Generality
The scintillating scotoma is a visual manifestation very often associated with migraine with aura .
This symptom consists in the perception of a dark speck surrounded by small colored stripes with intermittent luminosity, in a visual half-field. In practice, the subject who experiences a scintillating scotoma sees an area of less visual efficiency, while the details present in the rest of the visual field are perceived normally.
The scintillating scotoma manifests itself for reasons not yet fully known, but, in most cases, this symptom can be favored by the narrowing of the blood vessels associated with the eyes. This vasoconstriction (usually transient) reduces the sensitivity of the retina, hence the efficiency of vision.
What's this
The scintillating scotoma consists in the perception of luminous traces that circumscribe a dark spot in a visual half-field. This sort of patch surrounded by flashes or colored stripes corresponds to an area of reduced or absent retinal sensitivity, which manifests itself as an altered response to the luminous stimulus .
Regardless of the object observed, this spot does not undergo displacements in relation to the rest of the visual field.
The scintillating scotoma presents a rather variable frequency, while the duration of the manifestation is correlated to the pathological event. This symptom can manifest itself in the visual field of one or both eyes.
Causes
The scintillating scotoma is a visual manifestation that is most frequently found in migraine with aura, in the context of which it represents a prodromal symptom .
However, there are other situations in which they can arise. For example, scintillating scotomas can manifest themselves in relation to vision problems and various diseases related to the functionality of the eye, including:
- Glaucoma;
- Retinal detachment;
- Opacity of the lens (cataract);
- Macular disorders;
- Alterations of the optic nerve (eg neurites) and / or lesions located at the level of the optic pathways (from the retina to the visual cortical centers).
In other cases, scintillating scotomas can be secondary to:
- intoxication;
- Vascular problems (eg circulatory spasms of the retinal artery or ocular hemorrhages);
- Ischemia, injury or brain tumors.
More rarely, the scintillated scotoma is due to the undesirable effect in the use of some drugs.
Symptoms and complications
The scintillating scotoma is a manifestation which consists in the appearance in the visual field of a dark spot, from which broken lines or wavy strips of various colors (yellow, red, blue and green) develop. The flashing zone can also have the appearance of a flashing circle or curl.
These manifestations, on most occasions, occur along with many other very annoying symptoms. For example, the patient may also suffer from headache, overall fatigue, dizziness, nausea and vomiting.
This particular type of scotoma is characteristic of migraine with aura and frequently precedes the actual attack. In this case, this prodromal symptom is temporary and lasts a few minutes (usually no more than half an hour), before disappearing to make way for the typical intense headache.
Diagnosis
On examination of the visual field, the scintillating scotoma is represented graphically as a dark area circumscribed by a spot with intermittent brightness and variable color, which projects onto the fixed objects and can have various locations (peripheral or central).
Note
In the event that the scintillating scotomas are persistent and appear in association with other disorders such as headache, vomiting without nausea, problems with speech and paralysis, it is necessary to seek medical attention immediately. Sometimes, in fact, the scintillating scotoma could represent the first symptom of a neurological pathology.
Therapy
The treatment of scintillating scotomas is aimed at the triggering condition. In the case of migraine, for example, management provides the same suggestions suggested for this form of headache. In glaucoma, on the other hand, the scintillating scotoma resolves itself after taking drugs that reduce intraocular pressure.
In the presence of permanent neurological damage, there is no cure for eliminating scintillating scotomas. However, proper rehabilitation can help recover part of the visual functionality.
