What are Ocular Migraines, and What Causes Them?

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We have all experienced headaches. Most adults get a headache every now and then, but how do you know if your headache is serious? The term “ocular migraine” can be confusing. It generally means a headache that’s accompanied by changes in vision. The term is often used interchangeably to refer to two different conditions: migraine with aura, which usually isn’t serious, and Ocular (or retinal) migraine, which could signal something serious. An ocular migraine involves visual disturbance. Since some migraines, including ocular migraine with aura, can show symptoms similar to some life-threatening conditions, you need to know the differences and know when it as an emergency.

Although migraine headaches are quite common, ocular migraines are far less so.

Types of Migraines

  1. Migraine with aura – With symptoms such as blind spots, seeing stars and patterns, and other vision problems, migraine with aura can affect the vision in both eyes for a short time. It also interferes with a person’s speech and motor skills. About 20-30 percent of migraine sufferers experience migraine with aura.
  2. Ocular Migraine – An ocular migraine is different than a migraine with aura. An Ocular migraine, unlike a migraine with aura, will affect only one eye, and may or may not include a headache. Typically, any loss of vision associated with an ocular migraine IS NOT related to a migraine. It’s normally caused by another more serious condition. So if you experience loss of vision, be sure to see your doctor right away.

Symptoms include:

  • Partial or total vision loss in one eye; usually lasting about 15 minutes, with vision gradually returning.
  • Headache; may happen before, during or after the visual disturbance.

Causes:

The exact cause remains unclear. It is believed that the visual aura of ocular migraine is related to a phenomenon called “cortical spreading depression” which temporarily interrupts electrical impulses to the brain. You may see lines, shimmering lights, stars, or at times blind spots. Some people will experience temporary blindness in one eye.

In almost every case, the same eye is affected. And, it’s uncommon for any vision loss to continue for more than an hour. The vision may slowly blur or become dim, or there may be flashes of light or patterns of blank spots (scotomas), which enlarge to create total loss of vision.
If you EVER have a sudden loss of vision, AND have never been told you have a condition that may cause these symptoms, go to an emergency room IMMEDIATELY. Your sight may depend on it.

Triggers

  1. Genetics – Genetics plays an important role in migraines. This means you are more likely to have migraines if your family has a history of them. However, you can have them even if you do not have the migraine gene, because they also be cause by many other factors like stress and hormones.
  2. Hormone levels – Migraines are closely linked to estrogen levels in the body. Estrogen or the female hormone impacts the pain sensation in the body, so a drop in the estrogen level in the body could trigger a headache. In women, the estrogen levels fluctuate due to pregnancy, menstrual cycle, menopause or with oral contraceptives. These fluctuations play a prominent role in developing migraine symptoms. Other factors include;
  3. Glaring lights (such as looking at computer screens for a long time)
  4. Stress and anxiety.
  5. Dehydration and Alcohol
  6. Caffeine and smoking
  7. High blood pressure
  8. Foods containing tyramine and nitrates such as hot dogs, cheese, etc.
  9. Heat and exertion

Treatment:

Treatment for ocular migraines isn’t always necessary as symptoms are often temporary, and usually go away on their own in about 30 minutes.
We recommend resting your eyes until your symptoms pass, using a cool/cold compress on your forehead and taking painkillers as recommended, if you have an accompanying headache. Otherwise, the best thing you can do is to avoid exposure to common triggers.
If you ever have any concerns, it’s best to call your eye doctor, or book an appointment with your primary care physician.

Are Strokes and Ocular Migraine Connected?

Currently, there is no definitive answer. Researchers believe that ocular migraines and strokes may have a connection. They believe the connection has to do with the cells lining your blood vessels. Inflammation of these cells can cause them to become stiff and hence increase the risk of suffering a stroke.
Also, people who have migraine with aura are twice as likely to suffer a stroke as those who have no migraines.

Should you see a doctor?

Headaches are common among people and often go away on their own. But migraines need timely care and treatment. If you are facing any of the below symptoms, see a doctor.

  • Vision problems in conjunction with a headache.
  • Headaches with sensory problems.
  • Confusion or loss of alertness.
  • Have a severe headache resulting in a stiff neck.
  • Consuming painkillers for headaches that occur twice a week.
  • Experience frequent headaches without any history of migraines.

Takeaway

Ocular migraines are a sub type of migraine with symptoms occurring in one eye only. Patient’s suspected of having ocular migraines should be carefully assessed by their doctor to establish a cause.

To help distinguish ocular migraine from migraine with aura, it is important that people carefully assess whether there vision symptoms are in one or both eyes. This can be done by alternately looking through each eye. Knowing the difference between an ocular migraine and migraine with aura has important distinctions for treatment as well as outcomes.

If you have concerns about ocular migraines, or have noticed a recent change in your vision in generally, it’s best to schedule an appointment with your eye care professional so they can take a closer look at your eyes.


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