Ocular Migraines: Causes, Symptoms & Treatments

What is an Ocular Migraine?

An ocular migraine is an eye problem characterized by short episodes of vision loss or disturbances. 

For example, you may see flashing lights in one eye accompanied by a headache. 

Your doctor might refer to this type of migraine as an ophthalmic or monocular migraine. 

These episodes can be scary, but they’re mostly harmless and short-lived. However, sometimes an ocular migraine can indicate a more serious condition.

Some people experience ocular migraines every few months. The frequency varies from person to person.

Ocular migraines have specific symptoms. They shouldn’t be confused with a classic migraine, migraine with aura, or retinal migraine.  

Retinal Migraine vs. Ocular Migraine

Some people confuse an ocular migraine with a retinal migraine headache.  Ocular and retinal migraine symptoms are usually similar. For instance, you can experience a visual aura because of the condition. 

However, the main difference is that a retinal migraine results in visual disturbances in one eye, while ocular migraine disturbances occur in both eyes.  

Whether you experience ocular or retinal migraines, finding the right treatment is important. 

What Causes Ocular and Visual Migraines?

Currently, there is limited research on what causes ocular and visual migraines. 

The exact cause of ocular migraines is still unclear. However, studies have shown a change in blood flow into the eye during ocular migraines. This provides insight on how it occurs. 

However, it might be a hereditary condition, meaning it runs in families. According to research, up to 70% of migraine patients have a personal or family history of migraines.² 

Migraine triggers play a vital role in the onset and frequency of them, such as:³

• Strong scents (e.g., perfumes)
• Food additives such as artificial sweeteners
• Bright or flickering lights
• Poor lighting conditions
• Caffeine withdrawal
• Certain foods, such as smoked meats and aged cheese
• Cigarette smoke
• Lack of sleep
• Stress and anxiety
• Fatigue
• Hormonal changes
• Weather changes
• Dehydration
• Alcoholic drinks such as red wine
• Excess heat or high altitude
• Low blood sugar

What are the Symptoms of an Ocular Migraine?

The most common ocular migraine symptom is a small blind spot (scotoma) that impairs central vision in one eye. This blind spot expands, making it difficult to drive safely or read using the affected eye.

In addition to the flickering blind spot, other migraine symptoms include:

• A colorful light ring that is wavy or zigzag and surrounds a central blind spot (migraine aura)
• A blind spot that slowly migrates across your field of vision
• A migraine lasting between 4 and 42 hours 
• Sensitivity to light or sound
• Temporary vision loss
• Headache pain
• Nausea and vomiting
• A headache that feels worse when you move your head

If you have blind spots or other visual symptoms and aren’t sure whether they’re due to an ocular migraine or a visual migraine, cover one eye at a time and observe your sense of sight. If the visual disturbance affects one eye only, it’s most likely an ocular migraine.

When Should You Worry About an Ocular Migraine?

Although the symptoms of ocular migraines can be frightening, the condition is harmless and short-lived in most cases. However, ocular migraines can indicate serious health problems, such as an increased risk of stroke or severe carotid artery disease.

See an eye doctor if you lose your eyesight for the first time or it deteriorates. They can check for any serious conditions.

What Type of Doctor Do You See for Ocular Migraines?

See an ophthalmologist or optometrist if you experience ocular migraines.

Optometrists and ophthalmologists are eye care specialists who offer primary vision care services, including:

• Vision testing
• Diagnosis
• Correction of visual problems
• Treatment and management of visual issues and eye diseases

Diagnosing and Treating Ocular Migraines 

When you visit your doctor, they will ask about your symptoms, examine your eyes, and order additional tests to rule out other serious conditions, such as:

• Amaurosis fugax (lack of blood flow into the eye)
• Giant cell arteritis (inflammation in blood vessels)
• Spasms in the blood vessels that carry blood to the eye
• Autoimmune diseases
• Stroke or transient ischemic attack (TIA)
• Drug abuse

Medications

Always consult your doctor about the best treatment options. There is no one recommended treatment regimen since it varies from person to person.

If you don’t experience ocular migraines frequently, your doctor may advise you to use over-the-counter NSAIDs like aspirin and ibuprofen when the episodes occur.⁴

Your doctor may also recommend the following:

• Anti-nausea medication to reduce nausea and related symptoms
• Calcium channel blockers to lower blood pressure
• Anti-epileptic medications to prevent seizures
• Tricyclic antidepressants to alter the brain’s chemistry

Doctors don’t usually use traditional migraine treatments such as triptans and ergotamines for people with ocular (retinal) migraines.⁵ 

Triptans, for example, aren’t safe if you’re at risk for a stroke, which may be the case for people experiencing temporary blindness in one eye.

Electrical Stimulation

A recent technique for treating or preventing ocular migraine is to use a self-administered device that delivers electrical stimulation to the forehead or back of the head.

These devices include:

• Cefaly. A portable headband that was the first migraine treatment device to be authorized by the FDA. It is used every day for 20 minutes.⁷ 
• Spring TMS. This device activates a brain region with a magnetic pulse while held at the back of the head. 
• The gammaCore. This non-invasive vagus nerve stimulator relieves migraine discomfort by sending electrical stimulation to the vagus nerve.

Home Remedies

The following remedies can help ease your ocular migraine attack without going to the doctor:

• Apply some pressure on your temples
• Massage your scalp
• Lie down to rest
• Sit in a quiet and dark room
• Place a damp towel over your head
• Take over-the-counter painkillers to ease the headache

Migraine Prevention Tips 

If your visual migraine occurs frequently, here are some tips to help you prevent or manage the condition: 

Acupressure 

This evidence-based practice applies pressure with hands to specific points on the body to relieve pain and other symptoms. It can be an effective alternative therapy for migraine headaches.

Essential Oils

Essential oils, such as peppermint oil, can minimize migraines. According to a 2010 study, the menthol in peppermint oil can minimize migraines.⁶ The research showed that applying menthol to the forehead and temples relieved migraine-related pain, nausea, and light sensitivity.

Yoga

Yoga uses breathing, meditation, and body postures to promote health and well-being, relieving the frequency, duration, and intensity of migraines. 

Massage Therapy

Massage reduces stress and enhances coping skills. It also lowers heart rate, anxiety, and cortisol levels.

Herbal Supplements

Butterbur and feverfew are common herbal remedies that may aid with migraine pain and frequency reduction.

Avoid Triggers

Ocular migraine triggers include caffeinated foods, alcohol, dehydration, smoking, or stress.

Unwind at the End of the Day

Basic things like listening to soothing music or taking a warm bath after a long day can help your body relax and prevent migraines.

Summary

An ocular migraine is a condition that causes temporary vision loss and severe headaches. 

While this condition is typically self-limiting, consulting your doctor is the best way to determine your best treatment plan. You should also limit your triggers to prevent ocular migraines.