What Triggers An Ocular Migraine

About Dr Donald Mccormack

As an ophthalmologist, Dr. McCormack diagnoses and treats all eye diseases, prescribes eyeglasses and contact lenses to correct vision problems, and performs a wide range of clinical procedures and more complicated eye surgeries. He has special interests in treatments for dry eyes and glaucoma and has been a principal investigator in numerous clinical research trials for these conditions.

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This article is not intended to substitute for professional advice, diagnosis, or treatment. Always seek the advice of your physician.

What Are The Symptoms Of An Ocular Migraine

The most common ocular migraine symptom is a small blind spot that impairs your central vision in one eye.

This blind spot expands, making it difficult to drive safely or read using the affected eye.

In addition to the flickering blind spot, other migraine symptoms include:

• A colorful light ring that is wavy or zigzag and surrounds a central blind spot
• A blind spot that slowly migrates across your field of vision
• A migraine lasting between 4 and 42 hours
• Nausea and vomiting
• A headache that feels worse when you move your head

If you have blind spots or other visual symptoms and arent sure whether it’s an ocular migraine or a visual migraine, cover one eye at a time and observe your sense of sight. If the visual disturbance affects one eye only, it is most likely an ocular migraine.

Symptoms Of Retinal Migraine

The symptoms of retinal migraine may include:

• partial or total loss of vision in 1 eye this usually lasts 10 to 20 minutes before vision gradually returns
• headache this may happen before, during or after the vision attack

It’s unusual for an episode of vision loss to last longer than an hour. The same eye is affected every time in almost all cases.

Vision may slowly become blurred or dimmed, or there may be flashes of light. Some people see a mosaic-like pattern of blank spots , which enlarge to cause total loss of vision.

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What Is An Ocular Migraine

An ocular migraine refers to subtypes of migraine that are characterized by vision changes such as vision loss, blind spots, zig-zag lines, flashes of light, or seeing stars.

Unlike other types of migraine, an ocularmigraine may or may not occur with head pain.

The term ocular migraine may also be used to refer to a retinal migraine, which is a form of migraine in which visual disturbances occur in just one eye before the headache phase of a migraine attack.

What Are Ocular Migraines

The term ocular migraine generally means a headache that’s accompanied by temporary visual changes and then the patient is completely normal between attacks. However, the term is often confusing because its used interchangeably to refer to two different conditions:

• migraine aura that usually isn’t serious, and
• retinal migraine that could signal something serious.

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What Does An Ocular Migraine Feel Like

An ocular migraine begins with a sparkling and shimmering area that has a jagged border and that gradually spreads outward. It causes a small blinding spot that enlarges and blocks your vision temporarily. The brightness begins at the edge of your field of vision and gradually spreads to your line of vision. Zigzag lines or stars may also be seen. It is almost like looking through a broken window. Scotoma is the area where vision is disrupted and the whole episode is called a positive aura.

An ocular migraine is often referred to differently by different experts. While many call it a visual migraine or a typical aura without headache, the International Headache Society classifies such a migraine as a silent or acephalgic migraine.

Though it seems serious since you lose your vision partially, the condition is usually harmless and will resolve on its own within 2030 minutes without any medical intervention. Complete visual darkness, or a negative aura, is not a symptom of an ocular migraine, but of some other underlying condition that needs to be investigated.2

Apart from visual disturbances, ocular migraines can also interfere with your speech. You may also feel tingling, weakness, or numbness in your hands and legs, experience size or space distortions, or feel confused. All of these, however, are rare.3

Treating And Coping With Migraine

Migraine can be debilitating and impact your quality of life. If youre experiencing blind spots or vision disturbances, for example, you will want to wait until they pass before driving.

Ocular migraine will typically go away with time. You should rest and avoid triggers such as bright lights until the vision disturbances are gone.

There are both over-the-counter treatments and prescription medications that you can use to treat recurring migraine flares. Over-the-counter drugs like ibuprofen or Excedrin Migraine may also help reduce the symptoms.

