Ocular Migraines: Symptoms, Causes, and Treatment Options

Introduction

When we hear "migraine," we usually think of a bad headache, right? But did you know migraines come in different types, too? Some cause only headaches, while others don’t hurt at all but can make you see strange things or feel weird sensations; these are called auras! Now, there’s a special kind called ocular migraine. In this type, one eye has vision changes, like blurry spots or zigzags, along with a migraine headache. Sounds interesting, right? But don’t worry, these vision changes only last for a little while!

Did you know that ocular migraines are super rare? They happen to only about 0.57 percent of people! But how do they happen? And how do doctors find out if someone has them? And most importantly, how can they be managed? If you’re curious, keep reading to find out!

What Is an Ocular Migraine?

Ocular migraine or retinal migraine is a rare kind of migraine. In this, there are visual disturbances for a short duration in one eye, along with the headache. These visual issues may occur as zig-zagging lines, flashing or shimmering lights, seeing stars, or blind spots. It has four stages: prodrome, aura, headache, and postdrome. An ocular migraine can interfere with the ability to perform tasks like writing, reading, or driving. The symptoms of ocular migraine are temporary and are usually not considered a serious condition.

Symptoms of Ocular Migraine

The symptoms of ocular migraine may vary depending on the individual. However, the common symptoms are:

• A blind spot in the vision (scotoma).

• An aura that flickers or has zigzag lines (scintillating scotoma).

• Floating lines.

• Temporary loss of vision in one eye.

• During an ocular migraine attack, a bright or blind spot may appear in the center of vision, enlarging and sometimes moving across the visual field.

These symptoms usually disappear within 20 to 30 minutes. Some people may experience silent migraine, which causes some of the visual disturbance of migraine but no headache. Meanwhile, migraine headaches can occur before, during, or after the visual symptoms. Other associated symptoms include:

1. Slurred speech.

2. Nausea and vomiting.

3. Headache, which may be pulsating or throbbing.

4. Impaired motor skills.

5. Sensitivity to light, sound, and smell.

6. Numbness or tingling on one side of the body.

7. Loss of appetite.

8. Feeling tired.

9. Feeling cold or warm.

10. The skin may become pale.

Causes and Triggers of Ocular Migraine

The exact causes of ocular migraine are not known. Many theories have been put forward:

1. Ocular migraines may be caused by inflammation in the brain; the blood vessels swell and exert pressure on the nerves, causing pain.

2. It may develop because of abnormal electrical activity in the brain's outer surface or cortex, gradually spreading like a wave over the brain's visual area.

3. It may be due to the narrowing of the arteries, which leads to temporary obstruction of blood flow to the eyes, causing the symptoms.

Other factors considered in contributing to ocular migraine include:

1. Genetics: About half of the people with ocular migraines have a family member who suffers from the same.

2. Hormone Levels: For females, changes in hormones can sometimes bring on a migraine. This can happen during their monthly cycle.

3. Changes to the Retina: Ocular migraine is largely present with vision changes, so any conditions in and around the eye can trigger these types of migraine attacks. They can mainly be caused by blood vessel spasms or blood flow reduction in the retina or the lining behind the eye.

4. Lighting: Too much exposure to unnatural light sources could bring about a migraine attack.

5. Too Much Time on the Road: Driving for a long time without stopping can cause an ocular migraine.

6. Triggers: Some common migraine triggers include:

• • Skipping meals.
  • Dehydration.
  • Weather changes.
  • Excessive heat or high altitude.
  • Too little or too much sleep.
  • Stress.
  • High blood pressure.
  • Low blood sugar.
  • Alcohol.
  • Smoking.
  • Excess caffeine.
  • Caffeine withdrawal.
  • Stress and anxiety.
  • Loud noises.
  • Strong odors.
  • Deli meats and many prepared meals containing nitrates.
  • Aged cheeses, fava beans, hard sausages, soy products, fava beans, and smoked fish containing tyramine.
  • Aspartame.
  • Monosodium glutamate (MSG).
  • Artificial sweeteners.

Ocular Migraine Without Headache

Sometimes, a silent migraine or acephalgic migraine occurs when a person has only visual changes but no headache. Doctors need to make sure it’s not something more serious, like a stroke (when blood can’t reach the brain) or retinal detachment (when the retina pulls away from the back of the eye). These are very dangerous and need help right away!

Complications of Ocular Migraines

Most of the time, they are not dangerous. But sometimes, they can cause problems like:

• Eye stroke (central retinal artery occlusion) - When blood stops flowing to the eye.

• Branch retinal artery occlusion - When blood gets blocked in the retina.

• Retinal or vitreous hemorrhages - Bleeding.

• Ischemia - Restriction of blood in the eye.

• Vision loss.

If you see darkness or flashing lights, lose vision, or have trouble thinking, if symptoms worsen or new symptoms appear, get help immediately!

How Is an Ocular Migraine Diagnosed?

Ocular migraines can be diagnosed by performing a physical examination, taking a clear medical history, and questions regarding lifestyle and medication. A complete eye examination will be carried out, and a series of questions will be asked about the symptoms. It is also necessary to rule out other conditions with similar symptoms. Neurologic testing and additional blood tests or imaging may be required to rule out other similar conditions.

Treatment Options for Ocular Migraines

Sometimes, people have visual changes that usually last 20 to 30 minutes, so most people do not get treatment. When this happens, it's best to stop what you're doing and rest your eyes until everything looks normal again. Over-the-counter (OTC) and prescription medications are available for treating recurring migraine episodes. Other medications that can help in treating ocular migraines are beta-blockers, calcium channel blockers, anti-epileptics, and antidepressants.

Some special machines can help with migraines! They use magnets or electric signals to make you feel better.

Preventing Ocular Migraines

You can try these things to keep migraines away:

• Some things can cause migraines, which are called triggers. Find and avoid them. A headache diary can help you identify triggers.

• Avoid long screen time.

• Eating regular meals.

• Deal with stress using exercise, acupuncture, relaxation techniques, and biofeedback mechanisms.

• Reduce weight in case of obesity.

• Quitting smoking.

• Limit caffeine.

• Seep well.

• Eat good food, drink enough water, sleep well, exercise, and stay stress-free!

• If the doctor gives you medicine, make sure to take it!

Conclusion

Ocular migraines can cause people to see wavy lines and flashing lights or even have blurry spots for a little while. Sometimes, they come with a headache, and sometimes, they don’t. It’s important to know the reason behind them. Doctors can help treat them and stop them before they even start! Therefore, making healthy choices can help keep them away.

Key Takeaway From iCliniq

Ocular migraines can make you see flashing lights, zigzag lines, patterns, or blind spots. Sometimes, you might get a headache, too, but sometimes, you might not! Most of the time, they are not dangerous, but they can make daily life harder if they happen a lot. If you ever get new or worse symptoms, tell a doctor and get help immediately!