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.
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.
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. Its not uncommon for a single patient to experience a wide range of visual symptoms. Heres what you need to know to better understand the migraine subtypes that affect vision.
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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.
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What Are Some Symptoms Of An Ocular Migraine
Typically, you will see small blind spots referred to as scotoma that appears enlarge your central eyesight just before an ocular migraine strikes. The blind spots may occur as flashing lights with sparkles moving in zigzag lines close to the developed blind spot. The broadened blind spot may obstruct your eyesight and render you visionless for some time. The entire occurrence may end within few minutes, but the ocular migraine condition may last for up to 30 minutes.
The other symptoms that you may incur include:
- Moderate to excruciating headaches that may last for up to 72 hours
- Headaches may worsen when engaging in physical activities
- A feeling of numbness may also come in just before a migraine starts
- Unusual eye sensitivity to light
- Sudden and unexplained mood changes
- Nausea and vomiting
- Feeling tired for days or weeks preceding the attack
- Craving for certain types of foods
Comprehensive Eye Care For The Whole Family
Eye Medical Clinic has both optometrists and ophthalmologists on our experienced team of eye specialists. We have proudly served the Bay Area for more than 70 years and we are fully equipped to care for the eye needs of the youngest member of your family to the most senior member. Wed love to talk to you about your migraines as they relate to your vision and see how we can help.
We invite you to experience our expert eye care for every generation at Eye Medical Clinic. Our team, including experienced doctors John Sullivan, MD Mona Bagga, MD and Christina Nguyen Deane, OD, as well as a highly trained and dedicated staff, is dedicated to helping you enjoy your life to the fullestwith the clear vision, you deserve. Schedule your comprehensive eye exam today.
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Symptoms Of Ocular Migraines
Q: I have had ocular migraines for many years. I have the classic jagged strobe effect. No big deal usually.
But last year I had a weird and different thing happen that still worries me. All of a sudden my eyes crossed and stuck that way. My fingertips went sort of numb, and the side of my tongue and bottom lip went numb. When I tried to explain this to the nurse, I sounded like a stroke victim.
I saw a neurologist, and he felt it was just a more intense type of ocular migraine. Have you ever heard of this? The MRI showed nothing significant. S.
A: By definition, this would not be a classic ophthalmic migraine, because the symptoms are outside of what is seen. Therefore, I personally would not classify it as a “more intense type of ophthalmic migraine.” These symptoms could be associated with some of the more common non-ophthalmic migraine phenomena. Dr. Slonim
Q: My husband began having symptoms of something very strange. We looked online and found your site. It turns out he was having an ocular migraine.
Your explanation and even better the visual little flash movie explained exactly what he was having and put our minds at ease. We were both thinking brain tumor or aneurysm . So thank you for putting together such an amazingly informative website.
In reviewing your log, you or your doctor may find a consistent pattern of triggers related to your episodes. Avoiding these triggers might help reduce the frequency of your episodes. Dr. Slonim
What Are Ocular Migraines
The term ocular migraine is used to describe a migraine that takes place in the eye. These migraines can manifest as a variety of different visual disturbances including:
- Zigzag lines
- Bright flashes of light
- Scotomas or blind spots
- Scintillations or sparkling, usually of lights or stars but can also be blind spots
These are the most common symptoms of an ocular migraine, but the visual disturbance caused by this type of migraine can manifest as anything from shadows in the vision to a complete but temporary loss of vision in the eye.
What makes an ocular migraine different from an aura is that it typically only occurs in one eye and lasts only a few minutes to an hour. They are also not followed by an actual migraine headache .
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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.
Can A Sinus Headache Cause A Migraine
A common misconception is that sinusitis triggers migraines , but that isnt likely to happen. Sinusitis originates in a different region of the body than migraine and they are not necessarily connected However, the two conditions do share the same nerves that can be stimulated, and they do both produce many of the same chemicals in the body during an attack. There are certain signs that can help distinguish between the two and knowing this can help facilitate appropriate treatment of the condition that is present.
Dr. Ailani explains how easy it can be to mistake a migraine for a sinus headache:
With a sinus infection, you will often have a fever, bright colored mucus from the nose in large amounts, and pain that is worse when you lay down . You may notice the pain is worse in the morning after sleeping for several hours. Occasionally, someone may have a chronic sinus infection, something that has been going on for several months. In this case, a person may not have any symptoms, and may not have a headache either.
If you have a severe headache with sinus type symptoms and also have light or sound sensitivity, upset stomach, lack of appetite, and no fever, and you notice the pain resolves in 4-36 hours- this may be a migraine. If you notice the pain improves when laying in a dark, quiet room, or when taking over the counter pain medication, this again goes along with migraine.