Other medications that may help you manage ocular migraine include:

• beta-blockers

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Treatment And Prevention Of Ocular And Visual Migraines

As already noted, visual disturbances caused by ocular migraines and visual migraines typically go away within an hour.

If you are performing tasks that require clear vision when an ocular migraine or visual migraine occurs, stop what you are doing and relax until it passes. If you’re driving, pull of the road, park your vehicle and wait for your vision to return to normal.

As soon as possible, see your eye doctor, family physician or a neurologist for evaluation of your migraine episodes. Your doctor can let you know about the latest medicines for treating migraines, including those that may help prevent future attacks.

It’s also a good idea to keep a journal of your diet and daily activities. Doing so can help you identify possible triggers of your ocular migraines or visual migraines .

Many migraine attacks are stress-related. You might be able to reduce how often they occur by:

• Avoiding common migraine triggers

• Getting plenty of sleep

• Trying stress-busters such as yoga and massage

Migraines can be successfully managed so they are less frequent and debilitating. The first step is to see a doctor to discuss your symptoms including vision problems and discuss treatment and prevention options.

What Are Different Types Of Ocular Migraines

Migraine with aura

Migraine with aura causes symptoms such as flashes of light, blind spots, seeing stars or patterns, and other mild vision changes that resolve quickly. Although visual disturbances are the main symptoms, aura can affect other senses as well and interfere with speech, motor abilities, or smell.

Migraine aura can occur with or without a headache. While symptoms are usually brief, they continue for more than an hour in roughly 20% of cases. When aura symptoms emerge in conjunction with head pain, they usually occur in the:

• Premonitory phase: Phase between the symptoms that warn of an approaching attack
• Peak pain phase: When the head pain occurs

Migraine with aura affects 25%-30% of people with migraines, and less than 20% of people with migraine aura experience the aura phase with every migraine attack.

Retinal migraine

Retinal migraine is a type of migraine attack that causes vision changes in only one eye before or during the headache phase. Retinal migraine symptoms are more noticeable than aura symptoms and may include reduced vision, twinkling lights, and brief blindness.

Retinal migraine can result in irreversible vision loss. Because it can be difficult for people to distinguish between migraine with aura and retinal migraine, it is critical to visit a doctor if you suspect you have retinal migraine symptoms.

Painless ocular migraine

If these symptoms arise, you should avoid strenuous activity such as driving until they pass.

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Deterrence And Patient Education

It is critical to educate the patients about the red flags of vision loss. A visual loss that patients describe as darkness requires immediate medical attention and an emergency room visit. Patients must understand that this could be a sign of a stroke or an irreversible eye condition. Visual changes that are more consistent with migraine phenomenon are usually positive such as flashing light. Patients must also be taught that those could come without a headache or any pain. Preventive therapy is important to reduce the frequency of attacks and severity and must be taken on a daily basis.

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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Causes Of Ocular Migraine

An ocular or ophthalmic migraine is hold your breath a painless migraine! These are, however, associated with visual disturbances in both eyes. You may experience flickering or flashing lights, lines, stars, or blind spots that deter your vision. About 35 percent of migraine sufferers experience this kind of an aura, visual or otherwise. A painless migraine such as an ocular migraine is considered a migraine equivalent.1

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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What Are The Acute Treatments For Migraine

An isolated visual migraine, without headache, typically does not require any acute treatment, since the visual symptoms resolve on their own fairly quickly. The first few times someone experiences a visual migraine it usually causes a lot of anxiety. Once someone has become familiar with the symptoms of a visual migraine, new episodes no longer cause the same level of anxiety.

It can be helpful to try to rest during the episode. Some patients benefit from other strategies, including eating something, having caffeine, or taking an over-the-counter medication such as acetaminophen or ibuprofen .

Patients in whom the visual symptoms are accompanied by a severe headache often benefit from additional therapies. The goal of these medications is to try to cut short the headache before it becomes too severe. Some patients find naproxen , which is a stronger anti-inflammatory medication, to be helpful. Other patients try a class of medications known as triptans.

