Ocular, Visual, and Retinal Migraines

An ocular migraine is a rare condition characterized by temporary vision loss or even temporary blindness in one eye. Ocular migraines are caused by reduced blood flow or spasms of blood vessels in the retina or behind the eye.

Ocular migraine can be painful and disabling, but there are ways to help prevent and reduce symptoms.

Some research suggests that in many cases, the symptoms are due to other problems.

The medical community defines ocular migraine as migraine that causes visual symptoms, with or without other migraine symptoms, such as a headache.

In an ocular migraine, vision in the affected eye generally returns to normal within an hour. Ocular migraines can be painless, or they can occur along with (or following) a migraine headache.

Ocular migraine

Ocular migraine symptoms usually go away on their own, so most people don´t need treatment for them.  The best thing to do is to rest your eyes until your symptoms subside and your vision returns to normal. If ever have any concerns visit your optician. Learn more about different types of migraine and their symptoms, causes and treatments.

People and doctors use the terms "ocular migraine" and "retinal migraine" interchangeably.

Unlike ocular or retinal migraines, a visual migraine typically affects both eyes.

According to the American Migraine Foundation, about 25-30% of people with migraine experience aura, but less than 20% of these individuals experience it with every migraine episode.

If a Migraine occurs with head pain, that does not have any visual disturbance, then it usually called common migraine. When a migraine occurs and both eyes are affecgted, it’s a Migraine with aura.

When there is no headache or head pain but there are eye distrubences and or eye vision loss they are called an acephalgic or silent migraine.

See your doctor to find out if you have an ocular or retinal migraine. He can rule out other conditions that can cause similar symptoms. Be ready to describe what you went through as completely as you can to help him figure out what's really going on.

DNA can e a factor in ocular migraine

What causes ocular (or retinal) and visual migraines?

Exactly what causes ocular or retinal migraine is not known, but a personal or family history of migraines is a known risk factor

Ocular or retinal migraines are believed to have the same causes as migraine headaches.

Migraine headaches have a genetic basis, and some studies say that up to 70 percent of people who suffer from the disorder have a family history of migraine headaches.

According to the World Health Organization, migraine headaches appear to be triggered by activation of a mechanism deep in the brain, which releases inflammatory substances around nerves and blood vessels in the head and brain.

Imaging studies have revealed changes in blood flow to the brain during ocular or retinal migraines and migraine auras. But why this happens and what brings about the spontaneous resolution of ocular or retinal migraines and visual migraines remain unknown.

Common migraine "triggers" that can cause a person to have a migraine attack (including ocular and visual migraines) include certain foods, such as aged cheeses, caffeinated drinks, red wine, smoked meats, and chocolate.

Food additives, such as monosodium glutamate (MSG), and artificial sweeteners also can trigger migraines in some people.

Other potential migraine triggers include cigarette smoke, perfumes and other strong odors, glaring or flickering lights, lack of sleep and emotional stress.

It's rare, but people who have these types of migraines may have a higher risk of permanent vision loss in one eye.

Genetics

There is a genetic link to migraine. A family history of migraine or ocular (retinal) migraine increases your chances of having them. Here are 11 interesting facts about migraine.

Hormone levels

Migraines have been linked to the hormone estrogen. Estrogen controls chemicals in the brain that affect the sensation of pain. In women, hormones fluctuate due to the menstrual cycle, pregnancy, and menopause. Hormone levels are also affected by oral contraceptives and hormone replacement therapies.

But if you have an ocular or retinal migraine, even if they go away on their own, it's a good idea to talk to your doctor about your symptoms.

Symptoms

Ocular or retinal Migraines – one eye affected

In some cases, the entire visual field of one eye may be affected. Generally, the episode lasts less than an hour.

The symptoms that ocular or retinal migraine causes vary widely among individuals.

However, they can include: 

  • Seeing temporary flashes of stars, zig-zag lines, or other patterns
  • A bright or blind spot that starts in the center of vision and spreads to cover up to half of the visual field
  • This blind spot gets larger, making it impossible for you to drive safely or read with the affected eye.
  • Slurred speech
  • Impaired motor skills
  • Sensitivity to light and sound
  • Nausea and vomiting
  • Tingling or numbness on one side of the body
  • Intense pain, which may be pulsating or throbbing, in one or both sides of the head
  • Pain that activity exacerbates

Visual symptoms due to ocular or retinal migraine can be scary and disabling, but most are short-lived. However, the nonvisual symptoms, such as intense pain, may last from several hours to a few days.

