Scintillating Scotoma, you are not familiar with it, are you?
Visual aura or scintillating scotoma is not blurry, it is a transient or longstanding visual perceptual disturbance experienced with a migraine or seizure.
A crescent of stimulating zigzags or other geometric patterns that slowly advances to the edge of a visual field. The scintillations melt into the background to the physiological blind spot.
That’s when you know that you might be experiencing scintillating scotoma.
Scintillating scotoma definition is the blurring of vision with the sensation of a luminous appearance before the eyes. As mentioned, it may appear to be a zigzag or wall-like outline. Scintillating scotoma is also referred as teichopsia or a visual migraine, it is the most common visual aura prior to having a migraine. The slowly expanding area of visual loss with a stimulating, jagged border that can last up to 20 minutes and then goes back to a normal vision, can occur acephalgically (scintillating scotoma without a headache).
Scintillating scotoma is often confused with an ocular migraine, the pain originates from the eyeball or socket. The aura may have one symptom or a succession of visual disturbances.
And you know what?
Scintillating scotomas without pain most likely to occur at the age of 50. Most of the younger people, their visual aura is followed by a headache. In women, the transition is associated with their hormonal changes (or menopause), however, older men experience fewer headaches after auras.
However, triggers of the aura may vary from one individual to another.
Questions Having to Do With Scintillating Scotoma
What is the cause of scintillating scotoma?
It is not in the eyes or any component of the eyes such as the retina. The scintillating scotoma can be ‘seen’ with the eyes closed. There is no accepted cause of scintillating scotoma. Migraine is caused by abnormal brain activity, which can be triggered by a number of factors.(3)
What is a scintillating scotoma?
- What causes a scotoma?
Common causes of scotomata include demyelinating disease such as multiple sclerosis (retrobulbar neuritis), damage to nerve fiber layer in the retina (seen as cotton wool spots) due to hypertension, toxic substances such as methyl alcohol, ethambutol and quinine, nutritional deficiencies, vascular blockages either…(5)
How long do visual auras last?
Auras may be present without a headache, especially in older migraineurs, and rarely in non- migraine headache disorders. Although, the amount of time it takes for an aura to develop varies, the aura symptoms usually last from 5 minutes to 1 hour.(6)
Is an ocular migraine serious?
Symptoms are temporary and an ocular migraine is not considered a seriouscondition. Ocular migraine is sometimes confused with retinal migraine, but they are two distinct conditions. A retinal migraine is rare and affects only one eye. Loss of vision in one eye can be a symptom of a more serious medical issue.(7)
What does it mean when you have kaleidoscope vision?
It’s caused by the same changes in your brain chemistry, blood vessels or nerve excitability that cause regular migraines, only it’s taking place in your retina or in areas of your brain associated with eyesight. “You may experience flashing lights, wavy lines going through your vision or actual blind spots.(8)
Understanding Scintillating Scotoma
You start to worry.
Physical examination is the initial assessment to diagnose a scintillating scotoma. The medical tests used to detect the disorder, such as Amsler grid; perimetry; visual field test; and horizontal eccentricity.
The abnormal functioning of the occipital cortex at the back of the brain, not in the eyes. Normal central vision may return several minutes before the scotoma disappears from peripheral vision.
Annoying, isn’t it?
It is clearly and without any doubt, that the black spot you lately notice whenever you look at something or someone.
In Greek, the word scotoma means “darkness”. Scotoma in the medical field is a concealed region in the field of vision. People who are suffering from scintillating scotoma notices a dark spot or crescent of stimulating zigzags or geometric patterns that slowly advances to the edge of the visual field.
Scotomas can be characterized by one or more dark or light areas or blurred regions in the visual field. These people may also suffer from an increased requirement of greater illumination and contrast when reading and may experience difficulties in perceiving colors.
Scintillating scotoma begins as a spot of flickering light near or in the center of the visual field that can prevent vision within the scotoma area. The bright flickering light obstructs the normal vision, one or more shimmering arcs of white or colored flashing lights can be seen. It then gradually extends outward from the initial spot. The scotoma area may expand to completely occupy one half of the visual area, or it may be bilateral. It may occur as an isolated symptom without a headache in an acephalgic migraine
And what’s worse?
