Thursday, March 16, 2023

What Is An Ocular Migraine

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Ocular Migraines Can Be Alarming If You Dont Know What They Are And Suddenly Get One For The First Time

What Is An Ocular Migraine? Eye Doctor Explains

If youve ever noticed a patch of bright, shimmering light that gradually widens until it fills your entire field of vision, you might have had an ocular migraine. When we hear the word migraine, we tend to think its about headaches, but this particular type of migraine doesnt always have anything to do with pain.

What Does An Ocular Migraine Look And Feel Like

Ocular migraine symptoms may present with a few different types of vision changes. Migraine with visual aura is typically bilateral and simultaneous and often characterized by a jagged line that moves across the visual field slowly . It is then often followed 15 to 20 minutes later by the typical migraine headache, according to Andrew Lee, M.D., chair of the department of ophthalmology at Houston Methodist. Sometimes the visual effect is described as colored or flashing , he says.

Dr. Lee says that ocular migraine is not a true diagnosis in the International Headache Society classification of migraine with aura, but it can be used to describe the temporary vision change, either negative or positive, in a single eye.Most of these so-called ocular migraines are actually retinal vasospasm and not true migraine headaches.

Treatment For Retinal Migraine

Treatment for retinal migraine usually just involves taking pain relief for any headaches and reducing exposure to anything that might be triggering the retinal migraine.

Your doctor may sometimes prescribe preventative medication to try and reduce how often you get a migraine. Your doctor will discuss the best way to treat your symptoms with you.

There is no one best way to treat retinal migraine. Your doctor may have to try several different medications to see what works best for you.

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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.

How Can I Treat Migraines Without Using Medicines

Ocular migraine

It is very important to remember that many of the most effective preventive treatments for migraines do not require any medications. Frequent aerobic exercise is an excellent example of an effective way to improve headaches. Other strategies may include better sleep habits, stress reduction, massage, yoga, and acupuncture.

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Ocular Migraine Risk Factors

Some of the risk factors for ocular migraines are similar to risk factors for migraine headaches. These are the top risk factors:

  • Family history: If your parents and close relatives have ocular migraines, you are more likely to have them too. They tend to run in families.
  • Stress: Increased stress at work or home as well as emotional, physical, or financial stress may be a risk factor for ocular migraines. Stress can also trigger poor sleep patterns and fatigue, which can make migraines more likely.
  • Nutrition: Some individuals are sensitive to certain foods, such as cheese, chocolate, or red wine. Other people notice that preservatives such as nitrates or MSG are migraine triggers. Evaluating your diet can help you identify which foods seem to be associated with your ocular migraines.
  • Smoking: If you smoke, it could be contributing to the severity and frequency of your ocular migraines. Talk to your doctor about steps to stop smoking.

Reducing Your Risk Of Ocular Migraines

These strategies are similar to the ones used for preventing migraines

  • Avoid known triggers. These triggers can be the common ones listed above or any specific ones that only affect you.
  • Drink plenty of water. Try to aim for 2L of water a day as being dehydrated can trigger an ocular migraine attack.
  • Ensure normal blood pressure and sugar levels. Having high blood pressure or low blood sugar levels can trigger an ocular migraine attack
  • Reduce screen time. Staring at a computer screen for long periods of time can trigger an attack. Aim to have a 10 minute break every 30 minutes of screen time or near-work such as working on the computer, reading and watching TV.

Also Check: What Is Aura With Migraine

Different Types Of Visual Migraines

While ocular migraines on their own are usually temporary and not serious, they do come in three different types.

Painless Ocular Migraine

Sometimes, ocular migraines happen without headaches. They wont look exactly the same for everyone. Some people may see psychedelic images, others see flashing or shimmering lights, and others see stars or zigzagging lines. The effect begins small but soon spreads and obscures the field of vision in both eyes, then clears on its own.

The visual effects may be the only symptoms, but sometimes motor function or speech is also temporarily affected. While these types of ocular migraines are not considered serious, they do briefly interfere with ordinary activities, such as driving, reading, or writing. If one comes on while youre on the road, pull off to the side until it passes. Typically it lasts between thirty minutes and an hour.

