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What Is A Retinal Migraine

Visual Impairments Associated With Migraine Can Happen With Or Without A Headache

“Ocular Migraine” is a term that has been used to refer to a number of migraine subtypes that are characterized by a variety of visual disturbances including visual loss, blind spots, zig-zag lines, or seeing stars. Unlike other forms of migraine, they may occur without any accompanying head pain. It’s not uncommon for a single patient to experience a wide range of visual symptoms. Here’s what you need to know to better understand the migraine subtypes that affect vision.

Treating And Preventing Migraine With Aura Or Retinal Migraine

For infrequent attacks, medications that target symptoms can be effective, from NSAIDs for pain to anti-nausea medications. Preventative therapies including calcium channel blockers, antiepileptic or tricyclic medications. Quitting smoking is recommended and cessation of oral contraceptives may be advised in certain circumstances. Some options for relief without drugs can include resting your eyes, removing yourself from bright sunlight or other harsh lighting, and taking a break from looking at a screen. As with all types of migraine, try to avoid triggers like stress, dehydration, high altitude, low blood sugar, excessive heat and extensive time spent staring at a screen.

While the symptoms can be disorienting and distressing, they are often short-lived, and almost always reversible. Take some time away from triggers and wait for the symptoms to fade. For more information, visit the American Migraine Foundation’s resource center, which includes content specifically related to Migraine with Aura, Retinal Migraine and more. The American Migraine Foundation is committed to providing comfort and information to people living with this disease. You are not alone: find your support network today.

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Ichd Comparison Of Retinal Migraine And Migraine Without Aura

Retinal Migraine Description:

Repeated attacks of monocular visual disturbance, including scintillations, scotomata or blindness, associated with Migraine headache.

Retinal Migraine Diagnostic Criteria:

  • At least two attacks fulfilling criteria B and C
  • Aura consisting of fully reversible monocular positive and/or negative visual phenomena confirmed during an attack by either or both of the following:
  • clinical visual field examination
  • the patient’s drawing of a monocular field defect
  • At least two of the following three characteristics:
  • the aura spreads gradually over 5 or more minutes
  • aura symptoms last 5-60 minutes
  • the aura is accompanied, or followed within 60 minutes, by headache
  • Not better accounted for by another ICHD-3 diagnosis, and other causes of amaurosis fugax have been excluded.
  • Migraine Without Aura Diagnostic Criteria:

  • Headache attacks lasting 4-72 hours
  • Headache has at least two of the following characteristics:
  • unilateral location
  • moderate or severe pain intensity
  • aggravation by or causing avoidance of routine physical activity
  • During headache at least one of the following:
  • nausea and/or vomiting
  • photophobia and phonophobia
  • What Are The Potential Complications Of Retinal Migraine

    With retinal migraine, reduced blood flow to the retina may eventually cause damage. This can result in permanent partial or complete vision loss in the eye. It is unclear how often this happens or if there are factors that can predict it. Seeing your doctor for regular follow-up appointments can help identify potential problems with the retina. Most doctors also recommend preventive medications, even if attacks are infrequent.

    Treatment And Prevention Of Ocular And Visual Migraines

    Retinal migraine

    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.

    Retinal Migraines: Symptoms Causes And Treatment

    Mandy Armitage, MD

    If you suffer from migraines, you know how disabling and worrisome they can be. Even more scary is when, on top of the painful migraine, you also have changes in your vision, like blind spots or light flashes. Is this a normal part of migraine? Or is it something else entirely?

    Let’s take a look at one type of migraine that can affect your vision, retinal migraine, and how it differs from other migraines. We’ll also go over what you should do if you have retinal migraines.

    Are Retinal And Ocular Migraines The Same Thing

    To understand this, it’s helpful to know basic migraine terminology first. Basically, migraine is a headache disorder with two main types: migraine without aura and migraine with aura. When a migraine is accompanied by other symptoms, such as changes in vision, hearing, sensation, or even speech, this is referred to as migraine with aura. These symptoms are temporary. They usually start at the same time as the migraine, or they can occur up to 60 minutes before the headache. 

    Visual symptoms occur in over 90% of people who have migraine with aura and usually affect both eyes. They can include:

    • Small blind spots with bright colors or jagged lines around the edges
    • Flashing lights
    • Blurry or foggy vision 
    • Feeling like you’re seeing distorted shapes and sizes

    Sometimes the term “ocular migraine” is used to refer to visual changes that can happen in migraine with aura. 

    Retinal migraine is a separate diagnosis, as we’ll discuss below. It is characterized by temporary attacks of vision loss, which occurs in just one eye. In most cases the vision loss happens at the same time as the migraine headache or just before. Retinal migraines are rare, and some experts believe this vision loss is not due to migraine at all. However, the International Headache Society classifies retinal migraine under the umbrella of migraine with aura.

