Ocular Migraine

A migraine headache is a severe recurring vascular headache that occurs more frequently in women than in men. Before experiencing the actual pain many people will have an \”aura\” or visual disturbance that signals the start of a migraine.

An ocular migraine is a temporary loss of vision or distortion of vision in one eye, which may or may not be followed by migraine headache pain. Sometimes these are called optical migraines. They are usually no cause for concern but will interfere with daily acitivities that require sight. During this migraine the person may experience flashes of light, zizag patterns, blind spots or shimmering spots or stars.

Although there is no confirmed cause identified, the prevailing theory is that it is caused by a sudden tightening or constriction of blood vessels. This reduces the blood flow to the eye causing the visual disturbance and pain. Most of these last under 5 minutes and vision usually returns to normal.

These ocular migraines are more common in women who are under 40 and have a personal history of migraines or other types of headaches. People who have a history of other medical conditions, including lupus, hardening of the arteries, sickle cell, epilepsy or depression are also more at risk for developing the condition.

Unfortunately, a visit to the ophthalmologist can produce only a few answers in terms of how to treat or prevent this condition. The process that triggers these migraines is poorly understood and not well identified. Another theory is that the vision symptoms are not related directly to the eyes but instead as a result of the activity in the visual cortex of the brain located in the back of the skull. This is much different from the theory that ocular migraines are caused by blood vessel constriction in the eye.

It is important for you to stay still until the migraine resolves. If there are any unusual or lingering visual disturbances once the migraine has resolved (within five to 20 minutes) then you should seek the advice of your ophthalmologist for a checkup.

Normally there will be no treatment options recommended unless the symptoms recur regularly or with increasing frequency. In this case, because of the interruption in daily activities such as driving or reading, or because of the severity of attacks the physician may recommend medication.

In 50% of the cases ocular migraines will cause a temporary but complete vision loss in one eye and in the other half of the cases common visual disturbances are blurring vision, dimming or flashing lights. 41% of individuals will also have a headache during the vision loss but it will resolve as the vision loss results.

To get an accurate diagnosis you must visit your ophthalmologist who will be able to use a fundascope to see the back of the eye in the blood vessels. But, since these migraines are fairly brief, it\’s more likely that you will be diagnosed based on symptomatology than a physical examination.

In this case both your ophthalmologist and primary care physician should work closely together in order to get an accurate diagnosis since the symptoms of an ocular migraine are very similar to other serious diseases, such as eye disease and stroke. If you are over 50, have a cardiovascular disease and no other history of migraine you and your physicians should look further for other conditions which may have caused the pain and visual disturbance.

While an ocular migraine may be difficult to diagnose they are also relatively harmless. At home, it is helpful to have an immediate acting anti-nausea medication that is prescribed by your physician in order to control any nausea which may occur during the migraine. You may also attempt to keep a migraine headache calendar where you write down food, sleep or other environmental things you encounter during the day as well as whether or not you had a migraine. In this way you can help to identify the triggers for your ocular migraines and then work towards preventing an attack.

RESOURCES

MayoClinic: Ocular Migraines

Natural Eye Care: Ocular Migraines

All About Vision: Ocular Migraines

Eyecare Northwest: Headache, Migraines and Ocular Migraine