Odd visual field disturbance

January 16, 2020 3:46 AM

Sometimes I have weird mixed-up vision - blurred/scrambled, but only in places - parts of my visual field come in & out of focus. It's like I can see some fragments of an overall scene but I can't fit them together into a coherent picture. It goes away after a few mins, when I rest and/or eat. Pretty sure it's linked in some way to low blood sugar. Do you have this? Should I be worried?

It happened most recently yesterday afternoon. I'd just cycled from Liverpool Street to Marylebone - about 30mins. I was using an electric bike, so it wasn't hard work. But I was hungry, and already planned to buy some food from M&S at Marylebone station before I got on my train.

Once I got into the shop, I realised I couldn't see properly. First, it felt like I was in a very very unfamiliar / spatially confusing location - I couldn't quite figure out how to move from one aisle to another. But I know the layout there, so I toughed it out & made my way to the fridges. Once there, it was very hard for me to see what was on the shelves - it took real work & concentration to read the labels & find what I was looking for. Different parts of my visual field were coming in & out of focus, seemingly at random. Same at the self-service checkout - was very hard for me to scan & pay. I wanted to ask for help, but I couldn't tell whether there was anyone nearby to ask. Back out in the station concourse, I had less blurring but no sense of scale or direction or the overall layout of the building. Objectively I knew how to get to my platform, but the place felt very unfamiliar - almost alien. By the time I sat down on the train, I was pretty much back to normal. Total duration maybe 10mins.

I've had similar experiences before, although this was a bad one - first time I could remember it happening was after a games lesson at school, when I sat in the changing room with a kind of tunnel vision (centre was clear, edges scrambled) that scared me for maybe 5mins before it went away. I wear glasses for reading & screen work, but aside from that my vision is usually good. No other symptoms, no medication. I don't feel faint or nauseous when it's happening - no headaches during or after. I'm 50yo male in good overall health. It's both eyes - my sense is that it's a brain thing, not an eye thing.

Is this familiar to you? How worried would you be if it happened?

posted by rd45 to Health & Fitness (7 answers total)

Best answer: So, yes, this sounds very familiar to me as a sufferer of visual migraines and migraines with aura. I have gotten them after physical exercise, sometimes not particularly grueling, and when another number of triggers are in play. I’m not a doctor and I can’t diagnose you. And you should see your GP ASAP because losing vision to the degree you report could be the sign of something very serious, like a detached retina or a TIA or stroke. The fact that you are no longer experiencing it is good. And it sounds very similar to visual migraines I have had in the past. But you shouldn’t assume it was a visual migraine and move on. Let a doctor or other medical professional weigh in!
posted by pazazygeek at 4:01 AM on January 16, 2020 [14 favorites]

Best answer: I too have similar symptoms as aura, but for cluster headaches. If I address them at that stage and am able to rest, they can frequently be aborted without progressing to actual headaches. I remember that the first time, I was in a bookstore and had been sitting down reading for a long time but then I stood up and couldn't read the shelved titles unless I got really close and went word-by-word like someone just learning, then I took refuge in the restroom and didn't recognize myself in the mirror because my vision was so distorted, though logically I knew it was me. I got a ride to the hospital and an MRI (it'd have been a CT but I was pregnant), by which point the migraine/headache symptoms were becoming more obvious and the neurologist cheerfully told me it wasn't a stroke because it'd gotten better over the course of mere hours and without treatment. But they certainly took it all very seriously and wanted me to be there getting care.

For me, in the years since, the keto diet has been massively helpful, which seems to be in the realm of your blood sugar hypothesis. But talk to a doctor.
posted by teremala at 4:41 AM on January 16, 2020 [2 favorites]

Please do go to a doctor but anecdata - something similar has happened to me twice and it’s very disconcerting. I used ‘scintillating scotoma’ as a search phrase - I learned it from an Oliver sacks book. Good luck with the GP!
posted by mgrrl at 4:44 AM on January 16, 2020 [2 favorites]

Yep, nthing that those are migraine scotomata. Mine are almost always headache prodrome, but my brother gets just the scotoma, no headache after. Mine are occasionally accompanied by aphasia, where I can't speak coherently. Reading is almost always difficult and sometimes impossible. Occasionally understanding spoken language is slowed to the point where I have to turn off the radio because I'm missing every other sentence. It's tough when you have to interact or do tasks more complicated than, say, walking to the bedroom and getting under the covers, but it goes away quickly. You might hit up a neurologist just to get your baseline, in case your symptoms worsen/change, or in case they find out more about migraine. I keep waiting for the science and standard of care to surge forward because the link between migraine and stroke is not comfy to think about.
posted by Don Pepino at 6:10 AM on January 16, 2020 [4 favorites]

My visual auras before/during migraine are very similar. Echoing everyone else that you should get this checked out by a doctor to be certain.
posted by hurdy gurdy girl at 7:56 AM on January 16, 2020 [1 favorite]

Best answer: I, too, am one of the many people who had visual migraines for years (in the absence of any headache or pain) before realizing what was going on while thumbing through the illustrated plates in an Oliver Sacks book (just like Don Pepino!). Also, a couple of years ago, I developed central serous chorioretinopathy that distorts my vision, but in not-so-transient ways. What's different in your situation, though, is the feeling of spatial confusion. That definitely merits a quick chat with a doctor, if for no other reason than to have this logged in your record for future consideration. Not to instill panic, but you may have experienced a transient ischemic attack (I had one when I was 25 and haven't had one since). It's worth discussion with a GP. I wouldn't go to an emergency room, but I would call today and see if you can get a quick phone chat with your doctor or a PA today. (Edited to add: I'm not a physician, but I'm a toxicologist working in a clinical setting.)
posted by late afternoon dreaming hotel at 9:31 AM on January 16, 2020 [2 favorites]

Response by poster: Thank you for all answers. I visited my GP this morning & as a precaution I now have a referral to TIA clinic at the local teaching hospital.
posted by rd45 at 3:21 AM on January 17, 2020 [3 favorites]