Scotoma refers to the "cut outs' in vision that often occur to me when a migraine is beginning, as well as the surreal feeling experienced as symptoms compound. For all the years l have had the whole recorded symptoms of migraine, l can tell when one is on the way. If l am driving, l start to see changing blurry spots in my vision that jump around. It gives me enough time to pull over and either wait things out or call someone to drive me home. This doesn't o happen too often, the main take away is we "Migraineurs" get pretty good at assessing when we are about to have an episode. Bright sunlight can be a trigger but not always. That's been the struggle over the years. I can identify common triggers but they don't always cause an episode. I've learned to take a preventative approach. Eg get enough sleep, avoid constipation, bright lights, esp. Fluorescent, certain foods, alcohol ( a vaso-dilator) stress and on and on. Many episodes l have had are exactly like a TIA, Transient Ischemic Attack or 'mini-stroke' which includes parasthiesia of half my face, arm, fingets and tongue. That's a challenge as one gets older, if symtoms last and also include paralysis, weakness and drooping of one side, often the left, then it very well could be something more than migraine and warrants a trip to the ER. Take good care and know that you are not alone. Between my opthamologist, neurologist and family doc l've been getting good monitoring and care. Err on the side of caution with the symptamatology and have understanding medical help. Stay the course.