Pearls And Other Issues
- A retinal migraine a rare phenomenon that usually affects monocular vision transiently.
- Duration of symptoms on average is 5 to 20 minutes.
- The prognosis for an ocular migraine is good.
- The frequency and intensity of the headache typically decrease.
- During prolonged periods of retinal, choroidal, or optic nerve hypoxia, permanent visual loss may occur.
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.
Is An Eye Migraine A Normal Migraine
Same Triggers, Same Causes and Same Treatment
Eye migraine has the same triggers as classical migraine: fatigue, skipping meals, caffeine withdrawal, stress and certain foods can trigger a migraine.
They have the same causes as a typical migraine: the chemical reactions cause cortical spreading depression that effects the electrical impulses in your brain, hormones get released, and the blood vessels spasm.
At your earliest warning signal you need to take action. If you wait for the pain phase to kick in, it’s too late. Then the hangover comes later.;
Getting your timing right when treating an acute attack is crucial.;
For mild to moderate migraines you might be able to reduce your symptoms by using caffeine or natural alternatives. Over the counter medications like ibuprofen aka Advil® or Motrin® or acetaminophen aka Tylenol® might work well.
For severe migraines it might be best to consider using abortive medications from the family of;triptans, specifically designed to target migraines. Aleve® if you can take it, is a combination of ibuprofen and naproxen. They are not considered for people with a history of heart attacks, strokes or any other vascular disease.;
If you get migraines regularly you might want to consider a good prevention strategy or seek a more natural approach. But long term management may be required.
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So how do you treat your eye migraine symptoms so they don’t progress to full blown migraine attack?
Enhancing Healthcare Team Outcomes
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.;;
How Is An Ocular Migraine Diagnosed
Ocular migraine is diagnosed with a patient history, physical examination, and other tests such as:;
- Eye screening test
- Patient;sits in a chair in a room with the lights out
- A doctor looks through the lenses of the ophthalmoscope to examine the eyes
- Patient may be asked to look in various directions during the examination;
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What Are Eye Migraines
They’re commonly called eye migraines, but they’re actually a group of different types of migraine. ;Often these migraines are called ocular migraines , ophthalmic migraines, silent migraine, acephalgic migraine, and even ophthalmoplegic ‘migraines’. ;Confused? ;With good reason! ;Most of these terms are out dated, and sometimes defined in very different ways!
First, you need to remember that pain is only one possible symptom of migraine . Other symptoms include nausea, congestion, and visual symptoms. Silent migraine or acephalgic migraine is migraine without the headache.
Ocular Migraines And Aura
There are two types of migraines that are referred to as ocular migraines. Some people refer to migraines with auras as ocular migraines.
Some people experience an aura approximately 10 to 30 minutes before a migraine sets in. Aura symptoms can include:
- numbness or tingling in the hands or face
- feeling mentally foggy or fuzzy
- disrupted sense of touch, taste, or smell
- seeing blind spots, shimmering spots, flashing lights, or zig-zag lines
Not all people with migraines will experience auras.
Ocular migraines may also refer to eye-related migraines that come with visual disturbances that may or may not come with a headache pain. These are known as ophthalmic migraines. Ocular migraines can include some or all of the aura symptoms listed above. Ocular migraines are typically the result of migraine activity in the visual cortex of the brain.
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How Do You Treat Ocular Migraines
Treatment isnt always necessary for ocular migraines as symptoms usually go away own their own after about half an hour. Wed recommend resting your eyes until your symptoms pass, and taking painkillers as recommended if you have an accompanying headache. Otherwise, the best thing you can do is to avoid exposure to common triggers.
However, because ocular migraine symptoms are similar to those caused by a stroke-type event in the eye, its important that you seek medical advice from your GP quickly so that further investigations can be considered.
If you have any concerns about the frequency of your ocular migraines, visit your GP who may also be able to recommend further treatment.
How Is Retinal Migraine Diagnosed
There arent any specific tests to diagnose a retinal migraine.
If you see a doctor or optometrist during a retinal migraine attack, they may use a tool called an ophthalmoscope to check for decreased blood flow to your eye, but this generally isnt feasible because attacks are usually brief.
Doctors typically diagnose a retinal migraine by investigating the symptoms, conducting a general examination, and reviewing a personal and family medical history.
Retinal migraine is usually diagnosed by a process of exclusion, meaning that symptoms such as transient blindness cant be explained by other serious eye diseases or conditions.
If you need help finding a primary care doctor or optometrist, you can browse doctors in your area through the Healthline FindCare tool.
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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
- 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:
Headache Behind The Eye Triggers
Different things may set off each type of headache.
You might get migraines because of:
Things that may give you a tension headache include:
- Problems with the muscles or joints in your neck or jaw
- Dehydration or missing a meal
- Bright sunlight
Cluster headaches are often triggered by alcohol, smoking, or certain medications.
