Migraine, Farland discussed on Academy of Neurologic Physical Therapy Podcast

Automatic TRANSCRIPT

Just probably two or three days ago. I have been seeing this patient. Who refuses to see anyone. she's she has had asper her diagnose as an intractable migraine without aura and she has had migraines as a child. And she's in her late sixties now and She said this to me. She's like i go anywhere. They make me more dizzy. And i just don't wanna do it anymore so That was that was a red flag for me. And i was like okay. She's someone we need to really start from scratch from the bottom but there was a very interesting thing She mentioned and it came across my mind. And i thought. I'm speaking with you. And i'll probably ask you this question. She has been extremely sensitive to light throughout her life but now she has been getting a little bit more sensitive to light and i Randomly answered the question if she has cataract so she does have cataract but they're not ready for surgery yet. Have you come across And hypersensitivity in people if cataract if they have cataract or like Things like that. Yeah so this is a very important point when caring for somebody with the subaru migraine. Vision is the key word here. You must be very aware of their visual abilities. And whether or not they have any vision diagnoses. May you mentioned cataracts. That's of course very common in older individuals but even in younger individuals were seeing people who are wearing contact lenses and they may have unusual. Contact lenses like bifocals. Contact lenses for one near lands in one farland's we also were seeing patients who have progressive lenses And these progressive lenses multi focal lenses can be particularly challenging or obviously patients but in but especially for patients with migraine and In this patient you mentioned it while it's true that Early cataracts can be problematic particularly people who have sensory sensitivity I also would one know whether or not this patient has any visual issues. Such as are they wearing multi focal lenses or say are okay and then is there any strong business or oculus alignments now okay. So soon as i see a patient who's older with sniffer migraine. Break the bad news to them. Which is in my opinion. They should be wearing multi focal lenses. And of course it's bad news because they look nice and they're expensive and if patients already have them they like the way they look and they don't want to buy new ones but I think it's really important to have a conversation with your patients about their vision. Multi focal lenses are challenging. Because they're only infocus more or less in an hourglass pattern and upper right and upper left. Gaze is blurred by design. That's the way they're designed and.

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