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Ocular Migraines

Migraine Awareness Month:

An ocular 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 your visual field. Ocular 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 resolve completely once the migraine has passed. 

What is an Ocular Migraine?

The term ocular 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 ocular migraines commonly appear by obstructing a small area of vision which spreads gradually over 5 to 20+ minutes. 

A second type of ocular migraine is when you actually experience temporary vision loss or disruptions (flashes, blind spots, zigzag lines etc.) during or immediately following the migraine headache. Ocular migraines can also sometimes appear without any head pain at all. They may also be called eye or ocular migraines. 

What Causes Ocular Migraines?

Similar to classic migraines, the exact cause of an ocular migraine 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 certain blood vessels are associated with ocular migraine symptoms. 

For some, there are specific 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 diary to track your environment, diet and lifestyle habits, when you experience a headache. 

Treatment for Ocular Migraines

Treatment for ocular 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 visual disturbance goes away. 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 prior to a migraine headache, taking 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, that can lead to a retinal detachment and vision loss. 

If you get migraine headaches, among the best ways to prevent them are to keep your mind and body healthy by eating nutritious foods (cutting down on processed foods), getting appropriate rest and managing stress effectively.