Ocular Migraines

When most people think of migraines, they think of blinding headaches that lead to brain fog, difficulty concentrating, and ongoing pain. You might imagine the visual disturbance that goes along with traditional migraines, seeing auras or flashing lights. Traditional migraines may even involve blind spots or tunnel vision, depending on the severity of the migraine. Ocular migraines, however, have their own unique set of symptoms

What Are Ocular Migraines?

The first time you have an ocular migraine, it may fill you with fear. During an ocular migraine, you will experience a decrease in vision or even complete blindness for a short period of time. Symptoms may vary between individuals, but there are several common symptoms related to ocular migraines.

Retinal Migraines

Retinal migraines generally involve only one eye. Many people assume that retinal migraines are the only type of ocular migraine or use the term ocular migraine to describe a retinal migraine. Retinal migraines may occur due to a temporary constriction of blood vessels in one eye for a period of time.

A small, slowly growing blind spot in your central vision. Unlike traditional migraines, when vision might start to decrease at the edges or “tunnel” as it progresses, ocular migraines begin in your central vision: right in front of your eye. Initially, the spot, known as a scotoma, may be relatively small. As the migraine increases, however, it may grow or lead to complete blindness in the affected eye.

Bright, flickering lights within the blind spot. While you may be unable to see what’s going on around you, you may experience bright, flickering lights within the blind spot in your vision.

Shimmering, zig-zag lines within the blind spot. Instead of bright, flickering lights, some people experience zig-zag lines traveling across the blind spot.

The blind spot moves across your field of vision. In some cases, the blind spot may not grow to encompass your entire visual field in one eye. Instead, it may move from one point to another or shift slowly across your field of vision until it eventually dissipates.

Full Ocular Migraines

Unlike retinal migraines, full ocular migraines often occur in both eyes. You may experience full blindness, including both a gradual decrease of vision or a sudden onset of blindness in both eyes. You may have flashing lights, zig-zags, or floaters within your field of vision while remaining unable to see what’s going on around you.

You may struggle to tell whether migraine symptoms occur in one eye or in both eyes. Sometimes, visual disturbance may appear to be localized to one area of your field of vision, but you may find it spreads further than you think. Other times, it may seem to spread fully across your field of vision but be isolated to one eye. Covering one eye then the other will allow you to better determine whether an ocular migraine is limited to one eye or spreads across both eyes.

Patient holding head during an ocular migraine.

Are Ocular Migraines Harmful?

In general, ocular migraines are not considered harmful. Most people have no symptoms other than blindness or blind spots. Neither retinal migraines nor full ocular migraines are, in and of themselves, harmful. However, in some cases, retinal or ocular migraines may be a sign of a more serious problem. If you have a retinal or ocular migraine, it’s important to consult with a doctor as soon as possible to undergo an evaluation and ensure your symptoms don’t signal a larger problem.

Most of the time, ocular migraines are not caused by actual visual symptoms nor is their trigger within the eye. Instead, they are caused by migraine activity within the visual cortex of the brain.

What Causes Ocular Migraines?

Like other types of migraines, there are a number of potential triggers for ocular migraines. Some are unknown; others, you may be able to isolate and define, especially if you have ongoing ocular migraine symptoms. Triggers may include:

Stress and Anxiety

The higher your stress levels, the more likely you are to trigger a migraine of any type. Some people find that during periods of high stress, whether they’re working hard to meet a deadline or struggling to deal with personal problems, may cause more frequent instances of migraines, including ocular migraines. Others find that extreme anger or anxiety can trigger migraine symptoms.

Relaxing After a Period of Intense Stress

Some people don’t have migraines when they are in the middle of stressful situations. Instead, for whatever reason, those symptoms are triggered after the migraine is over. Sufferers are ready to kick back and relax for a little while, and instead, they may find a migraine taking hold.

Caffeine Consumption

Some patients find that their bodies are more sensitive to certain chemicals than others–including, most commonly, caffeine. Ocular migraines may occur shortly after caffeine consumption of a specific volume or as the caffeine starts to leave the bloodstream. If you cannot isolate ocular migraine triggers, consider whether caffeine could be to blame. Be sure to include chocolate and tea as potential triggers. Caffeine withdrawal can also act as a trigger for both ocular and retinal migraines.

Bright Lights or Loud Sounds

In some cases, ocular migraines, like traditional migraines, are triggered by environmental factors. Bright lights, especially flashing lights, or loud sounds can trigger an ocular migraine.

Weather Changes

Many people find weather changes trigger migraine systems, especially as high or low-pressure systems move into the area. Extreme changes in weather may be more likely to cause ocular migraine symptoms.

Low Blood Sugar

For some people, low blood sugar can trigger a range of migraine symptoms. Low blood sugar is more likely to trigger a retinal migraine than other types of migraines. High blood pressure and dehydration may also act as triggers.

Certain Types of Food

Like caffeine, some foods may trigger ocular or retinal migraines. MSG and artificial sweeteners, in particular, are known to cause a range of potential health problems, including migraines of all types. Highly processed foods, especially eaten in high quantities, may also trigger migraine symptoms. For some people, red wine may cause issues, while others find any type of alcohol can trigger both ocular and regular migraine symptoms.

If you suffer from regular ocular or retinal migraines, isolating the trigger can help you avoid future symptoms. Talk with your doctor about keeping a diary to help identify potential symptoms. Document food as well as potential environmental triggers. Over time, you may find a pattern, and, once you find a pattern, you can avoid future triggers.

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How Long Do Ocular Migraines Last?

Most of the time, ocular migraines are relatively short-lived in duration. Sometimes, they last for as little as 20-30 minutes before disappearing completely. In other cases, especially if they are accompanied by more traditional migraine symptoms, ocular migraines may last longer. If your vision does not return within an hour, contact a doctor, or seek emergency care to ensure your migraine symptoms were not caused by something more serious.

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What Should You Do If You Have an Ocular Migraine?

If you note ocular migraine symptoms, your actions will depend on the severity of the symptoms and how much they affect your ability to function. Since ocular migraines are generally painless, you may be able to continue with your normal daily activities, especially if symptoms are confined to one eye or wear off quickly. You should also follow these steps:

Make sure that you are in a place where you do not require visual clarity. If you are on the road, for example, you should pull over as soon as it is possible to do so safely. If you suffer complete blindness, sit or lie down and wait for the migraine to pass. Ocular migraines may also be disorienting, so you may need to sit down while waiting for symptoms to stop.

See if you can isolate a trigger. If possible, note what is going on in your environment that could have triggered a migraine, whether you note that you are highly stressed, that there are extremely bright or flashing lights in the room, or that you have recently consumed a specific food.

Contact your doctor if needed. While ocular migraines are generally harmless, you should consult your doctor to rule out any larger problems, especially if you have recently had an ocular migraine for the first time or frequency appears to be increasing. In some cases, your doctor may be able to help you manage ocular migraines with medication. In other cases, they may work with you to help isolate a trigger, which can help you avoid potential future episodes.

Ocular migraines, while generally painless, may cause frustrating limitations on your daily life, especially if you’re trying to drive or take care of normal tasks at home or work when they occur. Are you struggling with ocular migraines or other vision issues? Schedule an appointment for a consultation today or contact us with any challenges or questions you might have. We’re here to help identify the causes of your ocular migraines, prevent symptoms when possible, and make it easier for you to live your life in spite of any medical difficulties.