Have you ever suddenly seen a shimmering, ripple-like pattern in front of your eyes while you were sleeping? Like the air ripples when you look at a road in the sun, or like you're looking through a kaleidoscope? This experience can be a little scary. But don't worry. Today we're talking about a condition that affects many people, called scintillating scotoma.
What exactly is this scintillating scotoma?
Simply put, this is a dark spot in your vision that appears shiny or bright. In medical terms, we call a dark spot in your vision a "scotoma." "Scintillating" means shiny or bright. So the name comes from combining the two.
This condition usually lasts for a short period of time, such as five minutes, up to an hour. Sometimes it can last for several hours. Most often, the main cause of this is a migraine headache. However, it can also be caused by other changes in the brain or retina.
What shapes does this look like?
This can be seen differently by each person. Some people see it as shimmering, moving, rippled, pulsating, or wave-like patterns. There are several main patterns to this.
| The nature of the pattern | Description |
|---|---|
| Rings or arcs | They look like curved lines radiating from the center of your vision. They may be a complete circle, or they may be an arc like the letter C. These will gradually disappear. |
| Fortification patterns | These look like the teeth on the walls of an old castle. That is, they are lines that go in a zig-zag pattern. |
| Checkerboard pattern | A chessboard-like pattern of alternating black and white squares obstructs vision. |
What are the main reasons for this?
As we mentioned earlier, scintillating scotoma is most likely to occur due to two types of migraine:
1. Migraines with aura: Aura is a warning sign that precedes the onset of a migraine headache. It includes visual changes like these.
2. Retinal migraines or Ocular migraines: In this case, vision changes may occur in only one eye.
Think about it, this is how our vision works. What the eye sees is sent as signals from the retina to the brain. The brain interprets those signals and shows them to us as an image. When a migraine occurs, certain chemical and electrical changes occur in the brain, which disrupts this signaling system. That's when these flashing patterns appear.
However, this is not always due to migraines. Rarely, this symptom can also be caused by other, more serious conditions.
They are:
- Seizures: Sometimes these visual changes can occur before or during the onset of a seizure.
- Strokes and Transient Ischemic Attacks (TIAs): Scintillating Scotoma can also occur in these conditions, which are caused by reduced blood flow to the brain. This is what we should be most concerned about.
How is it treated?
The treatment for this depends on the underlying cause .
Since migraine is the most common cause, treating it can help control this condition. There are "rescue" medications that can be given to stop a migraine once it starts.
- Medications such as triptans .
- Drugs in the group called CGRP blockers .
- Painkillers called NSAIDs (Nonsteroidal anti-inflammatory medications) .
Your doctor will determine which of these treatments is best for you. Therefore, if you have these symptoms, it is very important to see a doctor and get proper advice.
What happens if left untreated?
This is a very important question.
If it is caused by a migraine, the visual disturbance called scintillating scotoma is temporary. It will go away after a while. However, the severe headache, nausea, vomiting, and inability to look at light that comes with a migraine can disrupt your entire day. Without treatment, all you can do is stay in a dark, quiet room and wait for it to pass. It can be a big disruption to your work and family life.
On the other hand, if this is a sign of a seizure, it is an important warning to you. It means you should stop what you are doing, get to a safe place, and call someone for help. If a seizure lasts longer than 5 minutes, or if another one occurs before you have fully recovered, it is a life-threatening emergency called Status Epilepticus .
Although rare, if this is a symptom of a stroke, delaying treatment can lead to permanent brain damage or even death. That's why it's essential to seek medical attention immediately if you experience something like this for the first time.
When should you see a doctor?
If you experience a scintillating scotoma like this for the first time in your life, consider it a medical emergency.
Because, no one except a doctor can tell whether this is a migraine or a more serious condition like paralysis. Therefore, if this happens for the first time, immediately go to the Emergency Department (ETU) of the nearest hospital.
If your doctor has already determined that you have migraines, talk to them about these symptoms. But if your migraines are different this time, or if they are more severe than usual, or if you have any concerns, don't hesitate to seek medical advice. When in doubt, it's best to seek medical advice.
Can you drive with scintillating scotoma?
Absolutely not. Driving while you have a scintillating scotoma is very dangerous. Losing even a small part of your vision can put you and others around you at risk. This dark spot usually grows gradually and can spread throughout your vision, so if you think it's a small spot and drive, it could become large and dangerous within minutes.
Take-Home Message
- Scintillating Scotoma is a dark spot with a shimmering, wavy pattern that appears before the eyes. It is often associated with migraines.
- If this is your first time experiencing something like this, it is an emergency. Go to a hospital's Emergency Department (ETU) immediately to make sure it is not a serious condition like a stroke.
- Do not drive under these conditions for any reason. It is very dangerous.
- If this is due to migraines, there are very effective treatments to control them. Talk to your doctor and get the treatment that's right for you.
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