Migraine with Aura

A fifth of people who suffer migraine headaches also experience ocular migraines, sometimes as a warning symptom that the headache is on its way. If youve experienced visual distortions before headaches, make sure to discuss it with your doctor. It is sometimes possible to reduce the frequency of migraines by avoiding triggers like eating certain foods, exposure to sudden bright light, and stress. Other triggers can include smoking and oral contraceptives.

Retinal Migraine

Pearls And Other Issues

What do I do to treat an ocular migraine?
  • 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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Headaches Behind The Eye In People Over 40

In particular, people over the age of 40 may begin experiencing headaches behind the eyes more frequently as they get older due to a condition called presbyopia. As the eyes age, it can become more difficult for them to focus on objects up-close, causing them to squint and strain in order to see more clearly. This strain can lead to feelings of pain behind the eyes, alongside soreness and redness.

With other common conditions such as blurry vision, digital eye strain, and difficulty seeing up-close, its best to have your eyesight checked by an optician if youre concerned.

Treatment Of Migraine With Aura

When you get treated for migraine with aura, the main goal is to prevent and manage pain.

Your doctor may suggest medications to prevent migraine with aura, including:

Your doctor may also suggest you take magnesium or riboflavin to prevent migraine with aura.

To stop a migraine with aura once it has started, you can try over-the-counter pain relievers such as acetaminophen, ibuprofen, or a combination of caffeine and acetaminophen.

Your doctor may also suggest prescription drugs called triptans and ergotamines. If the pain is severe, you may need to get treatment in an emergency room with medications you take through an IV.

If you are vomiting, your doctor may recommend anti-nausea drugs.

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What Is A Visual Migraine

Visual migraines can mimic other serious conditions, making it very important to see an eye doctor as soon as possible if you experience any sudden vision loss or changes to your vision.

A visual migraine, also known as an ocular migraine, causes temporary visual disturbance. This disturbance often appears suddenly and may create a blind spot moving across the visual field or the sensation of looking through a cracked window.

There are two types of ocular migraines:

Migraine auras are very common, affecting 1 in 5 migraine sufferers.

Migraine auras cause binocular visual distortions, affecting both eyes simultaneously. They may also cause:

  • Numbness or tingling
  • Changes in taste, smell, or sense of touch.

An aura can occur with or without a migraine, and may sometimes precede a headache. The visual distortions are temporary and usually last around 30 minutes. They can impact performance in certain activities, such as driving and reading.

The most common visual symptoms of migraine auras include:

  • Flashes of light

What Is A Retinal Migraine

Ocular Migraine

Retinal migraines are rare, affecting 1 in 200 migraine sufferers.

Retinal migraines cause repeated temporary episodes of blindness in just one eye. Most people experiencing a retinal migraine report that their vision suddenly becomes very blurry, or that there is a partial or complete blackening out of their vision. These episodes can last anywhere from 5 to 20 minutes and can occur prior to or during a migraine headache.

Vision loss in one eye is always a sign that needs to be taken seriously and requires urgent medical care.

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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

What Causes A Migraine

The central nervous systemâthe nervous system making up the brain and spineâhas a unique type of communication via specialized cells called neurons.

Neurons are branch-like cells that transmit electrical signals from one part of the body to another.

There are over 86 billion neurons within the brain. Similar to electric wiring, when stimulated, neurons fire, entering an excited state.

In a classic migraine, for whatever reason, a subset of neurons becomes hyper-excited, resulting in an over-stimulation of the affected neurons.

Some common triggers for migraines include strong smells, bright lights, certain foods, stress, and heat.

Thehyper-excitement of neuronscan spread to other subsets of neurons nearby. As this process occurs, the brain responds by dilating its blood vessels. This dilation of blood vessels increases the surface area of the blood vessels, often resulting in the vessel wall compressing onto pain-detecting nerves, resulting in the head pain better known as an intense headache.

Where a migraine occurs depends on where the affected neurons are located. A migraine, therefore, can occur in any lobe of the brain, and can spread from one area to another over time.

A classic migraine can have a visual disturbance, called an aura, when the neurons affected extend into the occipital cortexâthe part of the brain responsible for image processing.

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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.

Is There A Connection Between Strokes And Ocular Migraines

Ocular Migraines Explained –

Currently, there isnt a definitive answer. But some researchers believe that ocular migraine and stroke have a connection. The connection, they believe, has to do with damage to the cells lining your blood vessels. The inflammation of the cells can cause them to become stiff and hence increase the risk of suffering a stroke.

