Headaches and Palinopsia

[wyo327]

Perhaps this might be better asked in the Neuro forum but I thought I'd start here.

Over the post 3-4 months I've been getting bad headaches centered behind my right eyeball. While they aren't exception painful, they really don't respond to analgesics like Tylenol or Ibuprofen (at least not to the point
of full relief) and then tend to wax and wane over a period of up to 2-3 days and then go away.

Recently I started noticing slight 'trails' behind moving objects, mostly my hands when working on something, grabbing items off a table, open cupboards etc. From what I have read everyone experiences this to at least some degree and probably just doesn't notice it. Lately I've either BEGUN to notice it for whatever reason or it has actually gotten worse, I'm not sure.I can't recall noticing it before.

What is the actual diagnostic criteria for Palinopsia? I have so far been unable to find that information anywhere. The fact that I seem to be noticing these small 'trails' along with the recent bout of headaches centered behind my eye has me concerned.

It's my understanding that certain medications can sometimes cause visual field abnormalities. In particular I saw a few references to Lexapro as being a possible culprit. I have been on a low 5mg day dose of it along with 1mg Clonazepam at HS for about 4.5 years now for GAD with break thru Panic Attacks.

What should be my next step to figure out what's going on here? I guess if I had a frame of reference for how bad full blown Palinopsia really is, I could decide whether or not it was worth investigating with a Neuro or an Ophthalmologist.

Any suggestions would be most helpful, thanks!

[JohnHaganMD]

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[Lmnopeas]

How are your afterimages today? Headaches?

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

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[wyo327]

Ok, thank you Sir! New to this place so....

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

- means I've read the last posting and do not need to comment further.
JCH MD

[wyo327]

- ?

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

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[wyo327]

Thanks Doc,

So in all reality this is an EXTREMELY rare problem? That's what it sounds like to me.

You seem to be saying that the length of the trails are not so important, but the mere fact that I seem to be noticing them?

I was recently treated for conjuctivitis in my right eye with an antibiotic drop and while it took care of the 'gunky' eyelid part of it, I still have a persistent red 'ring' in the white part of my right eye. Makes me wonder I guess if it was perhaps a viral infection of the eye and not bacterial. I recently had a couple filings drilled out and the dentist just prior to the conjunctivitis and was getting fluid splashed in my eye from the drilling until I closed my eyes and kept them closed. A couple days later boom, conjunctivits.

I really appreciate you taking the time to to respond. I got an appointment with an Optometrist here (I live in a very rural area) but they can't see me until the 29th.

Cheers!

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

In my clinical practice in Kansas City I have never had a patient come in with that complaint. However since I've been answering questions on this internet forum there are perhaps 4-5 people that have that complaint. (the other thing that internet people get that I don't see in practice is "visual snow"). you can access previous discussion of palinopsia using the search feture.

I don't think the lengths of the tails/trails are as important as being aware of them. I'm sorry I can't tell you more but I have never taken care of a patient in my practicde with this problem.
JCH MD

[wyo327]

Dr. Hagan,

Thanks for your prompt reply.

How severe do the trails have to be to be called Palinopsia?

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

See  a neuroophthalmologist. Find onenear you at www.aao.org

JCH MD