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Migraine is one of the most common neurological disorders: about 15% of adults suffer periodically from this debilitating disorder. Symptoms include nausea, body weakness, photophobia and a sensitivity to light that results in a sometimes-blinding headache.
When a migraine is associated with visual disturbances, we refer to it as ocular or visual migraine. Weather changes, poor nutrition, stress, lack of sleep and genetics are some of the precipitators of ocular migraines, which manifest with blind spots, flashes of light and other unusual visual patterns.
Visual migraines are usually mild in nature and do not require any medical management. However, severe cases need treatment.
Home therapy such as resting, tension-relieving and stress-relieving activities and lifestyle modification is usually enough to push back mild migraines. Prescription drugs are another way to manage acute and serious cases of visual migraines.
Ocular Migraines Explained
According to the American Optometric Association, an ocular migraine refers to vision loss occurring in a single eye for less than 60 minutes with accompanying headaches. The term encompasses two forms of visual headache: migraine aura and retinal migraine. Migraine aura is more common but milder in intensity lasting just a few minutes.
If you have migraine aura that affects your vision, you may experience other sensations such as tingling or numbness just before or during the migraine attack.
Retinal Migraine Explained
Retinal migraine is often used interchangeably with ocular migraine, but this form is rare—and more severe. It primarily occurs in individuals who have had episodes of milder types of visual headaches.
It manifests with recurrent bouts of reduced vision, or even blindness, in one eye. Other serious medical conditions can also cause one-sided visual loss, so ensure you visit your physician for a comprehensive diagnosis should you experience such symptoms.
What Causes Ocular Migraine Auras?
Chemical changes in the visual cortex lead to the generation of abnormal electrical impulses in this area of the brain. As result, inappropriate activation of the visual pathways occurs and impairs normal vision.
Initially, the aura (collection of symptoms) does not have a significant effect on your normal functioning but may increase in intensity and duration causing considerable discomfort or disruption of activities. On average, the aura lasts for 10 to 30 minutes. About 30% of individuals suffering from migraines experience visual auras.
Apart from headache and visual symptoms, the eye-related migraine often presents with a severe pounding sensation in the head.
Recognizing an Ocular Migraine
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:
- Flashes of lights
- Zigzag lines within the visual field
- Glistening stars
- Shifting colorful spots
Negative symptoms include:
- Blind spots
- Tunnel vision
- Vision loss in one or both eye(s)
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 (making them seem closer, further away, or bigger or smaller than they really are), 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.
The American Migraine Foundation reports that migraines are highly heritable and have a significant genetic link. You are between two to three times more likely to suffer from migraines if one of your parents does. Ocular migraines can also be linked to and potentially triggered by stress, anxiety, bright and harsh lights, loud noises, electronic screen time, not enough or too much sleep, intense smells, too much physical exertion, caffeine or caffeine withdrawal, food additives, medications, tobacco, skipping meals, and changes in the weather or environment.
Women tend to suffer from migraines more often than men do. The Migraine Research Foundation publishes that while only about 6 percent of men generally struggle with migraines, about 18 percent of women battle them. This can be partly due to changing levels of estrogen that can come with menstruation, pregnancy, contraceptive medications, and menopause. Medical conditions, such as anxiety, depression, bipolar disorder, epilepsy, and sleep disorders, can also contribute to the onset of an ocular migraine.
What to Do in the Event of an Ocular Migraine
The American Heart Association publishes that migraine aura and visual disturbances occur about 20 percent of the time in the event of a migraine and can be a possible risk factor for ischemic stroke. Research findings show that if you suffer from migraine with aura, you are more than two times more likely to suffer from a blood clot or mass that clogs the blood vessel and leads to an ischemic stroke.
An ocular migraine can interfere with blood vessels in the brain, which in turn may raise the odds for clots and strokes. For this reason, if you suffer from ocular migraines, you should contact your health care provider to get it checked out and ensure that your risk factors are identified and addressed.
When suffering from an ocular migraine, it is important to take care of yourself. Try to manage the pain and symptoms as best you can. This may include:
- Moving to a quiet and dark room.
- Laying down and resting your eyes.
- Drinking a lot of water.
- Placing a cool compress on your head.
- Taking over-the-counter anti-inflammatory or anti-nausea medications.
Try to stay still in a safe place while the visual headache passes. Do not attempt to read, drive, or do anything else that requires extreme focus, concentration, or visual attention.
Ocular Migraine Treatments and Prevention
Except for the auras, the development of migraines is quite unpredictable. However, environmental and other physical factors that trigger episodes of the disorder can be controlled to reduce the chances of migraine occurrence. First, you need to keep a clear record of your visual disturbance episodes in order to identify possible triggers specific to you.
If medications or contraceptives are the likely precipitants for your migraines, consider talking to your doctor about changing the dosage, or stopping the drug. You can also choose another method of contraception that is less likely to affect your health, with the help of a qualified health care provider.
Adequate nutrition with abstinence from caffeine and smoking can also be effective in preventing visual headaches. However, smoking withdrawal may cause severe side effects and requires the guidance of trained personnel.
Sleep disorders such as insomnia are significant triggers of migraines. Having enough rest is therefore key in ensuring you’re free of the attacks.
Other therapies such as natural supplements can resolve or prevent the symptoms of migraines, but you need to discuss the possible side effects with your doctor.
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Visual Disturbances. (2018). National Headache Foundation.
The Genetics of Migraine. American Migraine Foundation.
Migraine is a Women's Health Issue. (2019). Migraine Research Foundation.
Migraine With Aura Linked to Clot-Caused Strokes. (February 2016). American Heart Foundation.
Understanding Ocular Migraine. (October 19, 2017). American Migraine Foundation.