What Is Optical Migraine Or Ocular Migraine
Whenever we talk about Migraines we tend to imagine about pounding and disabling headaches but when we talk about optical migraine or ocular migraine, this is a condition in which the affected individual does not have any pain but has visual disturbances affecting one or both eyes. Optical migraine or ocular migraine may scare the wits out of a person but it is normally a benign condition and resolves without the need for any treatment in about half an hour. Optical migraine or ocular migraine is also known by the names of ophthalmic migraines. If optical migraine or ocular migraine is followed by a severe headache then that condition is called as Migraine with Aura and the Optical Migraine or Ocular Migraine is termed as an aura preceding a headache. Optical Migraine or Ocular Migraine can be followed by a headache or it may occur after a migraine headache.
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.
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.
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Do Glasses Help With Ocular Migraines
After more than five years in business, nearly 90% of the tens of thousands who have used precision-tinted TheraSpecs glasses have experienced relief for their migraine-related light sensitivity. Some of the reported benefits include: Reduction in total migraine attacks, especially those induced by light.
What Medications Can Cause Ocular Migraines
While this article does not include an exhaustive list, common systemic medications that cause ocular side effects include: bisphosphonates cyclosporine and tacrolimus minocycline hydroxychloroquine ethambutol topiramate tamsulosin amiodarone anticholinergics erectile dysfunction drugs blood pressure
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Variations Of An Ocular Migraine
In general, there are two types of an ocular migraine: migraine with an aura and Retinal migraine. An aura migraine can impair the victim’s vision and include symptoms like blind spots, visual disturbances like stars or patterns, and flashes of light. It can also affect the central nervous system, causing impairment of motor skills and speech. A retinal migraine occurs in only one eye and usually is more severe in how it affects the vision. Victims of this type of an ocular migraine often lose their vision or see twinkling lights.
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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The Difference Between Migraines With Aura And Ocular Migraines
Theres nothing like itthe excruciating, throbbing pain in your head that can only be a migraine. If you suffer from migraines, you may have noticed some visual disturbances in addition to your headache. Most likely what you have experienced is a migraine with aura accounting for approximately 20% of all migraines. There is also another less common type of migraine with visual disturbance called an ocular migraine affecting only about one out of every 200 people who have migraines. These two types of headaches are very similar making it very confusing to tell which is which. Read on to learn the distinctions between the two.
What are the symptoms?
The symptoms of the two conditions are almost the same except for a few telltale signs. The main difference is a migraine with aura will affect both eyes while an ocular migraine affects only one. Both have visual disturbances such as:
- Flashes of light
- Shimmering, colored, or flickering lights
- Floating lines
The visual disturbances tend to go away before the headache begins for the migraine with aura but can last longer for the ocular headache. Also, the headache, which can also be accompanied by symptoms of nausea and severe light sensitivity, tends to be right behind the affected eye of an ocular migraine but can be more spread out for a migraine with aura.
What are the causes?
What to do about them?
Lets Talk About Ocular Migraines
The purpose of this post is to define the difference between classic and ocular migraines. Also, before I launch into specifics, I would like to start with this:
Flashing lights in your eyes can be concerning, as they can be a sign of retinal detachment or other retinal problems. It is essential to see an ophthalmologist if you have flashing in your eyes. An eye exam can reveal problems with the vitreous fluid, the retina, or even signs of a stroke.
Now, lets talk about migraines. This blog talks about two types:
Classic Migraines are thought to be caused by spasm of blood vessels in the brain. If this happens in the temple area, the result can be a severe, one-sided headache, sound sensitivity, nausea, and vomiting.
If, on the other hand, the spasm of blood vessels occurs in the back of the brain where vision is processed, this could be an Ocular or Eye Migraine. This condition can be one cause of visual disturbances that often do not need treatment. However, its still essential to have a complete eye evaluation to rule out more serious causes.
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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
Causes Of An Ocular Migraine
Although doctors don’t know the exact causes of an ocular migraine, there is some indication that it might be the result of spasms in the blood vessels that flow through the retina . The effect causes changes which spread across nerve cells. This is a rare condition, but because of the danger of permanent vision loss in one eye, it is important for sufferers to talk to their family physician for solutions.
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Diagnosing And Treating Ocular Migraines
When you visit your doctor, they will ask about your symptoms, examine your eyes, and order additional tests to rule out other serious conditions such as:
- Amaurosis fugax
- Giant cell arteritis
- Spasms in the blood vessels that carry blood to the eye
- Autoimmune diseases
- Stroke or transient ischemic attack
- Drug abuse
If you have been diagnosed with retinal migraines, consult your doctor about the best treatment options. There is no one recommended treatment regimen since it varies from person to person.
