What Causes Migraines With Visual Disturbances
While still being studied, ocular migraines are believed to occur when blood vessels in our eyes become constricted or narrowed, reducing blood flow. Once a migraine is over, the narrowed blood vessels relax allowing normal blood flow and restoration of visual disturbances. While some experts believe ocular migraines may result from changes in the nerve cells that spread across the retina.
Ocular migraines arent usually a sign of a serious problem and permanent damage is rare.
Triggers of ocular migraines may include:
- Strenuous Exercise
What Causes Ocular Migraine
The cause of ocular migraine is complicated and often debated, Ann Morrison, O.D., a clinical instructor at the Ohio State University College of Optometry, tells SELF.
One potential factor is misfiring electrical activity in your brain. An electrical impulse causes abnormal electrical activity that spreads over the surface of the brain, triggering the migraine, says Dr. Danan. The thinking is that if that waves of abnormal activity travel across your visual cortex, the part of your brain that processes visual signals, you can wind up with an ocular migraine, according to the Mayo Clinic6.
It’s worth noting that the causes of migraine, in general, aren’t well understood. According to the National Institute of Neurological Disorders and Stroke7 , researchers once thought that migraine was caused by the dilation and constriction of blood vessels in the brain, new research suggests that migraine is tied to our genetics, which could explain why having a family history of migraine can up your own risk of experiencing it.
Ocular Migraines: Causes Symptoms Treatments And Risks
Ocular migraines cause visual disturbances that are almost always temporary. Although migraines are commonly associated with headaches, an ocular migraine can occur with or without a headache. Visual symptoms with migraine, typically called aura, can be distressing, as many MyMigraineTeam members have shared:
- Second migraine aura in five hours.
- Ive had migraines forever, but the aura is getting worse with age
- I have had three severe migraines in the last couple of weeks. Each one started with an aura of zigzag lines in my right eye.
- My visual auras affect a big portion of my vision, so doing day-to-day things is difficult .
- The aura lasts maybe 20 to 30 minutes. Im always afraid that it wont stop!
- My aura starts from the outside corner of my right eye and travels across to my left eye from the inside corner to the outside corner. I cannot see through the pulsating waves.
Ocular migraines can coincide with various types of migraine, including hemiplegic migraine, cluster headaches, cervicogenic headaches, and chronic migraine. An ocular migraine without head pain can be a warning that a migraine headache will follow. The condition is associated with a greater risk of stroke.
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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:
Caffeine Light Flashes And Blurred Vision
The most commonly reported visual disturbance is the retinal migraine, also known as an ocular, visual, or eye migraine. This is different from the classic migraine, which is a visual aura followed by a migraine headache.
Retinal migraine signs and symptoms:
- Area of blocked, grey or white vision with scintillating broken shards of glass flashing lights,
- starts small in an area and seems to expand until finally dissipating,
- lasts from 5 to 20 minutes,
- usually in one eye, but often cant tell if it is one or both eyes,
- may happen multiple times in one day.
The causes of ocular migraines are controversial. Most sources indicate that it is thought to be a vasospasm of a retinal blood vessel. The decrease in blood flow to the retina results in the light flashes and areas of transient vision loss.
Triggers for retinal migraines are varied, from emotional, physical, or chemical:
- Caffeine: caffeinated drinks and chocolate,
- stress, emotional and events like quitting smoking,
- hypoglycemia ,
- changing to a higher altitude, and/or
- exercise with overheating and dehydration.
Retinal migraines can cause you to be alarmed. They have no known long-term consequences. If these occur frequently, consider lifestyle and dietary changes. If making changes does not help, consider a medical evaluation for health-related concerns.
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Coeliac Disease And Gluten Sensitivity
Coeliac disease is a serious condition where a persons immune system reacts when they eat gluten and causes damage to the lining of their gut. When this happens, they have symptoms such as diarrhoea, bloating, vomiting and stomach cramps. There can also be serious complications if it is not treated, such as anaemia. There is no cure for coeliac disease and people with it need to avoid gluten all their life.
There have been studies into the link between coeliac disease and migraine. There is no evidence to suggest that coeliac disease causes migraine. It is thought that if people with coeliac disease and migraine follow a gluten-free diet, this may help with both of their conditions.