Also, people who have migraine with aura are twice as likely to suffer a stroke as those who have no migraines.

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Causes Of Ocular Migraines

The precise causes of ocular migraines are still not known. This type of headache is not technically a problem with the eyes. It may be related to blood flow in the brain or changes in the brains biochemistry.

According to the World Health Organization , the cause of migraines may be a mechanism in the brain that releases pain-producing substances around the nerves and blood vessels. This mechanism results in the release of substances that cause inflammation around the blood vessels and nerves in the head. The outcome is what many people experience as migraine or painful headaches.

What Are Migraine Treatments

Most ocular and retinal migraines dont require treatment. They will go away on their own. It helps to rest and avoid triggers such as loud noises or bright lights.

If ocular or retinal migraines occur frequently, your eye doctor may suggest medications, including those used to treat other forms of migraines. Beta blockers, antidepressants, and anticonvulsants sometimes are helpful, although more research is needed to determine the most effective treatments.

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Headaches Behind The Eye Or Ocular Migraines

Its important not to confuse ocular migraines with generalised headaches behind the eye. Ocular migraines happen as a result of reduced blood flow to the eye, due to a sudden narrowing of the blood vessels, and usually occur in just one eye.

On the other hand, headaches behind the eyes are usually a symptom of traditional headache-type migraines, which can be caused by a number of conditions and external stimuli. Sensitivity to bright light , some prescription medications or simply staring at digital screens for too long can all lead to migraines and headaches behind the eyes.

What Are The Causes

Ocular Migraine

The exact causes of ocular migraines are not definitively established. However, many scientists think that the symptoms that you experience happen because of reduced blood flow to the brain. Spasm in the blood vessels is what causes a reduction in blood flow.

The source of visual disturbances in ocular migraines is the retinal blood vessels. Contrarily, the source of migraines with aura is the occipital cortex, which is located at the base of the skull.

Since the source of the problem in aura migraines is not the eyes but the brain, you will still experience the sensory disturbances even when you close your eyes.

Read Also: Headaches In Different Parts Of The Head

Retinal Migraine Is A Rare Type Of Migraine That Can Cause Visual Symptoms In One Eye Most Attacks Are Short

Do you get symptoms like twinkling lights, flashes or temporary vision loss in one eye only? You may have retinal migraine, a type of migraine with repeated attacks of visual disturbances that happen in one eye. We spoke with Deborah I. Friedman, MD, MPH, a neuro-ophthalmologist and Professor in the Departments of Neurology and Ophthalmology at UT Southwestern Medical Center, Dallas, for more information on identifying retinal migraine and understanding the differences with other types of headache.

If You Experience Sudden Changes In Vision It May Be The Result Of A Visual Migraine

Visual migraines are an episode of vision loss in one eye, usually lasting a short time and are rarely painful.

Classic migraines usually result in intense headaches or sensitivity to light and loud sounds. While, ocular migraines cause sudden vision impairment and are not necessarily painful. For example a street sign becoming difficult to read while driving.

Most ocular migraines dont actually cause or indicate any damage to your brain or eyes.

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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.

What Are Migraine Triggers

What is Ocular Migraine? – Chapter 1: Migraine Types – Explainer Video Series

A number of factors can trigger a migraine, whether its ocular, retinal, or classic migraine. The reasons can vary from person to person. If you have ocular migraines, pay attention to these possible triggers:

  • Stress and anxiety
  • Relaxation after a stressful time
  • Loud sounds or bright lights

Dr. Kim discusses common triggers for migraine headaches.

Click play to watch the video or read video transcript.

What are some triggers for migraines?

Retinal migraines are more likely to be triggered by other factors: intense exercise, dehydration, low blood sugar, high blood pressure, hot temperatures, and tobacco use.

Certain foods can trigger both types of visual migraines:

  • Red wine or other alcohol
  • Food and drink with caffeine
  • Hot dogs, sausage, and other processed meats that contain nitrates
  • Chips, fast foods, broths, and other products with the flavor enhancer monosodium glutamate
  • Artificial sweeteners
  • Food with the naturally occurring compound tyramine, including smoked fish, cured meats, and some soy products

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