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Sinusitis And Sinus Headaches
What most people dont realize is that true sinus headaches are actually quite uncommon and are often over diagnosed or misdiagnosed. Sinusitis is an inflammation of the sinuses, often due to a bacterial infection. The sinuses are air pockets that are situated at certain points in the facial bones. Scientists are not certain the exact purpose of sinuses. Some believe that it helps enhance the voice through resonation while others believe it may be a way for the body to humidify the air during inhalation. They are usually empty but do have a very thin mucus layer along the walls.
There are four pairs of paranasal sinuses, meaning that there are two at the same points on the left and right. They are:
- Frontal sinuses: above the eyes just over the eyebrows
- Maxillary sinuses: on each side of the nose, in the cheekbone
- Ethmoid sinuses: between the eyes, under the bridge of the nose
- Sphenoid sinuses: behind the eyes and ethmoid sinuses
Inflammation of the sinuses can occur due to bacterial, viral, or fungal causes and can present in one of the sinus pair, or several. If there is an infection present, it is important that it is treated. Failure to properly treat a sinus infection can cause serious health risks and can create a propensity to develop sinus infections in the future.
Whats An Ocular Migraine
The termocular migraine can be confusing. It generally means a headache thats accompanied by changes in vision which may include blind spots, changes in light perception, wiggly lines and flashing lights. As many as 20 percent of migraine sufferers may experience these aura symptoms.
It is generally accepted that there are two types of ocular migraines:
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About Dr Donald Mccormack
As an ophthalmologist, Dr. McCormack diagnoses and treats all eye diseases, prescribes eyeglasses and contact lenses to correct vision problems, and performs a wide range of clinical procedures and more complicated eye surgeries. He has special interests in treatments for dry eyes and glaucoma and has been a principal investigator in numerous clinical research trials for these conditions.
- For an appointment, call
This article is not intended to substitute for professional advice, diagnosis, or treatment. Always seek the advice of your physician.
Can Hormones Trigger Ocular Migraines
It is believed that the hormone estrogen plays a role in the development of ocular migraines, which cause pain by controlling brain chemicals. Estrogen is influenced by a number of factors in women, including menstruation, pregnancy, menopause, oral contraceptives, and hormone replacement therapies.
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Tips For Managing And Preventing Visual Migraines
If your visual migraine occurs frequently, here are some tips to help you prevent or manage the condition.
- Acupressure. This is an evidence-based practice of applying pressure with hands to specific points on the body to relieve pain and other symptoms. It can be an effective alternative therapy for migraine headaches.
- Lavender oil. Lavender oil can be inhaled or applied diluted to the temples to ease your migraine pain.
- Peppermint oil. According to a 2010 study, the menthol in peppermint oil can minimize migraines.6 The research showed that applying menthol to the forehead and temples relieved migraine-related pain, nausea, and light sensitivity.
- Yoga. Yoga uses breathing, meditation, and body postures to promote health and well-being, relieving the frequency, duration, and intensity of migraines.
- Massage therapy. Massage reduces stress and enhances coping skills. It also lowers heart rate, anxiety, and cortisol levels.
- Herbal supplements. Butterbur and feverfew are common herbal remedies that may aid with migraine pain and frequency reduction.
- Avoid Triggers. Ocular migraine triggers such as caffeinated foods, alcohol, dehydration, smoking, or stress
- Unwind at the end of the day. Basic things like listening to soothing music or taking a warm bath after a long day can help your body relax and prevent migraines.
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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Finding Ocular Migraine Relief
Ophthalmic Migraine Occurs In The Visual Cortex
Ophthalmic migraine is a vision-loss symptom that occurs due to the aura phase of the common migraine headache. It can occur with or without a headache. An ophthalmic migraine takes place in the brain, which affects vision in both eyes, and is generally believed to originate at the occipital cortex rather than in the eye itself. For this reason it is experienced in both eyes, not just one eye. It is also known as a scintillating scotoma.
A scintillating scotoma can occur with or without a migraine headache. Scintillating means sparkling or shining, and a scotoma is a partial loss of vision or a blind spot in an otherwise normal visual field.
This condition is marked by a spasm, or spreading wave of spasms that arise in the occipital area of the brain . Related blood vessel spasm and redilation is likely linked to these electrical charges. The experience of a person suffering from this condition is a sparkling or flickering of lights, as well as dots, wavy lines, zigzags, arcs, camouflage patterns, or blurry areas toward the periphery of vision . Typically, the scotoma starts as a small visual disturbance that slowly starts growing over much of the visual field over about 15-20 minutes before disappearing completely.
A headache might follow the visual effect, ranging from mild to severe, or accompanied by feeling tired, depressed, or washed-out. Sometimes a sensory aura will occur at the same time or just after the visual aura.
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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 2030 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