Headaches in optometric practice part 1 – migraine

The term migraine is used to describe a variety of primary headache conditions where there is recurrent moderate to severe headaches, often associated with a variety of autonomic-related symptoms. These include a visual aura and, because of this, optometrists are often consulted about migraine. Here are three cases seen where the underlying cause of the migraine was quite distinct.

Case 1: Acephalgic (silent) migraine

A 42-year-old myopic male (RG) had been experiencing ‘streaking of brake lights’ and a ghosting effect in the vertical plane when driving. This was noticeably worse at night, and becoming so intense that he had recently had to stop driving on a trip to Paris and ask his wife to take over. Following on from this visual sensation, he succumbed to a feeling of ‘very tired eyes.’ He admitted to being ‘a stressed individual’ and he believed the symptoms may be generated by stress mechanisms and bright lights.