Headaches in optometric practice part 7: migraine linked to hole in the heart

Thirty-six-year-old female patient Mrs AB attended the practice on two occasions in 2002 for an urgent appointment, having noticed a partial scotoma in her right inferior visual field. She had previously lost sight in her left eye due to a central retinal artery occlusion at the age of 23 with no obvious cause having been found. Since this episode, she was constantly anxious about her remaining vision.

She took no medication and her previous history included classic migraines. Following her left CRAO, she was investigated for hypercoagulability, which proved negative, although during her three successful pregnancies she was treated with clexane injections to prevent blood clots and thromboembolic episodes.