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Can High Blood Pressure Cause Ocular Migraines

Are Ocular Migraines Harmful

Blurry vision, brain fog, and increased ocular pressure, due to Intracranial Hypertension

In general, ocular migraines are not considered harmful. Most people have no symptoms other than blindness or blind spots. Neither retinal migraines nor full ocular migraines are, in and of themselves, harmful. However, in some cases, retinal or ocular migraines may be a sign of a more serious problem. If you have a retinal or ocular migraine, its important to consult with a doctor as soon as possible to undergo an evaluation and ensure your symptoms dont signal a larger problem.

Most of the time, ocular migraines are not caused by actual visual symptoms nor is their trigger within the eye. Instead, they are caused by migraine activity within the visual cortex of the brain.

Understanding High Blood Pressure

About 45% of adults in America have high blood pressure. Also known as hypertension, this condition is the most common type of cardiovascular disease. It occurs when the pressure that moves blood through the body is too high or forceful. When blood moves too hard and fast through the arteries and veins it causes damage to them. This can lead to organ damage as well as life threatening conditions like stroke and heart disease.

Blood pressure is measured by two numbers in a single reading. The first number, systolic pressure, is the force or pressure that is in the arteries each time the heart beats. The second number, diastolic pressure, is the force or pressure that is in the arteries when the heart rests between each beat. Normal blood pressure is around 120 mm HG over 80 mm HG in adults, but it can become elevated in time of stress or physical exertion. It is also normal for different people to have a different blood pressure normal.

People who have a blood pressure that is 130/80 or higher at least twice may have a problem with high blood pressure. When blood pressure is slightly over 120 mm HG systolic or slightly more than 80 mm HG diastolic it is considered to be prehypertension. Approximately 75 million American adults are prehypertensive. However, even at this stage the risk of damage to the brain, heart, arteries, and kidneys is increased.

Get Your Blood Pressure Down

Reducing your blood pressure isnt just going to help spare you from headaches, it could save your life. In addition to persistent high blood pressure, some people with blood pressure issues can experience a rapid increase that puts your entire life at risk.

Here are several things the American Diabetes Association recommends to lower your blood pressure:

  • Talk to your healthcare team about all of your treatment options
  • Research medications that lower blood pressure, including ACE inhibitors, ARBs, beta blockers, calcium channel blockers, and diuretics
  • Get more whole grains in your diet
  • Reduce your salt intake with a low-sodium salt substitute, and herbs and spices
  • Avoid packaged foods with more than 400 mg of sodium per serving
  • Eat more whole foods that dont contain any sodium in the first place
  • Make a weight-loss goal and start walking at a comfortable pace every day
  • Reduce your alcohol consumption
  • If you smoke, its time to quit!

In the end, reducing blood pressure comes down to living a healthier lifestyle. You dont have to be perfect, but if 80 percent of your day consists of healthy choices combined with more activity, youll see those numbers gradually come down.

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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.

On Understanding Ocular Migraines

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When we hear the word migraine, we often think of a painful and debilitating headache that is far worse than everyday headaches. The term ocular migraine can cause a little confusion but generally means a migraine that is accompanied by changes or distortions to vision. The term is often used synonymously in reference to two different conditions: a migraine with aura and a retinal migraine.

These migraine subtypes are characterized by several different visual disturbances that may include:

    Some patients may experience more traditional symptoms of a migraine such as:

    • Nausea

    Ocular migraines may occur with or without head pain.

    Types of Ocular Migraines

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    What Does Normal Pressure In Your Eyes Feel Like

    According to the American Academy of Ophthalmology, eye pressure is measured by the amount of fluid in your eye. Its similar to measuring your blood pressure. Your eye contains a substance called vitreous humor, which looks and feels like jelly and is located in the back of your eye. Aqueous humor is a watery liquid that is also located in your eye, but its mostly in the front part of the eye in front of the iris and behind the cornea.

    In a normal or healthy eye, there is a small amount of aqueous humor that always enters while an equal amount drains. Most of this liquid flows out of the eye through an area in front of the iris known as the drainage angle. This continuous flow ensure that you have a steady pressure in your eyes. So, what causes eye pressure to go up? An imbalance in this procedure can make you feel like you have too much or too little eye pressure in your eyes.

    Normal eye pressure should feel comfortable. In other words, it should feel like nothing is wrong with your eyes. This indicates that the drainage angle is working properly and there are no issues. You can measure your eye pressure in millimeters of mercury or mm, similar to how a thermometer measures temperature. Normal eye pressure measures between 10 and 20 mm. Some people have high or low eye pressure with no other symptoms. Others experience vision loss or optic nerve damage.

    What Happens During An Ocular Migraine

    Doctors arent always sure what exactly is happening in the brain during an ocular migraine, but it often has to do with abnormal electrical activity in the brain, or spasms/issues with the blood vessels at the back of our eyes, the retina. This is most likely why the visual affects of ocular migraines are short lived but disorienting none the less.

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    Experiencing Ocular Migraines See Our Raleigh Optometrists Today

    Seeing lights, lines, zigzags, or stars while experiencing a migraine, while common, can also be an indication of a major neurological issue or eye issue. If you live in Raleigh and are experiencing severe or frequent ocular headaches, be sure to see our Raleigh optometrists as soon as possible. Schedule an appointment here.

    High Blood Pressure And Headaches At The Same Time Without One Causing The Other

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    There have been numerous other studies trying to find links between other types of headaches and high blood pressures. However, none of them have consistently proven direct links. Here are some interesting findings about the relationship between high blood pressure and migraine headaches.