If you dont experience ocular migraines very frequently, your doctor may advise you to use over-the-counter NSAIDs like aspirin and ibuprofen when the episodes occur.4
Your doctor may also recommend the following:
- Anti-nausea medication to reduce nausea and related symptoms
- Calcium channel blockers to lower blood pressure
- Anti-epileptic medications to prevent seizures
- Tricyclic antidepressants to alter the brains chemistry
Doctors dont usually use traditional migraine treatments such as triptans and ergotamines for people with ocular migraines.5
Triptans, for example, arent safe if youre at risk for a stroke, which may be the case for people experiencing temporary blindness in one eye.
A recent technique for treating or preventing ocular migraine is to use a self-administered device that delivers electrical stimulation to the forehead or back of the head.
These devices include:
Causes And Risk Factors
Although the exact physiology of retinal migraine is unknown, one theory is that it may result from vasospasm, a narrowing of vessels that supply blood to the retina or that are part of the ciliary body of the eye.
Whatever the mechanism, like all types of migraine headaches, retinal migraines tend to be brought on by specific triggers such as stress, high blood pressure, smoking, and more.
Retinal migraines, in particular, may be triggered by:
- Staring at a screen for long periods
- Spending time in fluorescent or other harsh lighting
- Driving long distances or participating in other taxing visual activities
People believed to be at increased risk of retinal migraine headaches include those who:
- Are in their 20s or 30sin particular women, due to hormonal changes related to the menstrual cycle
- Have a history of other types of migraine
- Have a family history of migraine headache
- Have lupus, atherosclerosis, or sickle cell disease
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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.
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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Finding Ocular Migraine Relief
Symptoms Of Ocular Migraine
An ocular migraine can have you seeing stars…literally. Or you might get squiggles, or blind spots, or other visual mayhem that makes it very difficultif not impossibleto see. As you might imagine, this can make it hard to do pretty much anything, so an ocular migraine can really ruin your day.
Here are some of the common visual disturbances that happen with a migraine aura, according to a review article published in the Journal of Headache and Pain5:
- Bright flashes of light
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How To Treat An Ocular Migraine
Ocular migraines are treated the same way as other migraines, and both medications and lifestyle changes may help to cut down symptoms and reduce the number of migraines you have.
Migraine medications fall into two categories: drugs that help stop migraines when they happen and drugs that prevent migraines.
Medications you can take when you get a migraine include:
- Non-steroidal anti-inflammatory drugs like ibuprofen or acetaminophen
- NSAIDS with caffeine like Excedrin
- Prescription triptan drugs like sumatriptan or rizatriptan
Medications you can take daily to prevent migraines include:
- Beta-blocker medications like propranolol
- Certain antidepressants like amitriptyline
- Anti-seizure drugs including topiramate and Valproate
There are also new prescription monoclonal antibody drugs which may be self-injected monthly or every few months which have been effective for many people in preventing migraine.
Lifestyle changes are also a key way to prevent migraines. “I generally recommend that people maintain a routine lifestyle because the brain thrives on a regular routine,” Hindiyeh says.
Hindiyeh recommends several helpful lifestyle changes, including:
- Sleeping and waking up at the same time every day and avoiding naps
- Eating regular meals
- Doing some aerobic exercise every day where you get your heart rate up and sweat, like jogging or biking
It’s also important to avoid ocular migraine triggers like bright digital screens as much as possible.
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.
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Getting The Right Treatment For Your Migraines
Most people with migraines, even those with chronic ones, only take pain relievers during the actual attack. But headache specialists think more people should be taking preventative measures and there are now many more options than there used to be. These include non-drug devices that you put on your forehead or the back of your head that send pulses to your brain and cut down the number of attacks you have a month. There are also new classes of medications that target a particular molecule in your brain called calcitonin gene-related peptide that causes much of the pain you feel. These come in the form of injections that you take every month, either by injecting yourself or at the doctors office. If you prefer the ease of a once-daily pill, you’ll be pleased to learn that the FDA just approved one in late September 2021, which should be available in early October 2021.
There are older medications as well, including antidepressants, birth control pills, and anti-seizure meds. These tend to have more side effects and are effective for some people but not others. Even with these preventative medications, youll still have attacks and youll still need a pain reliever. But youll have fewer headaches and they wont be as painful, and with the newer meds, you may even be able to get away with taking an over-the-counter one.
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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