Migraine-related visual-field loss with prolonged recovery

Migraine is a complex neurologic syndrome that commonly causes visual disturbances. Although migraine visual disturbances are usually transient in nature, persistent or permanent visual field defects may occur. When persistent visual-field loss is found-even if migraine is suspected-appropriate workup must be performed to rule out other causes of vision loss.

Two patients went to the eye clinic for comprehensive examination. One patient with symptomatic visual loss and one patient with asymptomatic visual loss were evaluated by serial ophthalmic examinations, neurologic/medical evaluations, computed tomography of the head, and laboratory results. Each patient reported a history consistent with migraine, and each demonstrated resolution of persistent visual-field defects that had been present longer than 10 days. Since ophthalmic, medical, laboratory, and imaging results did not identify and etiology other than migraine as the cause of the vision loss, it is likely that each case represents a specific form of complicated migraine.

Previous reports suggest that migraine-related visual deficits usually become permanent if persistent for more than 7 days. These reports demonstrate that visual recovery may still occur when field defects are present for 10 days or more.