Recognizing An Ocular Migraine
A migraine aura can often begin before the actual headache or head pain sets in however, it can occur at the same time as well. An ocular migraine typically impacts both eyes simultaneously, though it can affect only one eye and not the other.
Symptoms of a migraine aura can be both positive or negative in nature. Positive symptoms include things that you can see, whereas negative symptoms involve missing portions of vision.
Positive symptoms include:
- Tunnel vision
- Vision loss in one or both eye
Other signs of an ocular migraine, or migraine aura, can include changes or loss of color vision, blurred vision, a kaleidoscope-like fracturing of images, heat waves, distortion in objects , or an appearance of seeing things as if one were looking through water. Numbness or tingling in the hands or feet, nausea, dizziness, sensitivity to light and sound, weakness, and head pain are additional possible effects of an ocular migraine.
The National Headache Foundation publishes that visual auras typically precede an actual headache or migraine by about 20 minutes to an hour, although the symptoms can persist with the headache itself. Visual impairments that accompany an ocular migraine can make it difficult to function normally and do things like drive safely or read.
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How To Get Rid Of An Ocular Migraine With The 3 Truths + Common Treatments
The most common treatment plan for ocular migranes is to make sure its nothing more serious and then go about a regular migraine treatment approach.
This usually means a life long sentence of medication.
Here at Migraine Professional we understand that its more important to focus on what is causing the underlying pathology to create the symptoms than it is to only address symptoms.
Of course you want to manage symptoms like pain, fatigue, brain fog and visual disturbances so they dont impair your life but you want to make sure you are going about a clear plan of action to deal with the causes.
If your brain is going through this electrical outagechoke uprevv or whatever you want to call it then you want to continually address and heal the causes of those.
This means we want to look at 3 different areas.
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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.
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.
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How To Prevent Ocular Migraines: Understanding The Causes
Any migraine is a debilitating condition that is produced by neurological responses to certain triggers. With eye-related migraines, changes in blood flow cause visual disturbances. Headaches do not always accompany the condition which is why its called a painless migraine.
The good thing is that research has identified causal factors that exacerbate the condition. Even though they are painless, the resulting interference in the visual field can easily put you out of commission for a time. Listed here are the leading symptoms and causes as well as how to prevent ocular migraines.
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.
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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
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.
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What Are Ocular Migraines
Ocular migraines are a larger group of visual aura type migraines.
They include many different types of migraines but all have the visual disturbance such as:
- Blind spots
There are two main types of ocular migraines:
Is described by the american migraine foundation as visual symptoms occurring in only one eye before or during a migraine. This type of migraine is more serious, may lead to permanent vision loss and needs to be brought up with your doctor immediately as it may be something more serious.
Migraine with aura
The most common presentation of migraine with aura is a visual disturbance that slowly increases, peaks and then disappears resulting in a headache. But not all migraines with aura are visual.
Ocular migraines may or may not come with head pain but are most commonly found with it.
Its always important to bring any of these symptoms up with your doctor to be sure its a migraine and not something more serious.
Other common names for ocular migraines are:
Below is a video of a type of ocular migraine.
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.
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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.
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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.
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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.
Headaches Behind The Eye In People Over 40
In particular, people over the age of 40 may begin experiencing headaches behind the eyes more frequently as they get older due to a condition called presbyopia. As the eyes age, it can become more difficult for them to focus on objects up-close, causing them to squint and strain in order to see more clearly. This strain can lead to feelings of pain behind the eyes, alongside soreness and redness.
With other common conditions such as blurry vision, digital eye strain, and difficulty seeing up-close, its best to have your eyesight checked by an optician if youre concerned.
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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 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.
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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.
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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Stay Calm This Shouldnt Last Long
One of the best things which you can do is to stay calm.
Typically the ocular migraines last ten minutes to an hour and are not known to have long lasting effects.
The more you can relax and avoid stress until the symptoms disappear, the better off you will be.
Plus, once you learn your early warning signals of your ocular migraine symptoms, you will know what to do and feel more in control.
You can take action to take care of yourself faster.
Symptoms Of Retinal Migraine
The symptoms of retinal migraine may include:
- partial or total loss of vision in 1 eye this usually lasts 10 to 20 minutes before vision gradually returns
- headache this may happen before, during or after the vision attack
It’s unusual for an episode of vision loss to last longer than an hour. The same eye is affected every time in almost all cases.
Vision may slowly become blurred or dimmed, or there may be flashes of light. Some people see a mosaic-like pattern of blank spots , which enlarge to cause total loss of vision.
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The Causes Of Ocular Migraines Are Unknown
Researchers dont know exactly what causes an ocular migraine. Its thought that they might occur as a result of a tightening or swelling in the blood vessels in the optic nerve at the back of your eye. This swelling or tightening is responsible for the unexpected light show you experience during an ocular migraine episode.
There is no specific diagnostic test available that can identify ocular migraines to diagnose your condition, the eye doctor may:
- Foods containing nitrates, caffeine, MSG, tyramine, or artificial sweeteners
A Guide To Healing Ocular Migraines
One in every 200 migraine patients experiences ocular or retinal migraines that can significantly affect their vision. These attacks are often preceded by aura, which typically affects both eyes. Patients might see spots, patterns or flashes of light before a headache develops, and symptoms range from light sensitivity to temporary vision loss. The worst ocular migraines can cause temporary blindness episode lasting several minutes, although the duration is usually less than an hour.
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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.