    A study comparing high blood pressure patients with headaches and high blood pressure patients without headaches

    Some patients with high blood pressure have headaches and others dont. This study wanted to see if having both high blood pressure and headaches is worse than high blood pressure without headaches. They wanted to see if perhaps headaches associated with high blood pressure meant that those high blood pressure patients had a worse kind of high blood pressure. This study was published in the American Journal of Hypertension in 2016. They followed 1,914 patients for 30 years. They initially marked them as having high blood pressure with headaches and high blood pressure without headaches. At the end of the 30 years, they tracked those patients and found out that 580 of them died from a heart attack and 97 of them died from a stroke.

    A study comparing the blood pressures of patients visiting the emergency department with headaches to the blood pressures of patients visiting the emergency department without headaches

    A study comparing the association between high blood pressure and migraine headaches in patients visiting the ER in northern Manhattan

    References:

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    Treatment For High Blood Pressure Headaches

    If you do get them, high blood pressure headaches tend to come during a hypertensive crisis. This is defined as blood pressure over 180/120 mm Hg. You might also have a nosebleed or feel generally ill.

    The American Heart Association and American College of Cardiology recommend these steps if you have a hypertension headache due to a hypertensive crisis.

    • Take your blood pressure if you suspect you have a hypertensive crisis.
    • If it is over 180/120 mm Hg, rest for 5 minutes.
    • Take your blood pressure again.
    • If you still have a headache or nosebleed or do not feel well and your blood pressure is still over 180/120 mm Hg, dial 9-1-1.

    Without quick action to lower your blood pressure, a hypertensive crisis can lead to permanent target organ damage, such as to your brain, heart, and kidneys.

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    Symptoms Of High Pressure

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    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.

    What Are Migraine Triggers

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    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
    • Strong odors

    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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    The visual cues are hard to ignore: shimmering or flashing lights, zigzagging lines or stars, black spots. All make it difficult to read, write, or drive. If you experience these symptoms, youre most likely having an ocular migraine. It can occur with or without the pain of a migraine headache.

    For people prone to migraines, one of every five has this visual aura before the headache pain begins. An ocular migraine by itself lasts anywhere from 10 minutes to an hour and isnt considered a serious condition.

    Headache specialist Richard Kim, MD, describes a migraine with aura.

    Click play to watch the video or read video transcript.

    What is a migraine with aura?

    Although some doctors think ocular migraines are caused by the same factors that create classic migraines, no one knows for certain. Ocular migraines seem to run in families. They have been linked to estrogen, a female hormone that fluctuates during menstruation, pregnancy, and menopause, or with use of oral contraceptives or hormone replacement therapies.

    Most ocular and retinal migraines dont require treatment.

    Understanding High Blood Pressure Headaches

    If you are one of the millions of people who live with high blood pressure, you were probably surprised when your doctor told you that your numbers were higher than they should beespecially because you feel fine.

    High blood pressure doesnt typically cause symptoms. However, some people may have headachesespecially if their blood pressure skyrockets into the danger zonea condition known as high blood pressure emergency or urgency.

    Heres what you need to know about a high blood pressure headache, what other symptoms may occur, and when to call 911.

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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 Causes Ocular And Visual Migraines

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    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

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    Complications Of Ocular Migraine

    Any problems in vision should immediately be reported to a physician. The symptoms of ocular migraine should be investigated fully in order to determine that there is no other disease or condition present.

    People who experience ocular migraines may be at risk for permanent vision loss. Patients should follow up with their physician on a regular basis and discuss any changes in their symptoms or their headaches.

    • Doyle, E., Vote, B. J., Casswell, A. G. . Retinal migraine: caught in the act Br J Ophthalmol. 88, 301302. doi: 10.1136/bjo.2003.021808 Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1772006/
    • Gan KD, Mouradian MS, Weis E, Lewis JR. . Transient monocular visual loss and retinal migraine. CMAJ.6 173, 1441-1442.
    • Grosberg, B. M., Solomon, S., Lipton, R. B. . Retinal migraine. Curr Pain Headache Rep. 9, 268-271.
    • International Headache Society. Retinal migraine. Retrieved from: https://ihs-classification.org/en/02_klassifikation/02_teil1/01.04.00_migraine.html

    What Should You Do If You Have An Ocular Migraine

    If you note ocular migraine symptoms, your actions will depend on the severity of the symptoms and how much they affect your ability to function. Since ocular migraines are generally painless, you may be able to continue with your normal daily activities, especially if symptoms are confined to one eye or wear off quickly. You should also follow these steps:

    Make sure that you are in a place where you do not require visual clarity. If you are on the road, for example, you should pull over as soon as it is possible to do so safely. If you suffer complete blindness, sit or lie down and wait for the migraine to pass. Ocular migraines may also be disorienting, so you may need to sit down while waiting for symptoms to stop.

    See if you can isolate a trigger. If possible, note what is going on in your environment that could have triggered a migraine, whether you note that you are highly stressed, that there are extremely bright or flashing lights in the room, or that you have recently consumed a specific food.

    Contact your doctor if needed. While ocular migraines are generally harmless, you should consult your doctor to rule out any larger problems, especially if you have recently had an ocular migraine for the first time or frequency appears to be increasing. In some cases, your doctor may be able to help you manage ocular migraines with medication. In other cases, they may work with you to help isolate a trigger, which can help you avoid potential future episodes.

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