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"Opthalmic Migraine," zig-zag lines, eye doctor or regular physician?

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Question: "Opthalmic Migraine," zig-zag lines, eye doctor or regular physician?

Answer:

Full Question:

Hi. I was looking to understand some symptoms that I have had and I came across an article on ophthalmic migraine. This sounds very much like what I am experiencing, but the symptoms are not discussed very thoroughly. I do have the "zig zag" lines, however, they are in both eyes and they appear in a half circle. Does this sound like a symptom of ophthalmic migraine? This has happened twice and the first time, it was followed by a pretty bad headache, not worse than any others I have had in the past. This time, there was no headache with it. I did take an aspirin to deter that, though. I did a search on this topic and none of them go into any more detail on the shape or size of the "zig zag" lines that may occur. I hope I have given enough information and followed the guidelines. I do intend on seeing a doctor about this, but don't know if I should go to an eye doctor or a regular physician. Thanks, Jennifer
 

Answer:

Dear Jennifer;

This is a somewhat difficult question to answer. Technically, there is no such diagnosis if you go by the International Headache Society's Guidelines for diagnosis and classification of headache disorders. When doctors assign a diagnosis not in the IHS Guidelines, it makes it difficult to comment.

In our experience, most people who think they have "opthalmic migraine" turn out to actually have Migraine with aura. They have some of the visual symptoms of the aura phase of the Migraine attack and often some other symptoms of a Migraine attack, but don't always experience the headache phase of the attack. Such Migraines, when treated by someone following the IHS Guidelines would generally be classified as Migraine with aura and described as "acephalgic," which means without headache. The visual symptoms can very a great deal from person to person. Starting out with your doctor is probably a good starting point. He may want you to see an ophthalmologist for an exam to rule out any eye problems, but Migraine needs to be treated by your doctor.

If you want to see more information on the phases of a Migraine attack and the associated symptoms, see:

    Anatomy of a Migraine
    When many people think “migraine” they think only of the pain of migraine. In reality, a migraine episode consists of far more. The typical migraine episode actually consists of four parts, referred to as phases or components.

Good luck,
Teri Robert and John Claude Krusz

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Published January 16, 2006

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