Ophthalmic Migraine Vs Ocular Migraine

How Can I Prevent Headaches

The key to preventing headaches is figuring out what triggers them. Triggers are very specific to each person what gives you a headache may not be a problem for others. Once you determine your triggers, you can avoid or minimize them.

For example, you may find that strong scents set you off. Avoiding perfumes and scented products can make a big difference in how many headaches you have. The same goes for other common triggers like troublesome foods, lack of sleep and poor posture.

Many people, however, are not able to avoid triggers or are unable to identify triggers. In that case, a more personalized multidisciplinary approach with a headache specialist is often necessary.

Know The Difference: Ocular Migraines Vs Visual Migraines

There are over a dozen different types of migraines, and while none of them are pleasant, some are definitely more dangerous than others. One of the more threatening types is the ocular migraine, which can potentially lead to permanent vision loss in the affected eye. Unfortunately, the term ocular migraine is often used interchangeably and confused with the term visual migraine when referring to visual disturbances. This confusion can be dangerous as they are in fact two different migraine types, with the visual migraines being much more common and relatively harmless. Visual migraines will typically cause visual disturbances in both eyes and occur alone or just before a regular migraine headache lasting only about 30 minutes.

On the other hand, the specific visual symptoms of ocular migraines affect only one eye, can occur alone, or during/after a regular migraine headache, and can take up to an hour to dissipatehowever, the long-term damage can be severe. As previously mentioned, they can potentially lead to permanent vision loss in that eye, but they can also have symptoms that mimic those of other medical conditions, including a stroke. For this reason, if your visual symptoms are in only one eye, you should see a physician immediately to determine the root cause of your symptoms and rule out the possibility of a stroke or another medical condition.

Visual Disturbance Symptoms of Ocular and Visual Migraines can include:

Whats The Difference Between Ocular And Visual Migraines

February 28, 2022 by Dr. Richard Snively

Migraines are headaches with a pulsing sensation that typically occur in one side of the head. A migraine can happen along with other symptoms like light and sound sensitivity, nausea and vomiting. Symptoms can last for a few hours up to days. Sometimes, the pain makes it difficult for sufferers to go on with their day.

Two types of migraines, visual and ocular, can affect your vision. Read on to learn about the difference between them.

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What Causes Ocular Migraine

Migraine aura is considered to be a result of abnormal electrical activity involving certain regions of the cortex of the brain. This abnormal activity spreads across the cortex at a slow rate of about 3mm per minute and this spread is responsible for the growth and movement of the visual disturbance over the 20-60 minutes that the visual aura lasts. Retinal migraine may be due to the same type of disturbance except occurring at the back of the eye in the retina, or it may be due to a reduction in blood flow to the retina.

Like other types of migraine, harsh lights and electronic screens can be triggers. Straining your eyes by staring at a screen for long periods of time, spending time in fluorescent or other harsh lighting, driving long distances and other taxing visual activities can increase your risk for attacks. Talk to your eye doctor about how to avoid attacks.

Ocular Migraine Vs Migraine With An Aura

Ocular migraines are often mistaken for visual migraines. Both migraines cause changes in the vision, however, ocular migraines tend to be limited to one eye.

An ocular migraine usually resolves within an hour. Although an ocular migraine may only last a short time, it could be a sign of other health issues. Talk with your medical provider to determine what may be the root cause and to rule out more serious problems.

An aura or visual migraine involves different types of visual disturbance that many people compare to looking through a kaleidoscope or cracked window. You may have visual symptoms such as flashing lights, blind spots, or zigzags.

Generally, a visual migraine affects both eyes, with changes in vision lasting less than 30 minutes.

Most commonly, the aura phase of the migraine comes before experiencing migraine pain. Many patients report that the aura resolves as the pain starts. An aura can last anywhere from 10 to 60 minutes.

Aura symptoms may also include physical numbness, temporary sight loss, speech changes, and weakness on one side of the body. You may notice additional sensory symptoms such as feeling pins-and-needles sensations throughout the body.

Many people who have migraines also experience other symptoms, such as nausea, vomiting, confusion, numbness, and dizziness. The pain level and frequency vary greatly across individuals.

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Ocular Migraine Vs Retinal Migraine

People may use the terms ocular migraine and retinal migraine to mean the same thing, but there are some important differences. An ocular migraine generally occurs in both eyes. A retinal migraine is rare and tends to occur in just one eye, when vessels that supply the eye with blood narrow. It usually lasts about 10 to 20 minutes and sometimes up to an hour. Symptoms are similar to ocular migraine and may also include complete, temporary vision loss in one eye.

Once the retinal migraine passes, blood vessels open back up and your vision returns to normal. Its a good idea to have retinal migraines checked out by a doctor to make sure symptoms are not signaling a more serious problem.