    Retinal migraine characteristics include:

    Effects Of The Pandemic On People With Migraine

    Various factors related to the COVID-19 pandemic unrelated to direct viral infection may have led to increased migraine frequency or severity in some people.

    A found that in a group of 1,018 people with a history of migraine in Kuwait, more than half reported an increase in migraine frequency or severity from the pre-pandemic period.

    Factors such as lack of communication with a neurologist and increased stress may have played a role.

    Only 4 percent of the study participants developed COVID-19, but of those people, 63.4 percent reported their migraine worsening.

    When Should I Seek Help For A Retinal Migraine

    If you have vision loss, seek help. Because there are many other things that can cause blindness, it’s important to get it checked out. These could include stroke or other diseases specific to the eye or brain.

    For this reason, there is no specific test for retinal migraine. The other things have to be ruled out before a diagnosis can be made. This “ruling out” process could include heart monitoring, blood tests, or imaging. 

    Also, retinal migraines rarely happen when a doctor is around, so there’s no one to test the visual fields and confirm vision loss. Given the overlap in symptoms with migraine with aura, it’s helpful to talk through them with your doctor to have a better idea of what’s going on.

    What Are The Risk Factors For Retinal Migraine

    Several factors increase the risk of developing retinal migraine. These risk factors are similar to other forms of migraine. Retinal migraines are more common in women. They can begin at any age, but typically start during adolescence and peak during childbearing years. Retinal migraines are also more common in people with a family history of migraine.

    Ocular Migraine: Visual Symptoms And Treatment

      While head ache is the commonest migraine symptom, visible disturbances are one other defining characteristic for some. This would possibly make you marvel a few phenomenon typically known as “ocular migraine.” What makes this considerably complicated is that though “ocular migraine” is a well-liked colloquial time period to explain a particular sort of migraine with visible disturbances, it isn’t a strict medical time period with a transparent definition. But it is true that there is multiple option to expertise the hell that could be a migraine, and some migraine experiences could be particularly perplexing due to the in-your-face visuals that actually nobody requested for. Here’s all the pieces it is advisable to find out about this phenomenon typically often called ocular migraine, from signs and causes to tips on how to deal when one strikes.

      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.

      Should I See A Doctor For An Ocular Migraine

      Retinal migraine: Causes, symptoms, and treatment


      You should see your doctor after your first instance of visual disturbance. They will likely conduct some examinations on your eyes to determine whether or not your ocular migraine is something to be worried about. After that, you may just be given advice on how to manage the symptoms and the pain, and advised to contact your doctor again if they increase in frequency or severity. You might also be prescribed medication to help reduce the intensity of the migraines.

      Should I Be Concerned About Ocular Migraines

      Q: I recently found out by looking on the Web that my symptoms point to ocular migraines. I have also discovered that flashing lights sometimes bring these on. I am an intensive care unit nurse who believes in not running to doctors for every little thing, but should I be concerned?

      Dr. Jerry W. Swanson responds:

      Not necessarily, but here’s what you should know. Ocular is a term that usually refers to a condition known as migraine visual aura, which involves episodes of passing visual disturbances, such as bright spots, affecting both eyes. Visual aura usually precedes a migraine . However, it may also occur during a headache. In some cases, as with ocular migraine, people experience the symptoms of visual aura without getting a headache. The symptoms of an aura usually begin slowly and last 15 to 30 minutes, although they sometimes persist for up to an hour.

      Often, the symptoms of ocular migraine begin near the center of vision as either a bright spot or area of visual loss that spreads to involve one-quarter or one-half of the visual field. Zigzag lines or other shapes may also appear. For some people, these shapes resemble the walls of a medieval fortress. In fact, the term “fortification spectrum” is used by neurologists to describe it.

      How Long Do Retinal Migraine Headaches Last

      The headache phase of a retinal migraine begins during or within 60 minutes of the visual symptoms.

      People suspected of having retinal migraine should be carefully assessed by their doctor for an underlying cause. As well, they should be evaluated to make sure that they do not have a different primary headache disorder that can mimic retinal migraine. Other primary headache disorders that mimic retinal migraine include migraine with typical aura.

      In retinal migraine the visual symptoms should only be present when looking through one eye. For example if you look through the right eye and close the left eye, you see twinkling lights but when you look through the left eye and close the right eye your vision is normal. In migraine with typical aura, when you alternate which eye you look through the visual disturbance will be seen with either eye but possibly more prominent with one eye or the other. This is because in retinal migraine the vision symptoms are coming from the eye , while in migraine with typical aura the vision symptoms are coming from the brain .   The distinction between retinal migraine and migraine with typical aura is important for treatment considerations and counselling regarding future outcomes. Irreversible visual loss may be a complication of retinal migraine but not migraine with typical aura. It is unclear how often permanent vision loss occurs with retinal migraine and there are no identified predictors for this currently.

