Hi Jaypo, great posts already on this thread with lots of helpful info & reassurance. Just to add I also have ocular migraine (as well as classical with visual disturbance aura) and have had floaters & flashes for good a few years, since around start of menopause proper (ie after final period). The classical migraine started around age 18 & the ocular in late 30s. No classical migraine at all in the 7 years since last period - so hope this gives hope of possibly seeing an end to the horrible things, to anyone who's a migraineur.
The floaters, flashes & visual disturbances of migraine can be pretty unnerving
, especially when you first get them & have no idea what's going on. As the other ladies have said, always wise to get them checked out, but floaters & flashes are usually nothing to worry about. When you go to the optician/Ophthalmologist, they will tell you what to look out for as regards changes that need checking out more urgently.
Floaters can appear as tiny, floating translucent bubbles, grey-black specks, crooked strands like fine hairs, or like chains of cells viewed through a microscope. There can be many, littering vision, or just one or 2, in one or both eyes. Many years on, though I know they are nothing to worry about, these still freak me out on bright days, so I understand your concern, Jaypo.
For me, the difference between the visual disturbances of ocular migraine & the flashes that come with floaters, is in the length of time I see the lights & their brilliance/darkness. With ocular migraine the moving bright-dark spots last between 10-20 mins & seriously impair vision - they're like the after-image you get when you accidentally look straight at the sun or a naked light bulb, but they move in the visual field. Although the entire field of vision is affected, if you cover one eye during an episode it's easy to see which of the two eyes is affected. The visual disturbances of ocular migraine & the aura part of classical migraine, for me, look simultaneously bright but dark (sorry, hard to describe), move around & block out a large area of vision.
The flashes that tend to come in middle age & are associated with floaters, are for me at least, more instantaneous - like a bright aerial firework going off briefly in your vision & they are just brilliant lights - none of the darkness associated with the visual impairment of migraine.
As another poster said, after ocular migraine, though thankfully the severe headache of classical migraine doesn't follow, you can feel out of sorts afterwards - tired & not quite right! A very mild headache does sometimes follow ocular migraine.
The dry eyes, again, are very common in midlife, though can start much earlier. I've had them for around 30 years & have been on artificial tears for the duration - currently Clinitas, which are a stronger, more effective solution than some lubricating eye drops. Only recently have medics started to show any concern about this condition - 2 Ophthalmologists have recently stressed the importance of using drops regularly (every 2 hours in my case) & have advised using a heated eye mask for 10 mins a day as well. You can get these from Boots (mine is Eye Doctor brand). The mask encourages better function of the Meibomian glands in the eyelids, which secrete lubricating oil. Apparently, failure to use drops regularly can cause damage to the cornea & when this happens, the nerves can be affected, so that sensation is reduced, meaning it feels as though the condition has improved, so patients wrongly stop using the drops. This is not meant to scare anyone - just to stress the importance of treating dry eyes for anyone who has them.
The dryness can be caused by Sjogren's, in which case it's often systemic (affecting lady bits, mouth, sweat glands & exocrine glands throughout the body) but can also be associated with other autoimmune conditions. Can just be part of ageing with no other underlying cause. More women than men tend to develop DES (Dry Eye Syndrome) & it's thought to be associated with androgen deficiency. Still only learning about this, but seems there's some thought that oestrogen-only HRT regimes make DES worse - it's said that women on combi regimes fare better, but that surprisingly, those not on HRT do best. An optician told me a few years ago that HRT is bad for DES & at that time I thought he'd got it wrong, as I'd assumed that oestrogen at least would help dryness anywhere in the body.
One of my reasons for starting HRT was in hope it would get rid of floaters, which I'd been told are a result of the decline in collagen, which as has already been said, leads to changes to the viscosity of the jelly-like vitreous humour that fills the area between the back of the lens & the retina. HRT hasn't helped yet! Waiting to see a Rheumatologist, where one of my questions will be whether Testosterone can help DES/Sjogren's.
Interested to know whether anyone's floaters have improved on HRT, or whether Testosterone has helped anyone with DES. One of the first changes I noticed on Evorel Conti, before I knew anything about Sjogren's, was that I suddenly had far more saliva! Assuming that was due to its Norethisterone being Testosterone-derived.