Pearls And Other Issues

• A retinal migraine a rare phenomenon that usually affects monocular vision transiently.
• Duration of symptoms on average is 5 to 20 minutes.
• The prognosis for an ocular migraine is good.
• The frequency and intensity of the headache typically decrease.
• During prolonged periods of retinal, choroidal, or optic nerve hypoxia, permanent visual loss may occur.

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What Causes An Ocular Migraine

Ocular migraines are caused by a narrowing of the blood vessels that supply the eye with blood, this constriction happens suddenly and reduces the amount of blood the eye receives. After the attack the blood vessels around your eyes relax, the normal blood flow resumes and your sight goes back to normal.

What Are The Preventive Treatments For Migraine

Many patients with isolated visual migraines, without severe headaches, have relatively infrequent episodes that do not require specific preventive treatments. If a patient is aware of the particular triggers that seem to bring on an episode, then those triggers can be avoided.

In patients where the pattern of migraines includes frequent, severe headaches, it is very reasonable to consider additional preventive treatments. The main goal for any of these strategies is to reduce the overall frequency and severity of the headaches. None of the preventive treatments is a magic bullet that is 100% effective. For example, it would be considered successful if a preventive treatment helped reduce the number of severe headaches from 8 per month to 2-4 per month.

There are numerous medications that can be used as a preventive treatment for migraine. One medication that is used commonly, particularly because it has no side effects, is vitamin B2 . Approximately 100mg of riboflavin daily is thought to improve migraine headaches . One common side effect of riboflavin is that the urine turns bright yellow. Other herbal medications used to reduce migraine headaches include petasites and feverfew.

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Symptoms Of Ocular Migraines

The symptoms of ocular migraine vary depending on individual experience. These are some common symptoms:

• Loss of vision in one spot
• Loss of vision off to one side of the visual field
• Seeing lights shimmering or colored
• Seeing zig-zag patterns and lines

The symptoms tend to occur in one eye. The visual symptoms generally resolve within about 60 minutes.

How Is Optical Migraine Or Ocular Migraine Treated

The best way to treat Optical Migraine or Ocular Migraine is to first identify what tends to cause them. In cases of females, if it is caused during their menstrual period then they need to contact their physician for a preventive medication for migraines. Some of the medications given for Optical Migraine or Ocular Migraines are:

• Aspirin
• Antiepileptic medications like Depakote or Topamax
• Antidepressants like Elavil
• Beta Blockers.

Apart from this, the affected individual needs to avoid triggers by identifying them so as to stay away from Optical Migraine or Ocular Migraine.

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Treatment And Preventive Measures

Ophthalmic and visual migraines can impact your day-to-day activities, but the appropriate treatment and preventive measures help you to maintain your quality of life.

If youve got migraine and are experiencing temporary blindness or other visual disturbances, wait until they get better before driving.

Ocular migraines typically go away with time by resting and avoiding bright light. Once the symptoms disappear, you should no longer be affected by them.

There are many treatments you can try at home, as well as medication prescriptions, which alleviate the symptoms of recurring migraines. Over-the-counter medications such as ibuprofen or Excedrin Migraine may help reduce the pain.

Here are some helpful tips for managing migraine when youre at home:

• Lie down or sit in a dark, quiet area with your eyes closed.
• massaging your scalp with a lot of pressure
• putting pressure on your temples
• putting a damp towel over your forehead

Takeaway

Ocular and visual migraines are something that should be discussed with your doctor, particularly if you have them regularly or theyre happening more often. Seeing your doctor is also advised if they arise.

Your doctor will find out whats wrong and can often prescribe medicines that reduce the severity or frequency of symptoms.

If you experience any drastic changes in your vision, sudden blindness in one eye, or problems with thinking, seek immediate medical attention.

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Why Am I Suddenly Getting Ocular Migraines

You may be suddenly getting ocular migraines due to an increase in stress in your life. Perhaps you are working more and exercising less. You may have been seeking comfort with unhealthy choices, such as smoking or drinking a lot of alcohol. You might have recently changed your diet or developed sensitivity to specific foods that are triggering migraine symptoms.

Talk with your doctor to evaluate the possible causes for this sudden change.

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Introduction And Historical Evolution

There has been extensive documentation of migraine as a disorder, dating back to over 4000 years ago from ancient Mesopotamia . One of the earliest descriptions of visual symptoms associated with migraine was a case report by Hippocrates in ancient Greece :

âhe seemed to see something shining before him like a light, usually in part of the right eye at the end of a moment, a violent pain supervened in the right temple, then in all the head and neck. vomiting, when it became possible, was able to divert the pain and render it more moderate.â

In 1882, Galezowski first used the term ophthalmic megrim to describe a case series of four patients with permanent monocular visual loss and migraine headaches. He hypothesized that ophthalmic megrim is a condition that may âoccasionally lead to organic changes in the retina or retinal vesselsâ, with findings such as retinal thrombosis and optic disc atrophy .

Without an internationally agreed definition, authors have used various terms interchangeably to describe monocular visual loss, which is either: associated with headache, not associated with headache, transient, or permanent. These terms include âophthalmic migraineâ, âocular migraineâ, and anterior pathway migraine .

