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Are Migraineurs at increased risk for eye problems?

Migraineurs may be at a slightly higher risk of developing certain eye problems. Although this is not usually reason for concern, it is probably reason to be thoughtful and watchful of our vision as a part of our overall health picture.

Visual aura is the temporary visual manifestation of a neurological event (spreading cortical depression) and does not include damage to the eye. Other headache disorders such as Intracranial Hypertension (Pseudotumor Cerebri) include a risk of vision problems. One type of potential vision difficulty that has been mildly associated with Migraineurs is Glaucoma.

What is the Glaucoma connection?

Recent research done in Russia and announced at the American Academy of Ophthalmology — Middle East-Africa Council of Ophthalmology Joint Meeting in Chicago, noted a correlation between normal tension glaucoma and Migraine patients with night-time low blood pressure readings. Past research showed there may be some small increased risk of a different type of glaucoma called Open Angle Glaucoma for Migraine sufferers, but the link between Migraine and normal tension glaucoma is even stronger in this small study than open angle glaucoma.

Most types of glaucoma include the hallmark symptom of increased eye pressure. Normal tension glaucoma occurs when the pressure inside the eye remains within accepted ‘normal’ limits. Despite this ‘normal’ pressure, the nerve receives damage and researchers simply don’t know why. The condition can go by several names:

  • Normal pressure glaucoma
  • Low tension glaucoma
  • Normal tension glaucoma

Like Migraine, normal tension glaucoma is more prevalent in North American women than men.

The study:

Researchers compared the blood pressure of 12 patients with both Migraine and glaucoma. Eight of the patients had normal tension glaucoma. They compared these patients to 16 patients who had Migraine but no glaucoma. They looked at both daytime and nighttime readings of both systolic (first number) and diastolic (second number) blood pressure readings.

The researchers concluded that Migraine patients with low diastolic blood pressure at night may be at increased risk for glaucoma. The study was small however, and a larger look at the correlation would have greater impact.

More information:

The goal of the Glaucoma Research Foundation is to educate doctors and patients about glaucoma, including the benefits and drawbacks of keeping ocular pressure in the low to mid-range of what is usually considered ‘normal’ pressure.

Testing for normal tension glaucoma includes a visual examination with an ophthalmoscope. The optic nerve is identified and if it is noted to be abnormal appearing – cupped or discolored – it is reason for concern. Additional testing is necessary for a diagnosis though, with the best way to observe visual field defects being a Visual Field Test.

In a visual field test, the patient is asked to put their head in the opening of a special box. The inside of the box is full of tiny pinholes. During the test, a computer emits light thru the pinholes, one at a time. The patient looks only at one tiny spot in the center of the box and presses a button when and if they observe the light somewhere in their vision. At the end of the test, the computer gives the doctor a printed “map” of the patient’s field of vision for each eye. Deficits may not be noticed by the patient, but are easily seen on this “map”.

My story:

This research interests me because I am a Migraineur and I have visual field deficits of unknown origin. This was accidentally discovered when I was prescribed a medicine for my autoimmunity that could damage my vision. Before I began taking the medicine, I had an exhaustive eye examination including a visual field test where the deficits were easy to see once on paper.
Visual field deficits like mine can be caused by any of a number of different things — for instance, I also test positive for the genetics favoring Macular Degeneration which can affect my visual field. As yet, I do not have macular degeneration however.

At this point my optic nerve appears normal, and I hope to keep it that way. I was unable to stay on the potentially harmful medicine more than a few weeks, so it’s unlikely there was any damage as a result. I’m past due for another eye exam, and hopefully there will be no further changes. I do, however suffer from low blood pressure, especially at night. In fact, the normal readings I get are when my thyroid levels are elevated (I have Graves’ Disease), or I am in pain. My ocular pressure readings are normal, but on the top end of normal. So, the research interests me and I’ll probably take this study to my ophthalmologist and see what he says.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

  • matt009au
    3 years ago

    Morning Ellen,
    Just wondering how your eyes are travelling?
    I’ve been having eye issues for the last 5 years which have been put down to migraines. They are not sure why but the tests show damage. I think I’ll ask about normal tension glaucoma at my next follow up.
    The deterioration of my vision does seem to coincide with periods of intense migraine activity.
    Matt

  • Brooke H moderator
    3 years ago

    Hi Matt,

    Thanks for reaching out. We’re glad this article resonated with you. It sounds like following up with your medical provider is a good idea. It must be challenging to cope with vision decline along with intense migraines. Please know you’re not alone in this and we’re here for support when needed.