Triptans are specially designed to work on receptors on blood vessels and brain cells in order to halt a migraine at an early stage. Although there are a number of different triptans, made by several different pharmaceutical companies, each of these is approximately equally effective. Triptans are often taken orally, but also come as injections and nasal sprays. These medicines are generally not considered safe in patients with a history of strokes, heart attacks, or other vascular diseases.

Visual Impairments Associated With Migraine Can Happen With Or Without A Headache

Ocular Migraine is a term that has been used to refer to a number of migraine subtypes that are characterized by a variety of visual disturbances including visual loss, blind spots, zig-zag lines, or seeing stars. Unlike other forms of migraine, they may occur without any accompanying head pain. Its not uncommon for a single patient to experience a wide range of visual symptoms. Heres what you need to know to better understand the migraine subtypes that affect vision.

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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.

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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Why It Might Not Be An Ocular Migraine

Your ophthalmologist will be keen to rule out other, more serious, medical conditions when assessing your symptoms. The most serious of these is a TIA or seizures. Other possible similar conditions include cluster headaches or migraine with aura.

Because of the severity of some of these, any episodes of visual disturbances must be assessed as soon as possible. Once youve been diagnosed with ocular migraine it becomes a matter of treating the symptoms. Until that time, any type of vision loss should be treated as a medical emergency and professional assistance sought.

What Causes Ocular And Visual Migraines

Currently, there is limited research on what causes ocular and visual migraines.

Although studies have shown a change in blood flow into the eye during ocular migraines, the exact cause of this change remains unclear.

However, scientists sometimes associate the condition with genetics, meaning it may run in the family.

According to research, up to 70% of migraine patients have a personal or family history of migraine.2

Migraine triggers play a vital role in the onset and frequency of migraines.

Common migraine triggers include:3

• Alcoholic drinks such as red wine
• Excess heat or high altitude

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Treatment Of Ocular Migraines

Ocular migraine episodes usually pass in about an hour or less. Rest is often the recommended treatment.

Migraine management methods may help to promote a sense of ease and calm. Try these methods:

• Rest quietly in a dark room.
• Place a cool compress on your closed eyes. This can be soothing and relaxing.
• Massage your scalp gently. Gently circle the area around the temples.
• Try yoga postures.
• Take an over-the-counter or prescription pain medication.
• Try calm, meditative breathing techniques.
• Consider biofeedback, which can help you recognize early signs of migraine and limit pain.

As you explore integrative treatments, keep an open mind and a spirit of investigation. For example, when learning new yoga postures, it may take some time to feel comfortable and familiar with the moves. With practice, youll discover which poses help you feel a sense of calm relaxation.

Do not drive or operate equipment while you have migraine symptoms.

What Type Of Doctor Do You See For Ocular Migraines

If you have ocular migraines, you can see an ophthalmologist oran optometrist.

Optometrists are eye care specialists who offer primary vision care services, including:

• Vision testing
• Correction of visual problems
• Treatment and management of visual issues and eye diseases

On the other hand, ophthalmologists are medical practitioners who specialize in eye and vision care. They differ from optometrists in their degrees of schooling as well as what they can diagnose and cure.

An ophthalmologist is a healthcare professional who has finished college and has at least eight years of further medical studies. He or she is licensed to practice medicine and surgery. Ophthalmologists hold a Doctor of Medicine degree.

Optometrists are healthcare professionals who complete four additional years of school after finishing undergraduate studies. They hold a Doctor of Optometry degree.

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Worried About Ocular Migraine Get Expert Diagnosis And Treatment At The West Boca Eye Center

Ocular migraine symptoms require attention from an ophthalmologist. This is the only clinician who can diagnose the condition and provide effective treatment. At the WBEC, we carry out any necessary testing and imaging to determine whether ocular migraine is the root cause.

If it is, a treatment program will be put in place. This is designed to track symptoms, determine triggers, provide any necessary medication, andvery importantlyput preventative actions in place.

Ocular migraine diagnosis and treatment is but one of the eye specialties this world-leading clinic is renowned for.

Discover more about this and our other areas of expertise at

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.

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