Gluten sensitivity is when a person has a bad reaction if they eat gluten. They may have similar symptoms to coeliac disease, but there is no damage to the lining of their gut or the risk of serious complications that can happen with coeliac disease.
Gluten is found in foods that contain wheat, barley or rye. These include pasta, bread, cakes, some sauces and most ready meals.
One of the symptoms of gluten sensitivity is headache. But there is no evidence that gluten sensitivity causes migraine. However, if you are sensitive to gluten, you may find that if you eat food containing gluten, it makes migraine attacks more likely or the symptoms more painful.
Caffeine And Diabetic Eye Disease
Diabetes is a group of chronic diseases that affect how blood sugar , is metabolized or not metabolized, by the body. This inability to utilize blood sugar results in high levels of circulating glucose in the blood vessels, which ultimately damages the integrity of the blood vessels.
Within the eye, the result is diabetic retinopathy, in which blood leaks into the retina. Because there is less blood perfusion, less oxygen is available to the retina. This results in the retina responding by the development of more fragile, leaky blood vessels in response to the low oxygen. Diabetic macular edema is the cause of vision impairment for those with diabetic retinopathy. This is the result of an inflammatory process.
Not a lot is known about the effects of caffeine and coffee on diabetic retinopathy
A notable research study indicated that caffeine decreased blood vessel permeability. This is attributed to its capability to block adenosine receptors. What researchers think that means is caffeine blocks the adenosine receptor in the brain and retinal tissue to prevent inflammation. Coffee has other active ingredients such as vitamins, minerals, and antioxidants. These other active properties of coffee may help decrease blood vessel leakage and the inflammatory process of diabetic retinopathy.
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Quick Lesson On The Anatomy Of The Eye
To understand flashes and floaters it is important to have an understanding of basic ocular anatomy. The eyeball consists of an anterior segment including the cornea, iris and lens and a posterior segment including the vitreous humor, the retina and the optic nerve.
The vitreous humor is composed of a transparent gel-like substance that fills the space in the eyeball between the lens and the retina, this helps to maintain the structure of the eye by providing shock absorption and support to the retina. The vitreous humor must be clear so that light can pass through it. According to a Caltech thesis, the vitreous humor is ~ 99% water and 0.9% salts 0.1% divided between protein and polysaccharide components.
The vitreous is enclosed in a clear membrane called the hyaloid membrane, which is attached to the retina in several areas.
As we age, the vitreous humor becomes more liquid, a process termed syneresis. Syneresis of the vitreous humor can cause it to shrink and collapse as well as pull away from the retina. This process can cause us to perceive floaters or wispy shadows in our vision and sometimes flashes of lights, due to pulling on the retina.
The separation of the vitreous humor from the retina is called a Posterior Vitreous Detachment .
Can Caffeine Trigger Migraine Attacks
While a little bit of caffeine may help ease a migraine episode, too much may have the opposite effect.
An example of this is the medication overuse headache, which is what can happen when you take more headache medication than you should during the course of a month.
When that regularity isnt maintained maybe you take a day off from coffee or get into a situation where you cant drink your usual amount withdrawal symptoms can occur.
One of these withdrawal symptoms might be a headache, which can turn into a migraine attack.
When it comes to the mechanisms of how too much caffeine actually triggers migraine attacks, researchers think there are two main ways an overabundance can create negative physiological effects:
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How Is A Migraine Diagnosed
Gathering details about the headaches is the key to making the diagnosis. The headache history should be obtained from both the patient and his or her parents.
The history includes a description of current and previous headaches specifically, how the patient feels before, during, and after the headache. Information on how often the headaches occur, how long they last, and any other symptoms are also collected. The names of medications taken in the past, current medications, and names of medications that have worked the best are also gathered.
After taking the medical history, your doctor will perform a physical and neurological examination. The exam is usually normal. Sometimes additional tests are needed, such as additional lab work, CT or MRI scan. In typical patients with migraine, no additional tests are needed. Based on all the information collected, your doctor can determine the type and cause of the headaches.