    Best,
    Brooke (Migraine.com team)

  • Kim Smith Lawson
    5 years ago

    Yep. Being watched for narrow angle glaucoma… sigh. You know, before I was diagnosed with hemiplegic migraine, I never, ever knew just what my migraineur family members had been going through. Such horror, especially when someone says : do you have a headache???

  • Janet Backstrom
    8 years ago

    Just getting over my worst ever migraine I’ve ever had. Two days of hellish pain and then the scary part last night I had lightening in the corners of my eyes. Has anybody else had this? I’ve made an appointment with opticians.

  • Janet Backstrom
    8 years ago

    Much better now, horrible couple of days. See you Friday.

  • Jane O' Donnell
    8 years ago

    Arrr hope ur ok Jan x

  • April Klepper
    8 years ago

    I’m a 57 year old woman diagnosed recently with low pressure glaucoma. I have suffered from migraines for over 20 years. I believe my migraines caused this awful disease for me. This is a scary diagnosis for anyone. All ages can get this. Get your eyes checked every year. Our eyes show us so much beauty! They are worth saving!

  • Teri Robert
    8 years ago

    April,
    I was diagnosed with low-tension glaucoma several years ago. The doctors theorize that it was caused by my Migraines because intraocular pressure is raised during a Migraine. I’m with you. We all need to have our eyes tested regularly, and that needs to include a visual fields test. That test is probably responsible for me still having some of my vision since the regular glaucoma test doesn’t catch low-tension glaucoma.

  • April Klepper
    8 years ago

    I an 57 years old & have been diagnosed with low pessure Glaucoma. I am a migraine sufferer of 20 years, I believe the cause of my glaucoma is due to the migraines. This is scar for any age! All ages can ghis awful disease.

  • Danita Villarreal Heersche
    8 years ago

    my left eye failed the field of vision test, I suffer from Hemipelgic Migraines.

  • Migraine.com
    8 years ago

    Don’t miss the discussion on the “Comment on Migraine.com” tab above!

  • Teri-Robert
    8 years ago

    Ellen,

    Thanks!

    When I was first diagnosed, there was a very tiny blind spot in my peripheral vision. Optometrist sent me to an ophthalmologist who saw what he called “changes” to the optic nerve, not exactly damage, but not “normal” either. He was concerned that there night be a neurological cause for the blind spot that he was missing, so he sent me to a neuro-ophthalmologist at Ohio State University. Between the two of them, they diagnosed normal-tension (also called low-tension) glaucoma.

    I started using eye drops, but the glaucoma progressed despite the drops, and I eventually had to have surgery to halt the progression.

    As for tips, I’d highly recommend that every Migraineur see an ophthalmologist once a year and have a visual fields test performed. The standard glaucoma test, which measures intraocular pressure, can’t detect this form of glaucoma.

    I’m VERY fortunate that I have a good optometrist who was doing the visual fields test and brought the defect to my attention. If the glaucoma hadn’t been diagnosed as early as it was, I could well be blind today. Glaucoma has to be fairly well progressed before we notice vision changes, and by then, it’s too late.

  • Ellen Schnakenberg author
    8 years ago

    Teri,

    I was so hoping you would comment on this! I didn’t know what type of glaucoma you had, but hoped maybe some of your experience would come in really handy…

    Was it only the visual field test that showed abnormalities when you were diagnosed? Were there any indications of nerve damage when they looked into your eye?

    As I said, I have some visual issues. They are getting worse. I had never been told of normal tension glaucoma though until I read the study I cited here.

    Do you have any tips to talk to your doctor or ophthalmologist about normal tension glaucoma?

  • Teri-Robert
    8 years ago

    Ellen,

    I’m SO glad you wrote about this! I have normal tension glaucoma, and have lost a lot of my vision; can no longer drive after dark because of it.

    I had glaucoma surgery at Ohio State University. The doctors there told me they think it may have been caused by my Migraines. Intraocular pressure is increased during Migraines, and I had Migraines for many years before we had abortive medications. The prevalence of Migraine in the general population is 12%. Among the patients being treated for normal tension glaucoma at OSU when I was a patient there, the prevalence was 40%.

    Had my optometrist not found a tiny blind spot in my peripheral vision when doing a visual fields test, the glaucoma might not have been diagnosed early enough to save any of my vision. I think all Migraineurs should be sure to have that visual fields test once a year.

    Teri

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