[18F] Experiencing chronic migraines and increased eye floaters

Patient Description

An 18-year-old female has been experiencing chronic migraines for about a year, with symptoms including pulsating pain on the right side behind the eye, nausea with vomiting upon standing, and sensitivity to light. The severity of the migraines is rated as 7 out of 10, and they occur three to four times a week, often becoming more frequent during academic breaks. The patient has been prescribed sumatriptan 25mg as needed, which provides relief. Additionally, for the past 6 months, the patient has noticed an increase in eye floaters, described as black spots or cobweb-like lines across the vision, which have been worsening. There is no prior history of migraines or light sensitivity before these events. The patient's concern is heightened due to the progressive nature of the visual disturbances.

Arora's Assessment

What might be happening

Based on the information you've provided, here are a few possibilities:

Migraines: These are severe headaches that can cause throbbing pain, usually on one side of the head. They often come with nausea, vomiting, and extreme sensitivity to light and sound. Migraines can last for hours to days, and the pain can be so severe that it interferes with your daily activities.
- Treatment typically involves medications to help reduce the frequency and severity of the migraines. Your doctor has already prescribed sumatriptan, which is a common treatment for migraines.
Retinal Detachment: This is a serious condition where the retina pulls away from the back of the eye. Symptoms can include a sudden increase in floaters, flashes of light, and a curtain-like shadow over your field of vision. This is a medical emergency and requires immediate attention.
- Treatment typically involves surgery to reattach the retina.
Stress: Chronic stress can lead to a variety of physical symptoms, including migraines and visual disturbances. It's possible that the increased frequency of your migraines around times when you don't have breaks is related to increased stress levels.
- Treatment typically involves stress management techniques, such as relaxation exercises, physical activity, and a healthy diet.

What you can do

If you haven't already, make an appointment to see an eye specialist (ophthalmologist) as soon as possible. The sudden increase in floaters and the curtain-like shadow over your field of vision could be signs of a serious condition like retinal detachment, which requires immediate attention.
Continue taking your prescribed medication for migraines as directed by your doctor. If you find that it's not helping or your migraines are getting worse, let your doctor know.
Try to identify any potential triggers for your migraines, such as certain foods, stress, lack of sleep, or hormonal changes. Avoiding these triggers can help reduce the frequency and severity of your migraines.
Practice stress management techniques, such as deep breathing, yoga, or meditation. These can help reduce the frequency and severity of your migraines.

What you should look out for

Seek immediate medical attention if:

Your symptoms worsen or you develop new symptoms
You experience a sudden increase in the number of floaters or flashes of light in your vision
You notice a curtain-like shadow over your field of vision

Remember, while I strive to provide accurate information, I'm not a doctor. Always consult with a healthcare professional for a formal diagnosis and treatment.

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1 yr ago

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