Prisms in both eyes due to exercise

[dk4210]

Hello All,
I am a 44 year old male and for the past 2 years I've been working out around lunch time. After my work out maybe once a month I would start seeing prisms in the bottom of my eye sight. I't so bad until I can't even read anything because the words looked jumbled.  It would last for about 20 - 30 minutes and go away, then the migraine headache would start.

3 months ago I started working out in the evening and did not have any issues. This week it all changed, I saw the prisms on Monday and last night was the first time that I saw the prisms during ( and not after) the workout. When I left the gym the prism got better, but I was unable to say or remember words. My wife got really concerned be cause I was so disoriented (Not really dizzy though)  and unable to connect my words.

I wish I could figure out what causes this and how to prevent it. I do know the common denominator is extreme exercise.

Anyone have any suggestions?

Thanks,
Dan

[John C Hagan III, MD, FACS, FAAO]

Dan,   it is extremely important you work with an neurologist or cardiologist (probably both) to make sure this is not an exercise related TIA (transient ischemic attack) which can be due to valvular heart disease, carotid disease, rhythm disturbance. You should do this immediately and not work out hard until you have a complete work up.

You also need to see an ophthalmologist Eye MD.  You can find one near you in USA at www.geteyesmart.org   At age 44 your reading difficulty could be accounted for by middle age eyes (presbyopia) and it is likely you need bifocals or reading glasses. However presbyopia would not cause the prism effects.

The absolute best thing this could be which can only be diagnosed after a complete medical, neurological and cardiac work up is exercise related ophthalmic  migraine.

This is extraordinarily important especially if you have high blood pressure, diabetes, smoke, are over-weight or have a family history of heart or neurological disease.  You're 44 and you are not bullet-proof anymore. If you have a family MD immediately call and have him/her refer you to a neurologist or cardiologist to begin what will be a complex work up.

Let us know how this turns out.

JCH MD

[dk4210]

Hi JCH MD,

Thanks for info, I don't have blood pressure or any heart issues as I know of and I have always been healthy. If it were any of the items that you listed "valvular heart disease, carotid disease, rhythm disturbance"  wouldn't I have those issues outside of exercise also?

Thanks,
Dan

[John C Hagan III, MD, FACS, FAAO]

Not necessarily.  If you have a family physician discuss in an office visit as soon as possible. Life after 40 is not like life before 40 and risks of all types of diseases increase significantly.

Think of all the men (and women) that drop dead of heart attacks in their 40's while thinking they are in good health.

Do not ignore this

JCH MD