What Is A Visual Migraine
Visual migraines can mimic other serious conditions, making it very important to see an eye doctor as soon as possible if you experience any sudden vision loss or changes to your vision.
A visual migraine, also known as an ocular migraine, causes temporary visual disturbance. This disturbance often appears suddenly and may create a blind spot moving across the visual field or the sensation of looking through a cracked window.
There are two types of ocular migraines:
- migraine auras
Migraine auras are very common, affecting 1 in 5 migraine sufferers.
Migraine auras cause binocular visual distortions, affecting both eyes simultaneously. They may also cause:
- Numbness or tingling
- Mental fog
- Changes in taste, smell, or sense of touch.
An aura can occur with or without a migraine, and may sometimes precede a headache. The visual distortions are temporary and usually last around 30 minutes. They can impact performance in certain activities, such as driving and reading.
The most common visual symptoms of migraine auras include:
- Flashes of light
What Are The Causes
The exact causes of ocular migraines are not definitively established. However, many scientists think that the symptoms that you experience happen because of reduced blood flow to the brain. Spasm in the blood vessels is what causes a reduction in blood flow.
The source of visual disturbances in ocular migraines is the retinal blood vessels. Contrarily, the source of migraines with aura is the occipital cortex, which is located at the base of the skull.
Since the source of the problem in aura migraines is not the eyes but the brain, you will still experience the sensory disturbances even when you close your eyes.
When Should You Worry About An Ocular Migraine
Although the symptoms of ocular migraines can be frightening, the condition is harmless and short-lived in most cases. However, ocular migraines can indicate serious health problems, such as increased risk for stroke or severe carotid artery disease.
Its essential to see an eye doctor when you lose your eyesight suddenly for the first time or if your eyesight deteriorates to check for any serious conditions.
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The Causes Of Ocular Migraines
Another frustration with ocular migraines is even experts arent totally sure what causes them. Some health professionals think ocular migraines have the same basic cause as regular migraines: someone whose parents and family members have struggled with migraines is more likely to experience ocular migraines. More specifically, ocular migraines could have to do with spasms in the blood vessels of the retina or unusual electrical activity throughout the cortex of the brain.
Regardless of the specific genetic or chemical causes of ocular migraines, health professionals do have a better idea of what triggers these occurrences. As with regular migraines, ocular migraines can be triggered by harsh light or, especially, electronic screens. Someone who spends the whole day looking at a computer screen, for instance, is at higher risk for experiencing ocular migraines than someone whose job does not involve much screen time.
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.
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Are Ocular Migraines Harmful
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.
Frequent Ocular Migraines: Should I Be Concerned
Ocular migraines can interfere with your ability to perform routine tasks like reading, writing, or driving as they cause visual disturbances and even temporary vision loss. Seek help from pain doctors experienced in diagnosing and treating every type of headache if your symptoms are occurring too frequently and the episodes last longer than the previous ones. Pain management experts at Advanced Headache Center can diagnose the true causes of your pain and recommend the best line of treatment to provide relief.
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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 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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What Are The Preventive Treatments For Migraine
Many patients with isolated visual migraines, without severe headaches, have relatively infrequent episodes that do not require specific preventive treatments. If a patient is aware of the particular triggers that seem to bring on an episode, then those triggers can be avoided.
In patients where the pattern of migraines includes frequent, severe headaches, it is very reasonable to consider additional preventive treatments. The main goal for any of these strategies is to reduce the overall frequency and severity of the headaches. None of the preventive treatments is a magic bullet that is 100% effective. For example, it would be considered successful if a preventive treatment helped reduce the number of severe headaches from 8 per month to 2-4 per month.
There are numerous medications that can be used as a preventive treatment for migraine. One medication that is used commonly, particularly because it has no side effects, is vitamin B2 . Approximately 100mg of riboflavin daily is thought to improve migraine headaches . One common side effect of riboflavin is that the urine turns bright yellow. Other herbal medications used to reduce migraine headaches include petasites and feverfew.
What Causes Ocular And Visual Migraines
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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Living With Ocular Migraines
The cause of ocular and traditional migraines is well understood both are the result of altered blood flow. However, there can be many different triggers resulting in altered blood flow. People who frequently experience ocular migraines or migraine headaches have usually identified what triggers their occurrences, and it varies from person to person. Common triggers include certain foods or drinks, like gluten, processed sugar, meats, or alcohol. Medications may also be a culprit for triggering these events. Others seem to identify environmental causes for their migraines, such as fatigue, restlessness, or extreme stress. An important part of living with ocular migraines and headache migraines is being able to identify the triggers for these events, and keeping them in mind for future avoidance.
What Causes Ocular Migraine
Migraine aura is considered to be a result of abnormal electrical activity involving certain regions of the cortex of the brain. This abnormal activity spreads across the cortex at a slow rate of about 3mm per minute and this spread is responsible for the growth and movement of the visual disturbance over the 20-60 minutes that the visual aura lasts. Retinal migraine may be due to the same type of disturbance except occurring at the back of the eye in the retina, or it may be due to a reduction in blood flow to the retina.
