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.
Diagnosing Migraine With Aura
ICHD III criteria for migraine with aura is:
A) At least 2 attacks fulfilling criteria B and C
B) 1 or more of the following fully reversible aura symptoms:
2) No motor or retinal symptoms.
Not all symptoms are listed here but brainstem auras can cause what feels like very strange outer body experiences. Sometimes it is referred to as Alice in Wonderland syndrome which is a rare but distinctive distortion of body image and perspective. This syndrome can occur at any age and is thought to be more common amongst children.
A Guide To Healing Ocular Migraines
One in every 200 migraine patients experiences ocular or retinal migraines that can significantly affect their vision. These attacks are often preceded by aura, which typically affects both eyes. Patients might see spots, patterns or flashes of light before a headache develops, and symptoms range from light sensitivity to temporary vision loss. The worst ocular migraines can cause temporary blindness episode lasting several minutes, although the duration is usually less than an hour.
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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.
A flickering blind spot in the center or near the center of your field of view
A wavy or zigzag ring of colored light surrounding a central blind spot
A blind spot that slowly migrates across your visual field
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.
What Medications Are Used To Relieve Migraine Pain
Over-the-counter medications are effective for some people with mild to moderate migraines. The main ingredients in pain relieving medications are ibuprofen, aspirin, acetaminophen, naproxen and caffeine.
Three over-the-counter products approved by the Food and Drug Administration for migraine headaches are:
- Excedrin® Migraine.
- Advil® Migraine.
- Motrin® Migraine Pain.
Be cautious when taking over-the-counter pain relieving medications. Sometimes overusing them can cause analgesic-rebound headaches or a dependency problem. If you’re taking any over-the-counter pain medications more than two to three times a week, report that to your healthcare provider. They may suggest prescription medications that may be more effective.
Prescription drugs for migraine headaches include:
Triptan class of drugs :
- Co-enzyme Q10.
Drugs to relieve migraine pain come in a variety of formulations including pills, tablets, injections, suppositories and nasal sprays. You and your healthcare provider will discuss the specific medication, combination of medications and formulations to best meet your unique headache pain.
Drugs to relieve nausea are also prescribed, if needed.
All medications should be used under the direction of a headache specialist or healthcare provider familiar with migraine therapy. As with any medication, it’s important to carefully follow the label instructions and your healthcare providers advice.
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Signs And Symptoms Of An Ocular Migraine
Symptoms of an ocular migraine are called auras which can present as a variety of disturbances in your vision. Patients often describe their symptoms as heat waves, dark spots, flickering lights or loss of peripheral vision. Other areas of the brain can also be affected by these blood vessel constrictions causing symptoms such as vertigo, hearing loss, nausea, difficulty speaking, or difficulty with concentration. These auras can be very disconcerting, often sending many patients to the emergency room.
How Is Retinal Migraine Treated
Treatment of retinal migraine attacks is a current area of exploration. No clear-cut guidelines exist. Today, treatment primarily relies on NSAIDs and antinausea medicines to manage pain and other symptoms. No treatments are available to restore vision during an attack. Doctors avoid typical migraine treatments, such as triptan drugs and ergot alkaloids. These drugs have constrictive effects on blood vessels, which may worsen retinal migraine.
Medications may be helpful to prevent attacks. This includes drugs that help prevent other forms of migraine, such as tricyclic antidepressants and antiseizure drugs. Doctors may also use drugs to help the blood vessels stay relaxed, including beta blockers and calcium channel blockers. Daily aspirin therapy may be helpful as well.
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What You Should Know About Ocular Migraines
When you tell your physician you have a headache, it typically involves follow-up questions. Can you pointing to where the pain is, what type of pain is it and what other symptoms do you experience are all important questions to ask in order to determine what type of headache youre experiencing and how it can be treated. This additional information is essential to determine if you experience ocular migraines.