      Serious Symptoms That Might Indicate A Life

      Sudden vision loss in one eye can be a symptom of a serious or even life-threatening condition, even if you’ve experienced retinal migraine before. Immediate medical care is necessary to rule out serious causes of monocular vision loss.

      It can be hard to tell the difference between migraine with aura and retinal migraine. If you think you have retinal migraine, it’s important to see a doctor who specializes in headache. Ideally, people with retinal should consult an or with headache expertise.

      What Are The Symptoms Of An Ocular Migraine


      At the onset of an ocular migraine, you may experience some visual changes. These can last anywhere from half an hour up to several hours. The symptoms include:

      • Seeing blind spots
      • Shimmering or flashing lights across visual field
      • Zigzag patterns


      Either accompanying these symptoms, or coming afterwards, you may experience the classic migraine headache, which could be even more disruptive and unsettling than the visual symptoms themselves. You might also have nausea or vomiting and be particularly sensitive to light and sound. You should only experience visual disturbances in one eye with an ocular migraine, and it is likely to affect the same eye in any subsequent episodes. If it affects both eyes, it’s probably a different condition, migraine with aura.


      What Are The Symptoms Of Retinal Migraines

      Alteration of vision in one eye is quite common in people with Retinal Migraines. This lasts for about 15-20 minutes even though in some cases it may go on for about an hour or so. There will also be black spots in the field of vision which gradually get bigger obstructing the vision totally. Some people have only blurriness of vision and not a complete vision loss. There may also see flashing lights in their field of vision for about an hour or so .

      The visual symptoms are then followed by a pulsating and throbbing headache. The headaches last for about a couple or hours or so, even though in rare cases they may linger on for a few days. Some people complain of nausea and vomiting due to the headache and feel that it is made worse when performing any activity .

      What Causes Ocular And Visual Migraines

      The exact cause of an ocular migraine can be difficult to pinpoint. But it’s believed they occur for the same things that cause migraine headaches.

      Migraine headaches have a genetic basis, and some studies say that up to 70% of people who suffer from the disorder have a family history of migraine.

      According to the World Health Organization , migraines are caused by the activation of a mechanism deep in the brain that leads to release of pain-producing inflammatory substances around the nerves and blood vessels of the head.

      Studies have shown changes in blood flow to the brain during ocular migraines and migraine auras . But exactly why this happens remains unclear.

      Common migraine “triggers” that can cause a person to have a migraine attack include:

      • Certain foods

      • Caffeinated drinks

      • MSG

      • Artificial sweeteners

      Stress and lack of sleep also can trigger an ocular migraine or visual migraine.

      Treatment Options For Ocular Migraines

      Ocular migraine is not well understood, and some treatments are supportive in nature, meant only to help deal with symptoms.

      Certain medications can also be helpful in preventing an episode. Triptans, which are sometimes used to treat other types of migraines, are not typically used to treat ocular migraines. Some of the medications that may be used to treat ocular migraine include:

      Migraine Aura With Visual Disturbance

      Visual problems with retinal migraine

      Migraine is a neurological condition that often causes intense headaches. Migraine tends to run in families.

      A migraine aura is experienced by about 25 percent of people with migraine, either before or at the same time as a migraine episode.

      Usually, people who have migraine with aura don’t experience an aura with all of their migraine episodes, just with some of them.

      An aura is a temporary visual, auditory, motor, or other sensory change. Visual disturbances can include:

      • seeing a blind spot

      Some people with a previous history of migraine report worsening migraine episodes during COVID-19. Some people without a history of migraine report experiencing migraine-like headaches.

      A found that among 47 people with COVID-19 who reported having headaches, 24 people reported migraine-like headaches, while 40 percent had symptoms of a tension headache.

      Before they developed COVID-19, only 12 of the study participants had previously experienced migraine episodes.

      According to a , the most commonly reported neurological symptoms of COVID-19 are headache and loss of smell.

      Severe neurological complications such as stroke or seizure have also been reported, although these aren’t common with COVID -19.

      People who develop COVID-19 sometimes develop symptoms affecting their eyes. A found that more than 11 percent of study participants with COVID-19 had eye symptoms.

      The most common eye symptoms were:

      • dry eyes or foreign body sensation
      • redness

      What Is An Ocular Or Retinal Migraine

      The term ‘ocular migraine’ causes a lot of because it is not an official medical diagnosis. People often use it to describe a migraine with visual aura. About 25 to 30% of migraine sufferers have migraine with aura. And visual auras are the most common type of aura. They last anywhere from a few minutes up to an hour. Auras affect both eyes and can precede the headache phase or occur during it. Other terms people may use to describe visual problems with migraine include eye migraine, visual migraine, and ophthalmic migraine. However, the medical term for a migraine directly affecting the eye is retinal migraine.