Aura tends to last between 10-30 minutes. It typically develops shortly before or during a migraine headache and is the second of a migraine's four stages. Aura generally sets in before the migraine becomes painful.

Visual Migraines – Both eyes are affected

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 blind spot that slowly migrates across your visual field
  • A wavy or zigzag ring of colored light surrounding a central blind spot
  • A flickering blind spot in the center or near the center of your field of view

The symptoms of a visual migraine typically affect both eyes and last 30 minutes or less. 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 or retinal migraine or a visual migraine, then cover one eye at a time. If the visual disturbance is occurring in just one eye, it's likely that it's an ocular or retinal migraine. If it affects both eyes, it's probably a visual migraine.

But don't take chances. If you suddenly experience any sort of blind spot in your field of vision, call or consult an eye doctor immediately to determine if it's harmless or possibly a sign of something more serious, such as a retinal detachment.

Treatment and prevention

Here are 12 migraine home remedies you can take advantage on.

Stress-reducing tools such as acupuncture might help reduce the frequency of severe migraine episodes.

The treatment of ocular or retinal migraine usually focuses on preventing and reducing symptoms.

As already noted, visual disturbances caused by ocular or retinal migraines and visual migraines typically disappear within an hour or less without treatment.

If you are performing tasks that require clear vision, when an ocular or retinal migraine or visual migraine occurs, stop what you are doing and relax until your vision returns to normal.

If you're driving, park on the side of the road and wait for the visual disturbances to completely pass.

If you experience visual disturbances that are accompanied by a migraine headache, see your family physician or a neurologist for evaluation of your migraine episodes.

Your doctor can advise you on the latest therapies for treating Migraines.

It's also a good idea to keep a journal of your diet and activities just prior to your ocular or retinal migraine or migraine aura episodes to see if you can identify possible triggers that you can avoid in the future.

If your ocular or retinal migraines or migraine auras (visual migraines) appear to be stress-related.  Some lifestyle changes and therapies may also reduce the frequency and severity of migraine headaches or episodes. These options include:

  • Limiting caffeine and alcohol consumption
  • Eating healthful meals on a regular basis
  • Establishing a consistent sleep schedule
  • Avoiding common migraine triggers
  • Losing weight if overweight
  • Getting plenty of sleep
  • Trying stressbusters such as yoga and massage
  • Staying hydrated
  • Dealing with stress using tools such as exercise, relaxation techniques, acupuncture, and biofeedback mechanisms
  • Tracking symptoms to find migraine triggers
  • Quitting smoking
  • Avoiding too much time looking at screens
  • Treating anxiety and depression with counseling and other options

Learn more about 14 non-tradition migraine treatment here.

How It Is Diagnosed

Your doctor will ask you about your symptoms and examine your eyes. He'll try to rule out other conditions that could cause similar problems, such as:

  • Amaurosis fugax, temporary blindness due to a lack of blood flow to the eye. It can happen because of a blockage in an artery that leads to the eye.
  • Spasms in the artery that brings blood to the retina
  • Giant cell arteritis, a problem that causes inflammation in blood vessels. It can lead to vision problems and blindness.
  • Other blood vessel problems related to autoimmune diseases.
  • Drug abuse
  • Conditions that keep your blood from clotting normally, like sickle cell disease and polycythemia

It is important to talk with a doctor about severe, frequent, or disabling headaches, as well as those that cause other symptoms, such as sensory problems or nausea. A person should seek emergency care for visual symptoms that affect only one eye.

Compiled using information from the following sources:

https://www.allaboutvision.com/conditions/ocular-migraine.htm

https://www.webmd.com/migraines-headaches/ocular-migraine-basics#1

https://www.medicalnewstoday.com/articles/325831.php#outlook

https://www.specsavers.co.uk/eye-health/ocular-migraines

https://en.wikipedia.org/wiki/Retinal_migraine