An ocular migraine is a rare condition characterised by temporary vision loss or even temporary blindness in one eye. Ocular migraines are caused by reduced blood flow or spasms of blood vessels in the retina or behind the eye.
But during a migraine, these stimuli feel like an all-out assault. The result: The brain produces an outsize reaction to the trigger, its electrical system (mis)firing on all cylinders. This electrical activity causes a change in blood flow to the brain, which in turn affects the brain's nerves, causing pain.
Harsh lighting, long screen time, other visual strain, stress, dehydration, food additives, and other causes all may trigger an ocular migraine, a subtype that focuses in the eye and causes vision changes.
Ocular Migraine Treatment
The visual portion of an ocular migraine usually lasts less than 60 minutes, so most people don't need treatment. It's best to stop what you're doing and rest your eyes until your vision goes back to normal. If you have a headache, take a pain reliever that your doctor recommends.
Ocular migraine, or migraine with aura, and stroke are two different conditions. Having an attack doesn't mean you're having a stroke or are about to have one. However, research has shown that people with migraine with aura are at an increased risk of stroke.
Retinal migraine (ocular migraine) is an eye condition that causes brief attacks of blindness or visual problems like flashing lights in 1 eye. These episodes can be frightening, but in most cases they're harmless and shortlived, and eyesight goes back to normal afterwards.
If you have visual symptoms that have not previously been evaluated by a health care provider, you should see a provider if you have any of the following: Visual changes in only one eye. Visual changes that last less than five minutes and more than 60 minutes. Visual changes without a headache.
Common migraine “triggers” that can cause a susceptible person to have a migraine or ocular migraine attack include certain foods, such as red wine, alcohol, aged cheeses, caffeine, nitrates (often found in smoked or cured meats, hot dogs, and other processed foods), and chocolate.
Retinal migraines are rare, affecting 1 in 200 migraine sufferers. Retinal migraines cause repeated temporary episodes of blindness in just one eye.
Migraines may progress through four stages: prodrome, aura, attack and postdrome.
Ocular migraines and stroke are two conditions that share similar symptoms and can often be confused. Although an ocular migraine alone does not indicate a stroke, studies show that those who suffer from ocular migraines may be at a higher risk of experiencing a stroke.
Stress is a common trigger of migraine headaches, including ocular migraine headaches. Since anxiety causes stress, anxiety is a common cause of migraine headaches, including ocular migraine headaches.
A visual migraine is a temporary visual distortion that often begins with a small sparkling, shimmering area that slowly expands outward. The growing spot often has jagged, zig-zag edges. The visual symptoms typically last approximately 20-30 minutes and then completely resolve.
An ocular migraine flare can interfere with your ability to perform tasks like reading, writing, or driving. Symptoms are temporary, and an ocular migraine is typically not considered a serious condition.
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. Zigzagging patterns.
Diagnosing an Ocular Migraine
If you are experiencing any kind of impairment to your vision similar to the symptoms above, it is always important to discuss those with your doctor. A neurologist can help a patient distinguish between whether they are experiencing migraine aura or more serious retinal migraines.
Triptans. Prescription drugs such as sumatriptan (Imitrex, Tosymra) and rizatriptan (Maxalt, Maxalt-MLT) are used to treat migraine because they block pain pathways in the brain. Taken as pills, shots or nasal sprays, they can relieve many symptoms of migraine.
Dehydration is one of several triggers that can exacerbate migraine headaches, including migraine variants like the one you are experiencing. Maintaining good hydration should help reduce the frequency of these visual migraines, which are also known as acephalgic migraine.
Though often overlooked, dehydration is one of the most common causes of migraine headaches—and thus, of visual and ocular migraines. For some especially migraine-sensitive folks, even mild dehydration can trigger a migraine event.
Focal seizures and seizure aura can mimic migraine aura. Visual migraine aura can be confused for occipital seizures and vice versa, although symptoms are classically distinct.
Most importantly, you need to remember that ocular migraine is a diagnosis of exclusion! As optometrists, we do not diagnose or medically treat migraines. However, many patients will walk into our office with visual or ocular symptoms associated with migraines or one of their differentials.
People with ocular migraines can have a variety of visual symptoms. Typically you will see a small, enlarging blind spot (scotoma) in your central vision with bright, flickering lights (scintillations) or a shimmering zig-zag line (metamorphopsia) inside the blind spot.
The most substantial evidence for magnesium's effectiveness is in patients who have or have had aura with their migraine. It is believed magnesium may prevent the wave of brain signaling, called cortical spreading depression, which produces the visual and sensory changes in the common forms of aura.
Common postdrome symptoms include fatigue, nausea, sensitivity to light, dizziness, body aches, and difficulty concentrating. One postdrome sufferer described the day after a migraine headache as feeling like “a mental fog, one so heavy that even routine tasks take on an otherworldly quality.”