What Is The Connection Between Ocular Migraines And Stroke
Ischemic strokes, or strokes caused by a blockage to the brain, account for the majority of all stroke cases in the United States todaynearly87 percent, in factand individuals suffering from migraines with aura are 2.4 times more likely to have an ischemic stroke than those who have migraines without aura, according to the American Heart Association. Recent studies have identified a direct correlation between migraines and the eventual development of certain cardiovascular diseases,. Although the exact underlying cause is not fully understood, one thing remains very clear: individuals experiencing migraines with aura have agreater risk of stroke than individuals who do not.
Souvik Sen, M.D., M.P.H., study author and neurologist at theUniversity of South Carolina School of Medicine has said, Since migraines alter the blood vessels in the brain, the greater incidence of strokes caused by blood clots in the heart or the brains blood vessels suggests that migraine also affects blood vessels in the heart and neck. Thats what possibly leads to these specific subtypes of stroke.
Experts are now advising individuals suffering from ocular migraines to be vigilant about their symptoms, as typical migraine symptoms could signify something much more serious.
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What Triggers An Ocular Migraine
Ocular migraines are caused by a narrowing of the blood vessels that supply the eye with blood, this constriction happens suddenly and reduces the amount of blood the eye receives. After the attack the blood vessels around your eyes relax, the normal blood flow resumes and your sight goes back to normal.
Retinal migraines can be triggered by a number of factors, including lifestyle choices and environmental influences. The precise cause of your ocular migraines can be difficult to pinpoint, however you may notice a pattern start to appear dependent on the activities you complete or the food you eat, for example if you skipped a meal you could experience an ocular migraine.
Common triggers of ocular migraines include:
- Stress take time out of your day to relax and unwind, this might be having a bath before bed or finding a quiet place in the office to complete your work
- Smoking this habit negatively impacts your health and affects many aspects of your body
- Low blood sugar making sure that you are eating regular meals will help to keep your blood sugar levels steady
- Hormonal contraceptive pills
- Excessive heat make sure that you feel comfortable, open a window or place a fan next to your desk, do whatever you need to do to keep your body at a regular temperature
- Dehydration its recommend that we drink 6-8 glasses of water a day as water is needed for our body to function properly
- Bending over
- High altitude
Common Symptoms Of A Migraine
The main symptom of a migraine is usually an intense headache on 1 side of the head.
The pain is usually a moderate or severe throbbing sensation that gets worse when you move and prevents you carrying out normal activities.
In some cases, the pain can occur on both sides of your head and may affect your face or neck.
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What Is A Vestibular Migraine
A vestibular migraine causes vertigo, a feeling of dizziness and imbalance. You might become more sensitive to movement and find that moving your head or seeing moving images can worsen the symptoms. These episodes are normal spontaneous, occurring without a headache, or before or after a headache. The duration of the attacks can vary you may experience vertigo for minutes, hours, or days.
How Do You Treat A Vestibular Migraine
Treatment recommendations for vestibular migraines centre on managing your triggers and living a healthy lifestyle. If you know that a lack of sleep or not eating enough trigger your migraines then its important that you create a meal and bed time routine that you can easily follow. Exercising regularly and managing your stress levels can also help to fend off attacks, however if you are having frequent episodes or they are severe then your GP can offer advice. They will be able to prescribe medication to help not only ease the symptoms but also stop the migraines occurring.
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Diagnosis Of An Ocular Migraine
The diagnosis of an ocular migraine is often made by comparing the patients symptoms to the criteria established by the IHS. Migraines can be difficult to diagnose other conditions that could be causing the symptoms need to be ruled out.
The potential difficulties of making a diagnosis is the reason the IHS have established criteria to help clinicians to make a proper diagnosis.
The diagnostic criteria for the diagnosis of an ocular migraine from the IHS Classification ICHD-II are:
There are several other conditions that should be ruled out when symptoms of an ocular migraine are present. These other conditions may have similar symptoms, but will require different treatments.
