Brief overview of ocular migraine symptoms
Seek medical attention promptly if you notice new visual symptoms, such as:
- Changes are visible in only one eye.
- Visual changes that take less than five minutes or more than an hour.
- Visual changes that would not cause a headache.
- New headaches or new visual changes.
- Experience of headaches or vision changes after age 50.
- New weakness on one side of the body or changes in speech.
- Areas that lead to partial or complete blindness.
- Experience of visual zigzag patterns.
- Lights that shimmer or flicker.
- Experience of visual floating lines.
These symptoms may indicate a more serious underlying condition and should be evaluated by a doctor.
What is an ocular migraine?
- Ocular migraine: also known as retinal migraine, causes episodes of visual disturbances in one eye combined with migraine headaches. It is a rare condition usually seen in people who have other migraine symptoms. The condition involves repeated brief episodes of partial vision loss, such as blind spots, that can occur before or during a headache.
- A retinal migraine: unlike a migraine with aura, affects only one eye. Nonetheless, vision changes in only one eye are typically not connected to a retinal migraine. These changes might be due to more serious conditions that need medical attention.
- Ocular migraines: may start as early as age 7, but most individuals begin experiencing them in their 20s, with the highest incidence in their 40s.
What are the causes of ocular migraines?
Researchers are unsure of the exact cause of ocular migraines (retinal migraines), but they have some hypotheses. One suggestion is that it might be linked to issues with the blood vessels or blood flow supplying the retina. This disruption in blood flow leads to visual symptoms. When the blood vessels relax, normal blood circulation is restored, and vision returns.
Experts are unsure about the exact causes of ocular migraines, but they have some theories, such as:
- Blood vessel spasms in your retina decrease blood flow in the retinal vessels. The retina, a light-sensitive tissue layer at the back of your eye, transforms images into electrical signals that are sent to your brain via the optic nerve.
- It is possibly genetic, as approximately 50% of individuals with ocular migraines have a family history of the condition.
What triggers ocular migraines?
Ocular migraines have similar triggers to migraines with aura. Typical triggers include:
- Stress.
- Smoking.
- High blood pressure (hypertension).
- Hormonal birth control pills.
- Exercise.
- Bending forward.
- High elevation.
- Dehydration.
- Low blood sugar, also known as hypoglycemia.
- Excessive heat exposure (hyperthermia).
- Alcohol and caffeine.
How is an ocular migraine diagnosed?
If you visit a doctor during an ocular migraine, they may use an ophthalmoscope to check for reduced blood flow in your eye. This can aid in diagnosing ocular migraine.
Because attacks tend to be short, your diagnosis of ocular migraine is more likely to be based on your symptoms, medical history, and family history.
Your doctor may recommend consulting an eye specialist, such as an ophthalmologist, to ensure you do not have a concealed eye condition that could be serious.
What are the common treatments for ocular migraine?
If ocular migraines occur rarely, such as once a month, doctors usually do not recommend treatment. But if you have frequent ocular migraines, the aim is to decrease the number of episodes. Treatment options include:
Research on the best methods to treat or prevent ocular migraines is limited. Your doctor may recommend one or more medications, such as:
- Medicines used to treat epilepsy include drugs like topiramate (Qudexy XR, Topamax, Trokendi XR) and valproic acid (Depakene, Depakote).
- Tricyclic antidepressants such as amitriptyline (Elavil), nortriptyline (Pamelor), or venlafaxine (Effexor)
- Blood pressure medications include beta-blockers like metoprolol (Lopressor) and propranolol (Inderal), along with calcium-channel blockers such as nicardipine (Cardene) and verapamil (Calan).
- CGRP inhibitors such as eptinezumab (Vyepti), erenumab (Aimovig), fremanezumab (Ajovy), and galcaneumab (Emgality)
Triptans, although a good treatment option for migraine with aura, are usually not recommended for retinal/ocular migraines because they constrict blood vessels, potentially worsening the temporary vision loss.