Enhancing Healthcare Team Outcomes

The diagnosis of retinal migraine is one of exclusion and all other causes of vision loss should initially be considered. All members of the healthcare team should be vigilant and refer the patient for immediate and emergent assessment for stroke or other thromboembolic causes for their symptoms if the patient presents with visual loss or changes.

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What Are The Signs And Symptoms

People mistake retinal migraine for migraine visual aura, which arises from the brain. People will sometimes say eye migraine and what they really mean is visual aura and migraine, or migraine pain in one eye says Dr. Friedman. Or they may call it ocular migraine because the problem seems to be with the eyes. In fact, theres no such diagnosis as ocular migraine, she says. The visual disturbances of migraine usually come from the brain, not the eyes.

A retinal migraine attack starts with monocular visual symptoms. These symptoms include:

• Scintillations
• Scotoma
• Temporary blindness

The visual symptoms of retinal migraine last between five and 60 minutes. Symptoms can also increase over time. A headache may go along with the visual disturbance or start within an hour afterward.

In reality, we see a lot of these that are not accompanied by a headache, says Dr. Friedman. But usually theyre typical migraine visual aura. Theyre not coming from one eye. They are classic migraine aura symptoms, such as zigzag lines that move across the visual field, C-shaped shimmering, loss of half of the visual field that splits right down the middle, tunnel vision or simultaneous visual loss from both eyes.

Ocular Migraine And Visual Migraine Symptoms

Ocular migraine symptoms generally include a small blind spot that affects your central vision in one eye. This blind spot gets larger, making it impossible for you to drive safely or read with the affected eye.

In some cases, the entire visual field of one eye may be affected. Generally, the episode lasts less than an hour.

Visual migraine symptoms can vary, and may include:

Visual migraines often appear suddenly and may create the sensation of looking through a cracked window. The visual migraine aura usually moves across your field of view and disappears within 30 minutes.

The symptoms of a visual migraine typically affect both eyes and last less than 30 minutes. A migraine headache may occur shortly after the symptoms of a visual migraine subside or no headache may occur.

If you’re experiencing a blind spot or other visual disturbance and you’re not sure if it’s an ocular migraine or a visual migraine , cover one eye at a time. If the visual disturbance affects just one eye, it’s probably an ocular migraine. If it affects both eyes, it’s likely a visual migraine.

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Triggers For Visual And Ocular Migraines

Many people know the individual triggers of a migraine and can identify combinations of them. This knowledge can be particularly useful when it comes to preventing migraines.

• Cigarette smoke
• Certain foods
• Caffeinated drinks
• MSG
• Artificial sweeteners
• Stress and lack of sleep

A migraine diary can provide insight into what triggers your migraine. Along with notes on everything in your life, it should include information about what you eat, when you exercise, when you sleep, and when your menstrual cycle starts.

The Difference Between Migraines With Aura And Ocular Migraines

Theres nothing like itthe excruciating, throbbing pain in your head that can only be a migraine. If you suffer from migraines, you may have noticed some visual disturbances in addition to your headache. Most likely what you have experienced is a migraine with aura accounting for approximately 20% of all migraines. There is also another less common type of migraine with visual disturbance called an ocular migraine affecting only about one out of every 200 people who have migraines. These two types of headaches are very similar making it very confusing to tell which is which. Read on to learn the distinctions between the two.

What are the symptoms?

The symptoms of the two conditions are almost the same except for a few telltale signs. The main difference is a migraine with aura will affect both eyes while an ocular migraine affects only one. Both have visual disturbances such as:

• Flashes of light
• Shimmering, colored, or flickering lights
• Floating lines

The visual disturbances tend to go away before the headache begins for the migraine with aura but can last longer for the ocular headache. Also, the headache, which can also be accompanied by symptoms of nausea and severe light sensitivity, tends to be right behind the affected eye of an ocular migraine but can be more spread out for a migraine with aura.

What are the causes?

What to do about them?

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What Is An Ocular Migraine

An ocular migraine is an eye problem characterized by short episodes of vision loss or visual disturbances.

For example, you may see flashing lights in one eye accompanied by a headache.

Your doctor may also refer to this type of migraine as ophthalmic or monocular migraines.

These episodes may be scary. But in most cases, they are harmless and short-lived. However, ocular migraines can be a sign of a more serious condition.

Some people experience retinal migraines every few months, but the frequency varies from person to person.

Retinal migraine is a unique condition that should not be confused with headache-type migraine or migraine with aura, which often affect both eyes.1

Can I Have A Visual Migraine Without A Headache

Definitely. It is actually very common to have a visual migraine without any headache. The medical term for this is acephalgic migraine, which literally means migraine symptoms without headache. Except for the absence of a headache, the visual symptoms in acephalgic migraine are identical to the episodes that accompany a classic migraine aura.