Unfortunately, there is a long list of other causes of ocular symptoms that should be ruled out, including:
Treatment Of Migraine With Aura
A comprehensive treatment plan is required for migraine with aura to help take control and reduce your attacks.
Reducing migraine is especially important for migraine with aura due to the potential risks from frequent and severe auras over an extended period of time. Studies have shown an association between migraine with aura and stroke. If you experience migraine with aura and take oral contraceptives your risk may be even higher. This is something to speak to your doctor or specialist about.
Unfortunately good treatment results can be difficult to achieve in severe cases of migraine. Migraine globally is undertreated and poorly managed.
Rarely does a miracle solution present itself as a miracle pill or cure. More often it is the result of an educated partnership between patient and doctor which results in a comprehensive evaluation and adjustment of behavioral, dietary and lifestyle factors which are supported where appropriate with acute and preventative treatments.
Let me know your aura symptoms in the comments below.
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What Is An Ocular Migraine
An ocular migraine is an eye problem characterized by short episodes of vision loss or visual disturbances.
For example, you may see flashing lights in one eye accompanied by a headache.
Your doctor may also refer to this type of migraine as ophthalmic or monocular migraines.
These episodes may be scary. But in most cases, they are harmless and short-lived. However, ocular migraines can be a sign of a more serious condition.
Some people experience retinal migraines every few months, but the frequency varies from person to person.
Retinal migraine is a unique condition that should not be confused with headache-type migraine or migraine with aura, which often affect both eyes.1
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- Alcoholic drinks such as red wine
- Excess heat or high altitude
How To Prevent Ocular Migraines
As with many headache conditions, each person may experience different triggers for an ocular migraine. It is a good idea to document what you were doing and when the experience occurred so that you can control your exposure to any stimuli that might spur the issue.
If you are driving or doing anything else that requires undisturbed visual acuity when an episode occurs, get to safety and try to relax until the symptoms pass. Limiting exposure to bright light and loud noises often help, especially if you are prone to migraine pain.
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Ocular Migraines Treatment And Medication
Optical migraines are challenging to treat as they occur for a very short time and usually go away within an hour. It is necessary to consult a doctor who will recommend the medications according to the frequency of the migraines as the treatment usually focuses on preventing and reducing the symptoms.
Your doctor might suggest mediations that include:
- NSAIDs like ibuprofen for occasional ocular migraine
- Tricyclic antidepressants such as amitriptyline
- Calcium channel blockers such as amlodipine
In certain cases, the medication used for treating epilepsy has also proved helpful with an ocular migraine.
If you are performing tasks that require a clear vision when an ocular migraine occurs, stop what you are doing and relax until it passes. Even if you are driving, pull off the road and wait for your vision to return to normal before moving forward.
Are Migraines Hereditary
Migraines tend to run in families. As many as four out of five people with migraines have a family history. If one parent has a history of migraines, their child has a 50% chance of having them. If both parents have a history of migraines, the risk jumps to 75%. Again, up to 80% of people with migraines have a first-degree relative with the disease.
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What Causes A Migraine
Although migraines are extremely common, their exact cause remains unknown. It appears likely that the visual aura relates to a phenomenon called cortical spreading depression which temporarily affects electrical impulses in the brain. The pain of a migraine headache probably relates to spasm or irritability of blood vessels in the brain, which are sensitive to pain . Beyond these hypotheses, however, the exact mechanism that triggers a migraine remains unknown.
It is often possible to identify certain risk factors that increase the chance of having migraines. A positive family history is very common, so the doctor will often ask about headaches in ones parents or siblings. Overall, migraines are more common in women than in men. In addition, a persons hormonal status can affect the pattern of migraines they experience therefore, it is natural for a woman to notice a change in headaches and other migraine symptoms in adolescence or around the time of menopause.
Many individuals can identify specific triggers for their migraines. These triggers include fatigue, skipping a meal, caffeine withdrawal, stress, and certain foods . For many patients with isolated visual migraines, however, the events can be very infrequent and no definite trigger can be determined.
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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