migraines

[Boomer46]

I had cataract removal surgery over a year ago with premium bifocal implants via laser. I've had occasional migraines since then but has come to daily occurrences since June 2022 (most of pain is behind left eye). I've seen my ophthalmologist twice since surgery and she says I have 20/20 vision with nothing wrong. I'm currently seeing a neurologist and he has prescribed Nortriptyline for preventative (which hasn't helped) and Rizatriptan to get rid of migraine. I also get neck soreness and most of pain is behind left eye. I can trigger a migraine by just reading text from my computer. Any thoughts/ideas appreciated.

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

I'm assuming you were born in 1946. Migraines are one of the few diseases that generally gets better as we get older.  It is extremely important to work  with your neurologist to be sure that what appears to be migraine might be caused by a serious disease of the cardio-vascular or central nervous system (example would be Temporal Arteritis/Giant Cell arteritis).  If conclusively you have all other problems ruled out and your migraines are triggered by reading and near vision, I would see a quality OPTOMETRIST and be check for a need for glasses for near/computer work and/or prism glasses for convergence insuffiency. Most ophthalmologist lack the patience to this type of testing.