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Ocular Migraines

Migraine Awareness Month:

A classic migraine is any migraine headache that involves a visual disturbance such as flashes of light, seeing stars or zigzags or the appearance of blind spots in the visual field. Classic migraines can interfere with your ability to go about your daily tasks such as driving, reading or writing, however, the visual symptoms don’t last long and do go away completely once the migraine has passed. 

What is a Migraine?

The term migraine may refer to a couple of different conditions. Firstly, migraines with auras often have eye-related symptoms that precede the actual headache. An aura is a physical symptom that is experienced usually within 5 minutes to an hour before a migraine comes on, and can include:

  • Blind spots (scotomas) or partial vision loss
  • Flashes of light, spots or zigzag patterns
  • Visual, auditory (hearing) or olfactory (smell) hallucinations or disruptions
  • Tingling or numbness
  • Mental fog, trouble finding words and speaking

These types of visual symptoms of migraines commonly appear by obstructing a small area of vision which spreads gradually over 5 minutes. 

Visual symptoms of migraine (temporary vision loss or disruptions like flashes, blind spots, zigzag lines etc.) can also occur during or immediately following the migraine headache instead of before the headache. Ocular symptoms of migraines can also sometimes appear without any head pain at all. These are called ocular, eye, ophthalmic, or retinal migraines. 

What Causes Migraines?

The exact cause of migraines is unknown. Genetic predisposition seems to be a factor to some extent, and having a family history of migraines does put you at greater risk. 

While they don’t know the cause, experts have seen that spasms in the blood vessels and nerve cells in the retinal lining at the back of the eye are associated with visual migraine symptoms. 

For some, there are certain environmental triggers, or a combination of factors, that cause migraines. These differ on an individual basis but can include:

  • Stress
  • Bright lights or loud sounds
  • Strong smells
  • A sudden or drastic change in weather conditions
  • Eating, or exposure to, certain food substances such as, alcohol, caffeine, nitrates, MSG (monosodium glutamate), artificial sweeteners and tyramine. 

Since triggers are different for everyone it’s advised to try to identify yours by keeping a journal to track your environment, diet and lifestyle habits, when you experience a headache. 

Treatment for Migraines

Treatment for the visual symptoms of migraines is usually not necessary as the symptoms typically resolve themselves within 30 minutes. It is advised to rest and avoid doing things that require vision and concentration until the headache goes away and the vision symptoms cease. If you are experiencing an ocular headache:

  • Lie down in a quiet, dark room when possible
  • Massage or apply pressure to the temples and scalp
  • Apply a damp towel to the forehead

If you experience auras, taking a migraine medication when the aura occurs, can often reduce the intensity of the headache that follows. In other words, you can use the aura as a warning sign that a headache is coming on and treat it preventatively. Your doctor may prescribe a pain reliever for associated head pain and, if migraines are chronic, a preventative medication may be given. 

It’s important to note that if you are experiencing any unusual visual symptoms or an increase in frequency or duration of symptoms, you should see an eye doctor right away to rule out any serious, vision threatening conditions. Symptoms such as floaters or flashing lights can also be a sign of a retinal tear or hole. 

If you get migraines, among the best ways to prevent them are to keep your mind and body healthy by eating nutritious foods, getting enough rest and managing stress effectively.