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How Can I Prevent An Ocular Migraine
Making sure youre well hydrated, eating a balanced diet, and are in overall good health when it comes to your blood pressure and blood sugar levels, should go a long way to helping reduce the occurrence of ocular migraines. In terms of treating any pain that comes with the ocular migraine, you can take pain relief such as paracetamol or ibuprofen, as well as reduce your exposure to the triggers we discussed earlier in this blog post. You may also be able to have anti-epileptic medication prescribed to you, which can help prevent migraines. However, there is still plenty of research to be done when it comes to treating ocular migraines.
To help with the pain, you might find it useful to:
- Lie down in a dark room
- Massage your scalp or temples
- Sit in a quiet environment
- Drink water
What Are The ‘red Flags’ That My Visual Symptoms Are Not Due To Migraine
The typical symptoms of a visual migraine are positive, meaning that there is something shimmering or sparkling that is disrupting the vision. Migraines are less likely to cause “negative” symptoms of pure visual darkness. An episode of visual darkness typically requires additional evaluation for other conditions, including a mini-stroke .
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How Do You Get Rid Of An Ocular Migraine
Treatment for ocular migraines tends to focus on trigger avoidance; once you know what brings on a migraine you can try to eliminate these factors. For example if you have an attack when youre tired, you should try to get enough sleep each night or fit a nap in during the day.
You can also use over the counter medication such as aspirin to reduce the pain and inflammation.;Aspirin;can also help to alleviate headaches or any discomfort you are feeling around the affected eye. Once the condition has been diagnosed by your GP you may be prescribed a number of medications such as beta blockers to help relax your blood vessels.
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.
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Causes & Risk Factors
Ocular migraines are typically caused by reduced blood flow or spasms of blood vessels in the retina or behind the eye. Risk factors include:
- Ocular migraines are believed to have the same causes as migraine headaches.
- More common in women than men.
- Most common age group 30-39.
- Family history of migraine.
- Same as prevention for migraines.
- Avoid migraine triggers.
- Common triggers include stress, hormonal changes, bright/flashing lights, drinking alcohol , changes in the weather, skipping meals/not eating enough, or too much or too little sleep.
- Keep a headache journal including information about what you were doing, eating, or medications are taken before or after a headache occurs.
- If you perform tasks that require clear vision, when an ocular migraine or visual migraine occurs, stop what you are doing and relax until your vision returns to normal.
- If youre driving, park on the side of the road and wait for the visual disturbances to pass completely.
- Your doctor can advise you on the latest medicines for treating migraines, including medications designed to prevent future attacks.
If your ocular migraines or migraine auras appear to be stress-related, you might be able to reduce the frequency of your migraine attacks without medicine by simply:
- Eating healthful meals regularly
Types Of Ocular Migraines
- Migraine With Aura
Ocular migraine with aura is a recurring headache that typically starts at the same time or after sensory disturbances known as an aura. These disturbances include visual changes such as blind spots, tingling in your face or hands. At times, the aura can occur without having a headache.
- Retinal Migraine
These migraines typically refer to symptoms that manifest only in one eye during or before the headache phase of the migraine episode. Retinal migraines tend to happen repetitively and are short-lasting accompanied by blindness or diminished vision.
The loss of vision is not related to migraines. A more severe underlying condition causes the loss of vision. You might need to see a doctor immediately to get your eyes checked.
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What Is An Ocular Migraine Aura
So, lets talk aura, those sensory changes that can accompany migraine . Aura most often manifests as visual disturbances, according to the Mayo Clinic4. But you could also experience different sensations, like hearing music or feeling like someone is touching you. When we’re talking about an ocular migraine, we’re only talking about the visual symptoms.
While some people experience an aura before their migraine headache strikes, an ocular migraine refers to the experience of only experiencing visual disturbanceswithout the stereotypical migraine head pain.
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:
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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
- Changes in weather
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
Treating And Coping With Migraines
Even if the migraines exist alone and are not a symptom of an underlying condition, they can still be debilitating and impact your life. If youre experiencing blind spots or vision disturbances, for example, you will want to wait until they pass before driving.
Ocular migraines will typically go away on their own within 30 minutes. 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 can be used to treat recurring migraines. Over-the-counter drugs like ibuprofen or Excedrin migraine can be used to reduce the symptoms of a migraine once you already have them. Your doctor can prescribe you:
- beta blockers, to relax blood vessels
- calcium channel blockers, which can prevent the blood vessels from constricting
- anti-epileptics or antidepressants, which are sometimes used to treat and prevent migraines
Some of these prescription medications will be taken on a regular basis instead of an as-needed basis when you get the migraines.
If youre experiencing ocular migraine pain, you can:
- lie down or sit in a dark, quiet room
- massage your scalp with a lot of pressure
- put pressure on your temples
- put a damp towel over your forehead
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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, its probably a different condition, migraine with aura.