A health condition in which attacks of visual disturbances affect one eye and are associated with migraine headaches is called ocular migraine. In most cases, vision problems are temporary. Physicians often treat this condition by avoiding the triggers, making lifestyle changes, and prescribing medicines.
This condition is also known as retinal migraine. It causes migraine headaches and some visual problems. For example:
- Scotoma (aura or blind spot)
- Scintillating scotoma (this involves an aura that moves or looks like a wave that alternates between light and dark)
In most cases, vision problems disappear when the attack is over. Rarely, these vision problems can become permanent. Moreover, the frequency of the ocular migraines also varies. Some people may experience them multiple times.
The symptoms of this condition may begin before the age of 7, but most people start experiencing them in their 20s.
Generally, it is difficult to estimate the exact number of people with ocular migraines, because most of them do not report their changes. However, migraines affect about 18% of women and 6.5% of men. It is important to understand that not everyone who experiences migraines will have ocular migraines.
Symptoms
The symptoms of this eye condition often vary among people. While the primary symptoms are vision problems and migraine headaches, people with ocular migraines may also experience other symptoms. Check below some visual symptoms:
- Zigzagging patterns
- Blind spots
- Shimmering of flickering lights
- Floating lines
The previous symptoms often last between 10 and 20 minutes before the vision returns to its normal state. Furthermore, ocular migraines often affect the same eye. However, a migraine headache can also cause additional symptoms. These include:
- Nausea
- Vomiting
- Loss of appetite
- Pale skin color
- Tiredness
- Sweating
- Chills
- Increased sensitivity to noise, light, or odors
- Moderate to severe head pain that is usually throbbing, pulsing, or pounding
Immediately contact your healthcare professional if any of the previous symptoms occur.
Causes
Healthcare providers do not fully understand why this condition occurs. However, they think ocular migraines happen due to problems with blood vessels or blood flow that support the retina. Reduced or a lack of blood flow can cause visual problems. When these blood vessels relax, the vision returns to normal because blood flow resumes. Furthermore, some experts believe there is a genetic component to ocular migraines because about 50% of people with this condition have a family history of migraine headaches.
Triggers
The triggers of ocular migraines are similar to migraine with aura. Check below the most common triggers:
- Hypertension (high blood pressure)
- Stress
- Smoking
- Hormonal contraceptive pills
- Exercise
- Bending over
- High altitudes
- Dehydration
- Hypoglycemia (low blood sugar)
- Hyperthermia (high body temperature)
- Alcohol
- Caffeine
Complications
There are some complications that may occur in people with ocular migraines, especially if they ignore the symptoms and do not get treatment. These include:
- CRAO (central retinal artery occlusion) – This complication is also known as eye stroke.
- BRAO (branch retinal artery occlusion)
- Retinal infarction (reduced or blocked blood flow in the retina)
- Central retinal vein occlusion
- Retinal hemorrhages (bleeding) – This complication may lead to edema (swelling) of the retina and disc.
- Ischemia (reduced blood flow) of the choroid or optic nerve
- Vitreous hemorrhage
In addition, there are some medications that can increase your risk of developing ocular migraine complications. For more details, discuss it with your physician.
How to Prevent Ocular Migraines?
Unfortunately, it is not always possible to prevent ocular migraines. One way to prevent them is to avoid triggers. Consult with your doctor about ways to find and avoid the triggers.
Diagnosis
Doctors may diagnose this condition by using a tool called an ophthalmoscope if you visit them during an ocular migraine. This instrument helps see reduced blood flow to the eye. However, when doctors are not sure you have ocular migraines, they may also ask some questions about the symptoms and family history to get more clues about the disease. Sometimes, you can be referred to an ophthalmologist to make sure you do not have an underlying eye disorder.
Treatment
The treatment is different for people with this eye disorder. It depends on the frequency of attacks, existing health problems, age, and preferences. Doctors usually recommend the following options for people with frequent ocular migraines. For example:
- Avoiding triggers – While some triggers cannot be avoided, it is helpful to know what situations trigger the symptoms. Physicians may also recommend some lifestyle changes, including dietary changes, managing stressors (such as high blood pressure), and stopping smoking.
- Medicines – The following medications are often recommended when lifestyle changes do not work, and you continue to experience the symptoms. They often prescribe calcium channel blockers (such as Nifedipine or Verapamil), Aspirin, or antiepileptic drugs.
Frequently Asked Questions
What is the difference between ocular migraines and migraine with aura?
In general, ocular migraines are a type of migraine aura, but they only affect the eyes. In people with migraine with aura, both eyes are affected. Moreover, the symptoms caused by ocular migraines do not last as long as migraine aura symptoms. Another difference between these conditions is that pain caused by an ocular migraine tends to be behind the affected eye, but migraine aura pain can spread in the head.
How long do ocular migraines last?
In most cases, visual problems caused by this disorder last up to 60 minutes. However, the headaches often last for 4-5 hours, but may continue for 72 hours if they are not treated.
Is ocular migraine a mini-stroke?
No, they are different conditions. However, a stroke can cause symptoms very similar to ocular migraine. That’s why it is recommended to go to the nearest emergency room (ER) or call 911 if any of the following symptoms occur. Examples include:
- Aphasia (difficulty speaking)
- Paralysis
- Dysarthria (slurred speech)
- Loss of muscle control on one side of the face
- Sudden partial or total loss of one or more senses (including vision, hearing, smell, taste, and touch)
- Neck stiffness
- Dizziness
- Ataxia (loss of coordination)
- Nausea
- Vomiting
If you have any other questions, ask your healthcare provider.
