Causes and risk factors
Scintillating scotomas are usually caused due to events that precede a migraine, typically a cortical spreading depression. Migraine has been attributed to several causes including genetics, imbalance of hormones, and the intake of certain food stuffs. Scintillating scotoma may also be caused by cardiovascular conditions.
Clinical presentation
The symptoms of scintillating scotoma begin before an attack of migraine in the ‘aura’ phase. The center of the visual field has a spot of flickering light. The patient may see flashes, shimmers, or zig-zag lines. The visual field in the area of a scintillating scotoma may also appear as a blank or blurred area. The spot slowly starts increasing in size. However, the visual field around the scotoma has normal vision. This scotoma eventually progresses to a classic migraine attack. Typical migraine symptoms include hemicrania (half-sided headache), nausea, and/or vomiting. Sometimes the scotoma resolves without culminating into a headache. All the symptoms of scintillating scotoma last for a maximum of an hour.
Investigations
The diagnosis of a scintillating scotoma can be made on the basis of the patient’s history.
Treatment
Since scintillating scotoma resolves spontaneously, no treatment is necessary. However, some patients may need medication to relieve the migraine.
Other modes of treatment
Homoeopathy has good scope in treating a scintillating scotoma.
When to contact a doctor
Contact a doctor as soon as you experience any loss of vision, especially when preceding a headache.
Systems involved
Ophthalmology
Organs involved
Eyes