- Ensure adequate sleep: as healthy sleep habits can prevent migraines and alleviate symptoms. If you notice a migraine starting during the day, consider taking a nap.
- Ensure you get enough exercise: While avoiding exercise during a migraine episode, incorporating regular light-impact activities might help prevent attacks and reduce symptoms when they occur. Sometimes, if you feel a migraine beginning, some individuals report that engaging in light activity can prevent it from worsening.
- Stay hydrated: to help prevent headaches and migraines. Dehydration can often cause a headache and may trigger migraines in some individuals. If you notice a headache starting, it could be a sign of dehydration. Whenever possible, carry water with you and sip it regularly throughout the day.
- Lower your lights: since light sensitivity is a common migraine symptom. Dimming the lights in your home and office might help reduce the risk of attacks.
- When experiencing a migraine, apply a cold or hot compress. Keep a cold pack or ice nearby and press it against your temple or neck at the start of an attack. Others might prefer a hot compress or heating pad. Regardless of the temperature, avoid leaving the compress on for more than 15 minutes to prevent skin damage.
- Receive a scalp massage: which can alleviate tension and enhance blood circulation in your scalp and neck muscles, potentially reducing discomfort.
- Consider trying essential oils: While scientific evidence is lacking, they may help relieve pain. If a particular oil enables you to relax, it could be worth testing. Many people find peppermint and lavender effective in reducing stress. However, during a migraine, some individuals become more sensitive to smells, and strong scents might even trigger a migraine.
What are some ways to prevent ocular migraines?
The initial step in preventing migraines is to identify and avoid your triggers. For instance:
- Quit smoking.
- Steer clear of foods and beverages that trigger your migraines.
- Remember to stay hydrated.
- Follow your doctor’s advice to control your blood pressure.
- Manage your stress healthily.
- Switch to a different birth control method if you are taking birth control pills.
If you regularly experience migraines, consult your doctor about preventive medications such as calcium channel blockers. Nifedipine or verapamil seems to be the most effective option for those with ocular migraines.
Living with ocular migraines
Having migraines can significantly impact your quality of life. If you experience vision problems, avoid driving until your headache subsides. It is crucial to identify and avoid your triggers and be prepared to manage a migraine if it occurs. Fortunately, there are ways to prevent attacks and alleviate your symptoms. Take good care of yourself, and talk to your doctor about medications and lifestyle adjustments. Ocular migraines are usually not dangerous, but frequent episodes can interfere with your daily activities. If you notice sudden vision changes during a migraine, see a doctor promptly to rule out any serious underlying issues. They can also recommend treatments to better control ocular migraines.
Frequently Asked Questions
What is the usual duration of ocular migraines?
Ocular migraines typically cause visual disturbances that last 5-60 minutes. However, if untreated, the headache may last 4 to 72 hours.
What distinguishes an ocular migraine from a migraine with aura?
A retinal (ocular) migraine is a type of migraine that affects only one eye. In contrast, a migraine with aura involves both eyes. The visual symptoms during an ocular migraine usually last for a shorter duration than those in a migraine with aura. Additionally, the headache often remains behind the affected eye in an ocular migraine, while in a migraine with aura, the pain can be more distributed across the head.
How frequently do ocular migraines occur?
Ocular migraines are rare, but their actual frequency is uncertain due to underreporting. While migraines impact roughly 18% of women and 6.5% of men, not everyone with migraines also has ocular migraines.
Is it possible to experience an ocular migraine in both eyes?
Ocular migraines usually affect only one eye. If you notice symptoms in both eyes, seek guidance from your doctor.
How can you tell the difference between headaches behind the eye and ocular migraines?
It is essential to distinguish ocular or retinal migraines from typical eye-related headaches. Ocular migraines occur due to decreased blood flow to the eye, usually caused by the sudden narrowing of blood vessels, and typically affect only one eye. Conversely, headaches behind the eyes are often connected to regular migraines triggered by various stimuli. Common triggers include sensitivity to bright light (photophobia), specific medications, and extended screen time, all of which can lead to migraines and eye-related headaches.
