Eye HealthApril 1, 2023 · 3 min read

What is an Ocular Migraine (And How Do You Treat it?)

woman massaging temples during an ocular migraine

The term “Ocular migraine” is frequently used to refer to several migraine subtypes. If you have symptoms of vision loss, it is important to consult your eye doctor to receive an accurate diagnosis.

Types of Ocular Migraines

Migraine with Aura

A migraine with aura often has visual related symptoms that precede the migraine headache. While visual auras are most common, auras can also present in a variety of ways.

Symptoms of Migraine with Aura:

Blind spots (scotomas) or partial vision loss
Flashes of light
Spots, stars or zigzag patterns
Tingling or numbness in various parts of the body
Mental fog
Speech or language difficulty
Muscle weakness
Dizziness

Retinal Migraine

While a migraine with aura typically affects both eyes, a retinal migraine usually only affects just one eye. Retinal migraine symptoms tend to be more intrusive than migraine with aura.

Symptoms of Retinal Migraine:

Scintillations (seeing twinkling lights)
Scotoma (areas of decreased or lost vision)
Temporary blindness

Retinal migraines can appear without a headache.

Causes of Ocular Migraines

Similar to classic migraines, the exact cause of an ocular migraine is unknown. Genetic predisposition seems to be a factor, and having a family history of migraines does put you at greater risk.

While the exact cause is unknown, experts have observed that spasms in the blood vessels and nerve cells in the retinal lining at the back of the eye are associated with ocular migraine symptoms.

For many, there are certain environmental triggers, or a combination of factors, that trigger migraines. Environmental triggers differ on an individual basis but can include the following:

Environmental Triggers

Stress
Dehydration
Bright/flashing lights
Loud sounds
Strong odors
Air pollution
A sudden or drastic change in weather conditions (including barometric pressure changes)
Travel
High altitude
Eating, or exposure to, certain food substances such as, alcohol, caffeine, nitrates, MSG (monosodium glutamate), artificial sweeteners and tyramine.

Since triggers are different for everyone it’s advised to try to identify yours by keeping a journal to track your environment, diet and lifestyle habits, when you experience a headache.

Treatment & Prevention for Ocular Migraines

Ocular migraine symptoms typically resolve themselves within 30 minutes. It is advised to rest and avoid doing things that require vision and concentration the vision symptoms cease and the headache resolves.

For those who experience infrequent ocular migraine attacks, taking a medication that targets symptoms can be effective (NSAIDS, anti-nausea medication, etc). While triptans can be effective for those experiencing a migraine with aura, they are not recommended for those with retinal migraines (they can prolong vision loss).

Preventative medication can also be prescribed for those with frequent migraine attacks. These medications include calcium channel blockers, antiepileptic or tricyclic medications.

As with all other types of migraines, avoiding and mitigating migraine triggers will help to prevent a migraine attack.

If you are experiencing any unusual visual symptoms or an increase in frequency or duration of symptoms, you should see an eye doctor right away to rule out any serious, vision threatening conditions. Symptoms such as floaters or flashing lights can also be a sign of a retinal tear or hole.

Senior man wearing glasses