Patients with complicated migraine with neurological symptoms require a more thorough neurological exam, more laboratory tests, and imaging scans. MRI and MRA scans allow the tissues and arteries within the brain to be seen and evaluated. Most patients with complicated migraine recover completely. A structural problem, such as a brain tumor, is rarely found.
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
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Why Does An Ocular Migraine Happen
Its believed that ocular migraines have similar causes as a migraine headache. Both may have a genetic link, with those who have a family history of migraines being more susceptible to them.
The cause of ocular migraines can be down to reduced blood flow in the retina. The blood vessels to the eye suddenly narrow, reducing the blood flow to the eye. Many triggers may contribute to the onset of an ocular migraine, and they may differ from person to person.
Triggers can include stress, lack of sleep, smoking and certain foods like caffeine, chocolate or red wine. Ocular migraines are more common in women, and more common amongst those under 40.
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
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Suffer From Ocular Migraines Our Raleigh Optometrist Shares 5 Triggers To Avoid
What causes ocular migraines? No one quite knows. At least, we dont understand what exactly causes the brain to suddenly release inflammatory substances around the nerves and blood vessels. However, there are several prevailing triggers that many migraine sufferers seem to have in common. If you suffer from chronic ocular migraines, here are some stimuli to avoid.
What Is A Migraine Headache
Migraine is a moderate-to-severe headache that lasts from 2 to 48 hours and usually occurs two to four times per month.
Migraine, also called an acute recurrent headache, occurs in about 3% of children of preschool children, 4% to 11% of elementary school-aged children, and 8% to 15% of high school-aged children. In early childhood and before puberty, migraine is more commonly seen in boys than girls. In adolescence, migraine affects young women more than young men. As adults, women are three times more likely to have a migraine than men.
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Complications Of Posterior Vitreous Detachment:
- Persistent Floaters
- Retinal tears
- Retinal Detachment
- Macular hole
As the vitreous humor liquifies , there is an increased risk for floaters, retinal holes or retinal detachments. It is very important to see your Eye Doctor as soon as you start seeing flashes or floaters. Your Eye Doctor will perform a series of tests including a dilated eye exam to view the vitreous and retina.
As the vitreous humor pulls away from the retina it can cause a retinal hole or tear. In some cases, a Retinal Detachment can occur which commonly presents with floaters, flashes and the perception of a curtain draping over ones vision.
Symptoms could include floaters that dont go away, distorted, blurry vision or a curtain over the vision.
Possible Triggers For Ocular Migraines
Associated factors which have been noted as potential triggers for ocular migraines include the following:
- Strenuous or intense exercise activity
- The use of hormonal medications oral contraceptive pills and HRT
- High altitudes and hot climates
- Withdrawal from substances such as caffeine
- Foodstuffs such as processed meats containing nitrates , tyramine , or monosodium glutamate / MSG , artificial sweeteners and chocolate.
- Beverages, such as alcohol or those containing caffeine
- Strong scents and fragrances or odours
- Lack of sleep
- Exposure to flickering lights
- Stress or anxiety
A single trigger, or a combination can result in the onset of an ocular migraine attack. Triggers can vary from person to person.
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Certain Foods And Additives
Alcohol, chocolate, and caffeine are all common migraine triggers. Other possible trigger foods include cheese, salami, and pickled foods containing large amounts of tyramine. Food additives such as monosodium glutamate and artificial sweeteners like aspartame can also trigger migraines in some individuals.
Comprehensive Eye Care For The Whole Family
Eye Medical Clinic has both optometrists and ophthalmologists on our experienced team of eye specialists. We have proudly served the Bay Area for more than 70 years and we are fully equipped to care for the eye needs of the youngest member of your family to the most senior member. Wed love to talk to you about your migraines as they relate to your vision and see how we can help.
We invite you to experience our expert eye care for every generation at Eye Medical Clinic. Our team, including experienced doctors John Sullivan, MD Mona Bagga, MD and Christina Nguyen Deane, OD, as well as a highly trained and dedicated staff, is dedicated to helping you enjoy your life to the fullestwith the clear vision, you deserve. Schedule your comprehensive eye exam today.
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