Majority of the people who suffer from scotoma experience persistent black spots or dark region. The disorder may give the sufferers a difficulty to identify the people they know by their physical attributes.
In pregnant women, scintillating scotoma manifests or is an early symptom of severe preeclampsia. It can arise due to the elevated intracranial pressure that can lead to malignant hypertension.
Cortical spreading depression, a wave of electrophysiological hyperactivity followed by a wave of inhibition, it is a pattern of changes in the behavior of the nerves in the brain during a migraine, is the common cause of scintillating scotoma. A migraine is caused by hormones, the influence of the genes, stress, or from a variety of food.
Although, the scintillating scotoma is caused by a variety of factors. It can be a result of a corrective surgical operation, or from an ocular infection that has left a scar. Glaucoma; obstructed retinal veins and optic nerve; stroke or a brain injury; side effects of high blood pressure and multiple sclerosis; serious vitamin deficiency; poor nutrition; and toxic substances. Scotomas from tumors or problems from the pituitary gland are less common, it can compress the optic nerve or impede the blood supply. However, they are curable or reversible by operations.
Patients with scintillating scotoma can keep a diary on which the episodes occur, and a small sketch of anomaly that may vary between episodes.
Scintillating Scotoma Pain
A person’s daily life will be drastically affected by the loss of vision.
You experience at least 5 headache attacks in a span of 4 to 72 hours, and the headache must have at least two of the following characteristics:
- The headaches have a unilateral location
- Pulsating quality
- Moderate or severe pain intensity
- Aggravation by or causing avoidance of routine physical activity
And during a headache, you can experience one of these symptoms:
- Nausea and/or vomiting
- Photophobia and/or phonophobia
Your ability to do the simple activities of daily living is compromised— your ability to read, mobilize, and watch the television becomes difficult. The pain intensity can range from moderate to severe and intensifies with movement or physical activities. Some sufferers lie quietly in a dark room, and it subsides gradually within a day or after a sleep.
The symptoms of scintillating scotoma appear gradually over 5 to 20 minutes, and last fewer than 60 that can lead to a classic migraine with aura, or an acephalgic migraine. Scintillating scotoma is seen as an early symptom that indicates a migraine to scintillating scotoma without a migraine
The migraine aura is a complex neurologic symptom that follows or accompanies the headache phase. It can be a combination of visual, sensory, or motor symptoms. Negative visual phenomena or negative scotoma is common during aura, the sufferer may experience homonymous hemianopia or quadrantic field of defects; central scotomas; tunnel vision; altitudinal visual defects; and complete blindness. Scintillating scotoma is the most common positive visual phenomena.
Scintillating Scotoma Prevention
A proper medical treatment to prevent the enlargement of the dark spot in the eye, and address the underlying cause of the development of scotoma.
Scintillating scotoma may also be a result of stress and fatigue. Help yourself by:
- Managing your stress levels. Meditate, go for long walks, do yoga or whatever relaxation technique suits for you.
- Eating a balanced diet and nutritious meal. Monitor your consumption of coffee, caffeinated drinks, alcohol, and food high in preservatives.
- Avoiding long hours facing the computer, take frequent breaks. Do the 20-20 rule, every 20 minutes, look away from the computer and focus on something 20 feet away from you.
- Doing regular exercises three times a week. Exercise can reduce the amount of pain from migraines, although it can never directly hinder a migraine.
- Paying attention to your food consumption. There are foods that can trigger migraines.
- Having an adequate sleep, and religiously follow a sleep routine. Wake up early at the same time each morning.
- Staying away from a loud environment, use hearing protection.
Enough sleep can relieve strain in the eye and restore good vision. Meanwhile, dietary habits also play an important role in migraine control and visual auras. Thus, monitor your consumption of coffee, caffeinated drinks, alcohol, and food high in preservatives. It is recommended to have a balanced diet that can supply essential nutrients, such as carotenoid oxidants, vitamins A and C, and dietary minerals.
