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.
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” .
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.
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.
Are There Steps You Can Take To Lower Your Stroke Risk
Yes, there are things you can do — starting right now — to lower your risk of stroke. For one thing, be sure to have a complete physical every year and see your neurologist for migraine prevention and treatment. Ask your doctor about:
- medications that can lessen the frequency of migraine attacks
- an assessment of your risk factors for stroke
- birth control methods that don’t increase your risk of blood clots
There are also lifestyle changes you can make to reduce your risk of stroke. Some of the most important include the following:
How Can I Treat Migraines Without Using Medicines
It is very important to remember that many of the most effective preventive treatments for migraines do not require any medications. Frequent aerobic exercise is an excellent example of an effective way to improve headaches. Other strategies may include better sleep habits, stress reduction, massage, yoga, and acupuncture.
They May Make You Feel Like Youre Having A Stroke
A migraine with aura isn’t just visual. Dr. Rothrock says that some people have sensory auras, which means they get numbness or tingling in their face or hand. “This can be misdiagnosed as a stroke or partial seizure,” he says. A patient history is one of the best ways to make the diagnosis. An MRI can rule out a stroke.
Symptoms Of Migraine With Aura Vs Ocular Migraine
The most common symptoms of migraine with aura are visual changes that affect both eyes and include seeing things like:
- Light flashes
- Sparkly or shimmering dots
You could also get nausea or feel numbness and tingling down one side of the body. You might have changes in the way you talk, such as trouble coming up with the correct word or slurring your speech. Sometimes you have trouble with coordination.
Often these problems will come before the head pain. Sometimes you have the symptoms without any pain.
Also known as retinal migraines, ocular migraines are less common than migraines with aura. But they can be more serious. If you don’t get treatment, there’s a small chance that the vision loss in one eye could become permanent.
In an ocular migraine, a change in vision can happen in one eye before, during, or after a headache. The symptoms include:
- Seeing twinkling or sparkling lights
- Having blind spots
One way to tell if the vision changes are only happening in one eye is to close each of your eyes and check if you only see the changes in one of them.
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.
What Else You Should Know About Ocular Migraines
An ocular migraine is short-lived and may not be painful, but it can be debilitating – you have to be careful while doing daily activities like driving, reading, or writing. The chance of permanent vision loss due to an ocular migraine is rare but the reduced blood flow for a prolonged time can damage your retina. So it is a good idea to make an appointment with your ophthalmologist to check your condition.
Since hormones play such a big role in causing migraines, declining estrogen levels as women age and enter menopause is a reason why migraines usually reduce in severity in older women.11
Can I Have A Visual Migraine Without A Headache
Definitely. It is actually very common to have a visual migraine without any headache. The medical term for this is “acephalgic migraine,” which literally means migraine symptoms without headache. Except for the absence of a headache, the visual symptoms in acephalgic migraine are identical to the episodes that accompany a classic migraine aura.
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.
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 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.
Migraine Aura Without Headache: The Symptoms
- Retinal migraine – Vision disturbance occurs in both eyes which may lead to temporary blindness.
- Ocular migraine – Vision disturbance occurs in just one eye and may include zig zag lines, blind spots, flashing lights, visual blurring, “seeing stars,” or visual dimming.
Should I See A Doctor For An Ocular Migraine
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.
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 Acute Treatments For Migraine
An isolated visual migraine, without headache, typically does not require any acute treatment, since the visual symptoms resolve on their own fairly quickly. The first few times someone experiences a visual migraine it usually causes a lot of anxiety. Once someone has become familiar with the symptoms of a visual migraine, new episodes no longer cause the same level of anxiety.
It can be helpful to try to rest during the episode. Some patients benefit from other strategies, including eating something, having caffeine, or taking an over-the-counter medication such as acetaminophen or ibuprofen .
Patients in whom the visual symptoms are accompanied by a severe headache often benefit from additional therapies. The goal of these medications is to try to cut short the headache before it becomes too severe. Some patients find naproxen , which is a stronger anti-inflammatory medication, to be helpful. Other patients try a class of medications known as “triptans.”
Triptans are specially designed to work on receptors on blood vessels and brain cells in order to halt a migraine at an early stage. Although there are a number of different triptans, made by several different pharmaceutical companies, each of these is approximately equally effective. Triptans are often taken orally, but also come as injections and nasal sprays. These medicines are generally not considered safe in patients with a history of strokes, heart attacks, or other vascular diseases.
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.
Risk Factors And Genetic Predispositions
Eye nerves can become deformed in people who suffer from other migraine types, putting them at higher risk of ocular migraines due to blockages in the arteries involved .
Patients with blood clotting disorders are also 3 times more likely to develop a blockage in the artery involved in ocular migraines .
Some diseases that may increase the risk of developing ocular migraines include lupus, artery hardening , and sickle cell disease .
Although a genetic predisposition for ocular migraines has not been identified, about 29-50% of patients with ocular migraines have a history of other migrainetypes .
Other factors such as age and history of heart disease may play a role in the risk of developing ocular migraines .
What Can I Do To Manage Ocular Migraines
- Rest in a dark, quiet room. This will keep your symptoms from getting worse. Do not look at a computer screen. Sleep may help relieve any headache pain.
- Apply ice if you have headache pain. Use an ice pack, or put crushed ice in a plastic bag. Cover the ice pack with a towel and place it on your head. Apply ice for 15 to 20 minutes every hour, or as directed.
- Apply heat if you have pain or muscle spasms. Use a small towel dampened with warm water or a heating pad, or sit in a warm bath. Apply heat on the area for 20 to 30 minutes every 2 hours. You may alternate heat and ice.
- Keep a symptom record. Write down when your ocular migraines start and stop. Include your symptoms and what you were doing when it began. Record what you ate or drank for 24 hours before the migraine started. Keep track of what you did to treat your migraine and if it worked. Bring the symptom record with you to visits with your healthcare provider.
Ocular Migraine Treatment And Prevention
Because they generally are harmless and typically resolve on their own within a half hour, ocular migraines usually require no treatment.
If you are performing tasks that require good vision when an ocular migraine occurs, stop what you are doing and relax until the visual disturbance passes. If you are driving, pull off to the side of the road as soon as you can safely do so, and wait for your vision to return to normal.
There is no test to confirm the diagnosis of ocular migraine. Nonetheless, whenever you are experiencing unusual visual symptoms such as those described here, it is recommended that you undergo a comprehensive eye exam with an eye doctor. This is important so as to rule out sight-threatening conditions such as a retinal tear or detachment, which require urgent attention and/or treatment. Rarely, ocular migraine symptoms can also be associated with stroke.
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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.
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:
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:
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 20–30 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
How Long Does An Ocular Migraine Last
Ocular migraines usually last between 30-60 minutes. If yours lasts longer, it’s best to seek advice from a healthcare professional to confirm that you are not experiencing the effects of an underlying health condition.
Ocular migraines can be accompanied by a variety of symptoms and you may or may not have them all.
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
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.
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
- 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: