Ocular Migraines: Causes, Symptoms & Treatments

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What is an Ocular Migraine?

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

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

Your doctor may also refer to this type of migraine as ophthalmic or monocular migraines

These episodes may be scary. But in most cases, they are harmless and short-lived. However, ocular migraines can be a sign of a more serious condition.

Some people experience retinal migraines every few months, but the frequency varies from person to person.

Retinal migraine is a unique condition that should not be confused with headache-type migraine or migraine with aura, which often affect both eyes.1

What Causes Ocular and Visual Migraines?

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

Although studies have shown a change in blood flow into the eye during ocular migraines, the exact cause of this change remains unclear.

However, scientists sometimes associate the condition with genetics, meaning it may run in the family. 

According to research, up to 70% of migraine patients have a personal or family history of migraine.2 

Migraine triggers play a vital role in the onset and frequency of migraines.

Common migraine triggers include: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

What are the Symptoms of an Ocular Migraine?

The most common ocular migraine symptom is a small blind spot (scotoma) that impairs your 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
  • A blind spot that slowly migrates across your field of vision
  • A migraine lasting between 4 and 42 hours 
  • Sensitivity to light or sound
  • Vision loss
  • 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 it's 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 is 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 increased risk for stroke or severe carotid artery disease.

It’s essential to see an eye doctor when you lose your eyesight suddenly for the first time or if your eyesight deteriorates to check for any serious conditions.

What Type of Doctor Do You See for Ocular Migraines?

If you have ocular migraines, you can see an ophthalmologist or an optometrist.

Optometrists 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

On the other hand, ophthalmologists are medical practitioners who specialize in eye and vision care. They differ from optometrists in their degrees of schooling as well as what they can diagnose and cure.

An ophthalmologist is a healthcare professional who has finished college and has at least eight years of further medical studies. He or she is licensed to practice medicine and surgery. Ophthalmologists hold a Doctor of Medicine degree. 

Optometrists are healthcare professionals who complete four additional years of school after finishing undergraduate studies. They hold a Doctor of Optometry degree.

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

Professional Treatments

If you have been diagnosed with retinal migraines, 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 very 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.

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 region of the brain 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

Tips for Managing and Preventing Visual Migraines 

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

  • Acupressure. This is an evidence-based practice of applying 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.
  • Lavender oil. Lavender oil can be inhaled or applied diluted to the temples to ease your migraine pain.
  • Peppermint oil. 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 such as 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.

Ocular Migraines: Common Questions and Answers

Below are some frequently asked questions about ocular migraines:

Can dehydration cause ocular migraines?

Dehydration is one of the triggers of ocular migraines. Keeping your body hydrated will help prevent or reduce the frequency of occurrence of migraines.

Can anxiety cause ocular migraines?

Just like dehydration, anxiety is also a trigger of ocular migraines. The symptoms of ocular migraines can also cause anxiety, which worsens ocular migraines. 

Simple reassurance from your doctor will lower anxiety levels and decrease or eliminate ocular migraines.

Can high blood pressure cause ocular migraines?

Researchers are working to fully understand the relationship between high blood pressure and ocular migraines. 

Current research points to the fact that migraine attacks are prevalent in people with high blood pressure. 

Anyone suffering from high blood pressure is advised to get it under control, especially those with a known history of ocular migraines.

Are ocular migraines a symptom of a brain tumor?

A migraine that is accompanied by vision issues can be associated with certain tumors, such as the occipital lobe tumor

Although this is a rare condition, migraines are common among patients with brain tumors.

Is an ocular migraine a sign of a stroke?

An ocular migraine is not necessarily a sign of a stroke, but can indicate increased risk

However, research indicates that people with a history of ocular migraines are at a higher risk of stroke. 

Sometimes, migraines and strokes can occur together, but this is rare.

Cholesterol plaques in the eye that can cause temporary vision loss or blind spots. They are a strong indicator of impending stroke.

Why am I suddenly getting ocular migraines?

The exact cause of ocular migraines is currently unknown. However, scientists associate the condition with genetics. 

Other factors include stress, alcohol, fatigue, dehydration, hormonal changes, and smoking, among others.

How do you get rid of an ocular migraine fast?

Most people do not need treatment since the episodes of blindness usually last less than 60 minutes. 

The quickest way to get rid of an ocular migraine is to stop what you’re doing and rest your eyes until your eyesight returns to normal. 

You can relieve the headache using over-the-counter painkillers or just place a damp towel over your head.

Resources
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What Type of Migraine Headache Do You Have?,” American Migraine Foundation

Migraine Research,” Migraine Research Foundation

Understanding Ocular Migraine,” American Migraine Foundation, 19 October 2017

NSAIDs in the Acute Treatment of Migraine: A Review of Clinical and Experimental Data,” National Center for Biotechnology Information (NCBI), 17 June 2010

Retinal Migraine,” American Migraine Foundation, 10 March 2016

Cutaneous application of menthol 10% solution as an abortive treatment of migraine without aura” National Institute of Health (NIH)

Treating Migraines: More Ways to Fight the Pain,” US Food and Drug Administration (FDA)

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