However, if these auras is an effect of an underlying condition, it is best to consult a physician to better determine the prevention and cure of the condition.
Scintillating Scotoma Treatment
A scintillating scotoma can trigger pain within the eyeball, it causes flickering of lights and spots. Headaches will then be experienced, it can cause discomfort, nausea, and vomiting. The headache episode after experiencing scotoma can be eased with medications. Without any doubt, migraines are debilitating, that is why the right treatment options for scintillating scotoma should be found.
In the past there has been little that could be done by way of treatment for a scotoma, however, research into the plasticity connections of the brain and how they can be renewed is showing a great promise.
Advanced research in neuroplasticity and the ability of the brain to develop and heal has led to effective means of the rehabilitation and treatment of vision. New research includes drug trials and both radiation therapy or radiosurgery.
Good for you.
After the scintillating scotoma has been diagnosed, the underlying cause is determined by the physician. By there, the physician has developed a proper treatment option. It is risky to manage the underlying cause and to prevent further damage to the eye.
Vision restoration therapy works by stimulating the brain in precise and consistent ways. Quality of life is improved with this therapy, there are significant improvements in their vision.
NeuroEyeCoach is a therapy designed to re-train the ability of the person to scan the environment, re-integrate the left and right vision to improve the visual field.
Vision restoration therapy(1) focuses on the restoration of the lost vision, meanwhile, the NeuroEyeCoach tries to make the most out of the remaining vision.
Eye exercises can cope up with the condition, it can help them use their eyes in abnormal methods to compensate for the loss of vision. There is equipment being manufactured and distributed that can promote vision treatment systems that can treat scotoma. However, the credibility of the equipment has not been properly evaluated and established.
Now that’s a problem!
Most of the cases of scotoma are not curable. However, it is still a need to seek treatment from an ophthalmologist in the evidence of the occurrence of the scotoma. Be sure to change your lifestyle.
Scintillating Scotoma Rehabilitation
How do you find your blind spot?
Stand a foot away from a mirror, close your left eye, and stare at your nose, eyebrow or mouth. As you look straight at the features that are farther from your eye, you notice that the details of your eyes become less distinct.
Scotoma located at the outer edges of the vision does not cause severe vision problems. If the scotoma is located at the central vision, it cannot be treated or corrected with glasses, contact lenses, or surgery. However, there are aids you can use depending on the condition of your scotoma(2). These tools are:
- Phone keypads and watch faces are in a large-font mode.
- Filters to reduce glare on the computer screens.
- Talking clock or scales.
- Audiobooks, magazines, newspapers, or machines that read the printed material aloud in a computer voice.
- Using a large-type printed books, or changing the font size in an eReader
- Personal computer hardware, such as lighted keyboards, large type, and software that magnifies screens and converts text to speech for both computers and phone mobiles.
- Magnifying eyeglasses, handheld magnifiers, or stand magnifiers to enlarge objects or reading materials.
Regular checkups from an ophthalmologist are important.
Rehabilitation does not only limits to the eye movements, but also you need to rehabilitate your way of living. Protect your eyes by using sunglasses. Do not smoke. Stay at a healthy weight and limit your consumption of coffee, alcohol, and caffeinated drinks.
Scintillating scotoma usually presents a migraine with aura. The condition is usually caused by stress, and it could be a result. Suitable rehabilitative measures, treatments, and prevention should be chosen after a thorough assessment of the visual impairment. The length of how long you go between visual examinations can detect visual problems with no symptoms.
Indeed, scotomas are difficult. It is a result of lesions that greatly affect the pathway of the visual tract. People may need to be informed that scotoma has devastating effects, a prompt assessment and treatment should be done to preserve eyesight.
If you suspect that you are exhibiting the symptoms of scotoma, consult to an ophthalmologist. Seek optical care to give you an immediate and preventive measure to help you recover from the condition and the symptoms.
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