you are driving, and wait for them to go away. If they persist for longer than an hour, you should seek immediate medical attention. Article contributed by Dr. Brian Wnorowski, M.D.

Published: 22 July 2020

When your eyes feel itchy, it’s a natural reaction to want to rub, rub, rub. It temporarily relieves the itching, and frankly feels great when you’re doing it. Unknowingly, however, you are likely doing short-term – and in some cases long-term – damage to your eyes. Here are some of the detrimental effects that can result from eye rubbing. Worsening of ocular allergies: rubbing an eye inflamed from allergies starts a vicious cycle. During the allergic ocular response, a chemical called histamine is released from a cell called a mast cell. It is this release of histamine that starts the red, itchy, watery eyes associated with allergies. Rubbing the eyes releases more histamine, causing the eyes to become more inflamed, perpetuating the cycle. Risk of increased eye pressure: Putting pressure on the globe of the eye drastically increases intraocular pressure (IOP). While the effect is temporary, prolonged rubbing can increase your risk of developing glaucoma, a potentially blinding eye disease, especially if the IOP spikes high enough. Risk of retinal detachment: Any trauma to the eye can risk detaching the retina, the paper thin film that lines the back of the eye. Retinal detachment can present with symptoms such as seeing flashes, floaters, or a blacking out of the vision, but other times it can go undetected until it’s too late. Rubbing the eye causes unnecessary trauma to the globe, which can rupture the attachment of the retina to the back of the eye. Keratoconus: More and more research is starting to show that ocular allergies and eye rubbing is a risk factor for developing keratoconus, a disease in which the cornea starts to bow out and form a cone shape. While the exact cause is not known, research suggests that the contant rubbing weakens the collagen bonds that helps the cornea keep its shape, resulting in the abnormal corneal bowing. Nothing good comes from eye rubbing. If your eyes are itchy, you can try over-the-counter antihistamine drops, cool compresses (which slows histamine release), and allergy medications to stop the itch. Article contributed by Jonathan Gerard