      The International Headache Society classifies a retinal headache as a specific subtype of migraine. IHS describes it as repeated attacks affecting one eye. The attacks include seeing twinkling lights, areas of decreased vision, and temporary blindness. The headache phase can happen with these visual changes or within 60 minutes of them. 

      Retinal migraine is a relatively rare form of migraine. Like other forms of migraine, retinal migraine is more common in women of childbearing age. 

      Due to the rarity of this type of migraine, doctors are still exploring the best way to treat it. In general, relievers and rest may help during an episode. Prevention strategies include avoiding triggers and using medication, even if attacks are infrequent.

      Vision Changes With Retinal Migraine

      The type of vision changes a person might have include:1

      • Seeing twinkling, flashing, wavy, or zigzagging lights or halos
      • Blind spots or dark spots in vision
      • Temporary blindness
      • Tunnel vision

      These symptoms spread slowly over 5 minutes to 1 hour and last up to 1 hour, followed by head pain. Sometimes the vision changes overlap the head pain. Retinal migraine is one of the least understood forms of migraine.2

      Some people call this type of migraines by the older term “ocular migraine.”

      Signs And Causes Of Ocular Migraines

      Signs and Causes of Ocular MigrainesMany people experience different kinds of migraines even without knowing. An ocular migraine occurs when you experience a blind spot, floating lines, patterns that look like they are zigzagging and flashes of lights. This flash of light can sometimes be accompanied by feelings of headache behind the eyes.What is an ocular migraine?An ocular migraine is a type of migraine that is caused by a set of visual disturbances which may or may not be accompanied by pain. This type of migraine is sometimes known as ophthalmic migraines. These migraines are characterized by a small blind spot at the center of one’s vision. This blind spot starts to enlarge later and is often accompanied by flashing lights as well as other visual manifestations. Ocular migraines are typically nothing to worry about. A small percentage, around fourteen percent of the world’s population usually experience some type of migraine which include, retinal, traditional, ocular and other types of migraines.Types of Migraines

    • Migraine with pain
    • This type of migraine is mainly caused by a traditional migraine, which leads to an intense pain, usually on one side of the head. This type of pain can last for hours, or even days and is usually accompanied by nausea and sensitivity to light. When experiencing ocular migraine, it can sometimes be followed by pain, but are usually more concentrates around the affected eye.

    • Migraine without pain
    • Migraine Aura
    • Retinal Migraines
    • Ocular Migraine Vs Retinal Migraine

      The terms “ocular migraine” and “retinal migraine” are often used to mean the same thing. But to be precise, a retinal migraine is a rare type of ocular migraine.

      It’s also worth differentiating the term “visual migraine,” in which the migraine affects an area of the brain that involves vision. This may result in aura affecting sight in both eyes, not just one.

      How Long Does Retinal Migraine Last

      The visual effects of a retinal migraine usually last no more than an hour.

      Not all retinal migraine attacks come with a headache or nausea, but such symptoms may last longer — potentially for more than a day.

      Both children and adults of any age can experience retinal migraine. These tend to be more common in the following groups:

      • people under 40 years old
      • women
      • people with a family history of retinal migraine or headaches
      • people with a personal history of migraine or headaches

      People with certain illnesses that impact the blood vessels and eyes may also be at risk. These illnesses include:

      How Can I Prevent A Visual Migraine

      Speak to your doctor to determine the best way to prevent a visual migraine. If you have specific triggers that bring on a migraine, then try to avoid these triggers as much as possible.

      Some doctors may recommend certain medications that may help to reduce your risk of visual migraines, such as:

      • Riboflavin

      Do Ocular Migraine Symptoms Persist

      It’s possible that ocular migraine could persist even after recovery from COVID-19 in some people.

      Some people develop headaches that last for months after COVID-19. For example, in one case study, a woman had persistent loss of smell and experienced headaches 80 days after the onset of her symptoms.

      She experienced migraine-like headaches during her COVID-19 illness, but she reported that her subsequent headaches felt different.

      Researchers are still trying to understand why some people develop long-haul COVID-19 symptoms after recovering from their initial infection. It’s possible that increased inflammation and neurological damage play a role.

      Enhancing Healthcare Team Outcomes

      What Is a Retinal Migraine? Natural Relief for Retinal ...

      The diagnosis of retinal migraine is one of exclusion and all other causes of vision loss should initially be considered. All members of the healthcare team should be vigilant and refer the patient for immediate and emergent assessment for stroke or other thromboembolic causes for their symptoms if the patient presents with visual loss or changes.  


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