Like other types of migraine, harsh lights and electronic screens can be triggers. Straining your eyes by staring at a screen for long periods of time, spending time in fluorescent or other harsh lighting, driving long distances and other taxing visual activities can increase your risk for attacks. Talk to your eye doctor about how to avoid attacks.
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Deterrence And Patient Education
It is critical to educate the patients about the red flags of vision loss. A visual loss that patients describe as darkness requires immediate medical attention and an emergency room visit. Patients must understand that this could be a sign of a stroke or an irreversible eye condition. Visual changes that are more consistent with migraine phenomenon are usually positive such as flashing light. Patients must also be taught that those could come without a headache or any pain. Preventive therapy is important to reduce the frequency of attacks and severity and must be taken on a daily basis.
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 30 minutes or less. 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, then cover one eye at a time. If the visual disturbance is occurring in just one eye, it’s likely that it’s an ocular migraine. If it affects both eyes, it’s probably a visual migraine.
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What Are Migraine Triggers
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
Treatment Of Migraine With Aura
When you get treated for migraine with aura, the main goal is to prevent and manage pain.
Your doctor may suggest medications to prevent migraine with aura, including:
Your doctor may also suggest you take magnesium or riboflavin to prevent migraine with aura.
Your doctor may also suggest prescription drugs called triptans and ergotamines. If the pain is severe, you may need to get treatment in an emergency room with medications you take through an IV.
If you are vomiting, your doctor may recommend anti-nausea drugs.
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Ocular Migraines: Common Questions And Answers
Below are some frequently asked questions about ocular migraines:
Can dehydration cause ocular migraines?
Dehydration is one of the triggers of ocular migraines. Keeping your body hydrated will help prevent or reduce the frequency of occurrence of migraines.
Can anxiety cause ocular migraines?
Just like dehydration, anxiety is also a trigger of ocular migraines. The symptoms of ocular migraines can also cause anxiety, which worsens ocular migraines.
Simple reassurance from your doctor will lower anxiety levels and decrease or eliminate ocular migraines.
Can high blood pressure cause ocular migraines?
Researchers are working to fully understand the relationship between high blood pressure and ocular migraines.
Current research points to the fact that migraine attacks are prevalent in people with high blood pressure.
Anyone suffering from high blood pressure is advised to get it under control, especially those with a known history of ocular migraines.
Are ocular migraines a symptom of a brain tumor?
A migraine that is accompanied by vision issues can be associated with certain tumors, such as the occipital lobe tumor.
Although this is a rare condition, migraines are common among patients with brain tumors.
Is an ocular migraine a sign of a stroke?
An ocular migraine is not necessarily a sign of a stroke, but can indicate increased risk.
However, research indicates that people with a history of ocular migraines are at a higher risk of stroke.
In this article
Treatment And Prevention Of Ocular And Visual Migraines
As already noted, visual disturbances caused by ocular migraines and visual migraines typically go away within an hour.
If you are performing tasks that require clear vision when an ocular migraine or visual migraine occurs, stop what you are doing and relax until it passes. If you’re driving, pull of the road, park your vehicle and wait for your vision to return to normal.
As soon as possible, see your eye doctor, family physician or a neurologist for evaluation of your migraine episodes. Your doctor can let you know about the latest medicines for treating migraines, including those that may help prevent future attacks.
It’s also a good idea to keep a journal of your diet and daily activities. Doing so can help you identify possible triggers of your ocular migraines or visual migraines .
Many migraine attacks are stress-related. You might be able to reduce how often they occur by:
Avoiding common migraine triggers
Getting plenty of sleep
Trying stress-busters such as yoga and massage
Migraines can be successfully managed so they are less frequent and debilitating. The first step is to see a doctor to discuss your symptoms including vision problems and discuss treatment and prevention options.
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What Are The Symptoms Of An Ocular Migraine
The most common ocular migraine symptom is a small blind spot that impairs your central vision in one eye.
This blind spot expands, making it difficult to drive safely or read using the affected eye.
In addition to the flickering blind spot, other migraine symptoms include:
- A colorful light ring that is wavy or zigzag and surrounds a central blind spot
- A blind spot that slowly migrates across your field of vision
- A migraine lasting between 4 and 42 hours
- Sensitivity to light or sound
- Vision loss
- Nausea and vomiting
- A headache that feels worse when you move your head
If you have blind spots or other visual symptoms and arent sure whether it’s an ocular migraine or a visual migraine, cover one eye at a time and observe your sense of sight. If the visual disturbance affects one eye only, it is most likely an ocular migraine.
How Common Are Ocular Migraines
Q: Thank you for the information you have published about ocular migraines. I’ve had numerous episodes over the past five years, but most recently was last week when I was two and a half hours away from my home. It took over an hour for it to totally go away. I appreciate your explanation of the usual symptoms, because it described what I experienced to a “T.”
I had one question, though. Other sources on the Internet say this phenomenon is rare. But you say it is quite common. Is it? B.M.
A: Ophthalmic migraines are not rare, especially if you are a woman under age 40 with a history of migraines. Dr. Slonim
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