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What is Scintillating Scotoma & How is it Treated?|Symptoms, Causes and Risk Factors of Scintillating Scotoma

A blind spot or an Aura that obstructs part of our vision is a Scotoma. Blind spots that flicker and waver between the light and dark are known as Scintillating Scotomas.

Usually, Scintillating Scotomas are temporary. However, they can indicate an underlying health condition. Let us explore more about scintillating scotoma, its symptoms, causes, risk factors, and treatments.

What is Scintillating Scotoma?

About Scintillating Scotoma:

Scintillating Scotoma is a common visual aura, which was described first by the physician Hubert Airy. This condition might precede a migraine headache, however, it can also happen without a headache. Like many other types of Scotoma, Scintillating Scotomas appear as dots, floaters, or blind spots in the field of our vision. Scotomas obscure what you see, however, they are not pieces of dirt or dust that have landed in our eyes.

Scotomas are related to the neurological signals, which are being sent from our eye to the brain. Anomalies in such neurological messages to the brain can result in something that looks like “blind spots” when we look at the world around us.

Scintillating Scotomas might look wavy or alternate between light and dark again. The edges of the blind spot that you see are usually jagged. Scintillating Scotomas can occur before or during a migraine attack or because of an underlying health condition like Multiple sclerosis or Glaucoma.

Knowing more about the condition can help in figuring out what is causing it and when to meet with your doctor.

Symptoms Of Scintillating Scotoma:

Scintillating Scotoma generally begins as a spot of flickering light in or near the center of the visual field that prevents vision within the Scotoma area. Typically Scintillating scotoma affects both eyes since it is not a problem specific to one eye. The affected area in the eye flickers but is not dark. Gradually, it expands outward from the initial spot. The vision of the eyes remains normal beyond the borders of the expanding Scotomas.

In Scintillating Scotoma, the objects might be better seen by not looking directly at them in the early stages when the spot is near or in the center. It must be mentioned that the scotoma area might expand and completely occupy one half of your visual area, or it might also be bilateral.

In Scintillating Scotoma, one might either experience a headache or might not experience a headache.

It might be difficult for you to read if you have Scintillating Scotoma and it could also be dangerous to drive a vehicle if you have a Scotoma.

Causes Of Scintillating Scotoma

Causes Of Scintillating Scotoma:

Scintillating Scotomas are generally caused by something known as Cortical spreading depression. Usually, this is an abnormal electrical activity that is moving through one’s brain. These electrical impulses might be associated with conditions like inflammation, high blood pressure, or hormonal fluctuations.

Health conditions like Migraine with aura, seizure, visual or ocular migraine without headache, Multiple sclerosis, stroke, glaucoma, head injury, stress, pregnancy, preeclampsia, hypertension, and food allergies are related to Scintillating scotomas.

Risk Factors For Scintillating Scotoma:

Risk factors of Scintillating Scotoma include the following.

If You Are Pregnant:

You should not ignore the symptoms of scotoma if you are pregnant. Scintillating scotomas can be triggered by some hormonal changes, like those that happen during pregnancy. Migraine might occur in you for the first and also only time during your pregnancy because of the same reason.

However, Scintillating scotomas can also be one of the earliest symptoms of severe preeclampsia. High blood pressure during pregnancy can result in scotomas, and 25% of people having preeclampsia are known to experience visual symptoms.(1)

If You Have A Family History:

Some people are at a higher risk of developing the symptoms of Scintillating scotoma. You are most likely to develop the condition if you have frequent migraines with aura. You are at a higher risk of developing scotomas if you have a family history of migraines with aura and if you are a female.

If You Have A Mental Health Condition:

If you have a mental health condition like depression, you might be at a higher risk of developing Scintillating scotomas.

Some Lifestyle-related Risk Factors:

Certain lifestyle-related risk factors like stress, high blood pressure, and anxiety, might also be linked with the development of the condition of Scintillating Scotoma.

Treatments For Scintillating Scotoma

Treatments For Scintillating Scotoma:

Basically, Scintillating scotomas do not need treatments. In most cases of the scotomas, the blind spots resolve on their own within an hour.

Lying down to rest by closing your eyes, drinking enough water, and taking an OTC pain reliever like Ibuprofen or acetaminophen, might help in relieving mild symptoms of scotomas.

However, your doctor might suggest various treatment options if you have symptoms of Scintillating scotomas usually due to migraine or any other underlying health issue.

These treatment options might include anti-epileptic medications to help treat neurological symptoms, beta-blockers to relax your blood vessels, antidepressants that can level your serotonin levels for lowering the risk of migraines

When To See Your Doctor:

Some symptoms are quite dangerous and must be addressed by a medical professional. If you have Scintillating Scotoma and experiencing symptoms like muscle weakness, sudden and severe headache, dizziness or nausea, difficulty speaking or having slurred speech, numbness in the face or arms and legs, or confusion and disorientation, then you should consult with your doctor. It is also important for you to see a doctor if headache and scotomas follow after an injury or accident. You should also discuss with your doctor if you are experiencing severe migraines for the first time or if the symptoms of headache have changed from your typical experience.

Final Words:

Generally, Scintillating Scotomas are not a cause for a big concern and they go away without any treatment. However, recurring scintillating scotomas can indicate some underlying health conditions like glaucoma, migraine, preeclampsia, and multiple sclerosis.

It is always essential for you to talk to your doctor if you are concerned about the condition. They will help you with the proper diagnosis and treatment of the condition.


Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:March 22, 2022

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