New Year’s Eve, I was working at home before going out to dinner. Probably due to the workout of working t home, I started feeling kind of weird. Having already being diagnosed with and being pharmaceutically treated for high blood pressure, I felt that is was high just from a feeling that I get. I went out to dinner and started having cloudy/blurred vision in my right eye. Later a left sided headache started that would not go away and fearing a stroke or something was taking place we were off the the ER as the fireworks were going off at midnight. 4 1/2 hours later, they diagnosed with high blood pressure and blamed it on my body needing a change of prescription. An EKG showed no irregularities. They prescribed perkocet for my pain and sent me on my way. The headache eased with the perkocet but there still remains a slight pressure in my left side felt in my eye and ear. Little pings of pain still happen on the left side of my head. I saw my Dr. Tuesday and was prescribed a different version of the Benicar that was previously prescribed. He gave me a supplemental BP med Metroprolol to take with the Benicar.I do not smoke or drink but know that I’m physically out of shape somewhat. I’m scheduled for a CT scan this Friday but wanted your thoughts.
Doctor Joshua’s Answer:
Obviously I have a very limited medical history to work from (I don’t even know your age, sex, previous illnesses, other medications, or the blood pressure measurements here) so I’m not going to make any specific comment on your case, but I’ll outline some basic principles that would be generally applicable. I encourage you to follow your own doctor’s orders.
Temporary loss of vision in one eye can be caused by a blood clot or other embolus (embolus means basically anything that can block a blood vessel). This is called amaurosis fugax. This is however nearly always painless so if a patient complains of headache, it’s somewhat unlikely that there has been a clot.
Temporary vision disturbance followed by a headache (the vision disturbance resolving at around the time the headache starts) can be, and often is, migraine. If there is a loss of vision on one side, this is called hemianopic migraine. This does not however occur in one eye, but rather on one side of the visual field. It’s easy to subjectively confuse vision loss on one side of the visual field with vision loss in one eye.
Blurred vision, cloudy vision, colorful shapes, shimmering light, sensitivity to light, zig-zag or saw-edge shapes, blind spots commonly occur in migraine just before the headache begins. Even if you don’t have a history of migraine, you can still have a migraine attack.
Migraine is by far the most common cause of vision disturbances in the general population. Headache is nearly always associated with the vision disturbance.
Loss of vision in one eye can also be caused by a number of other causes, and is always cause for immediate medical attention.
High blood pressure can provoke headaches. High blood pressure is also a risk factor for stroke and other serious complications, so it’s good to monitor the blood pressure and adjust the medication as needed.
Continued pain on the left side of head after this attack warrant a head CT or MRI and a consultation with a neurologist.
These are just briefly some of the things your doctor will need to take into consideration when addressing your symptoms. It’s great that you do not smoke, but I encourage you to increase physical exercise - getting in shape is just about the best thing one can do to lower one’s blood pressure and reduce other health risks.
Let us know how things turn out!
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