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Ocular Or Retinal Migraine

Category : 
Author : Dr Deepak Garg
Ocular & Retinal Migraines - Causes, Symptoms, and Treatment

What is an ocular migraine? Is it a sign of something serious?

Ocular migraine, also known as retinal or visual Migraine, is a condition that affects the visual system. It is a type of migraine that causes temporary visual disturbances, such as flashing lights, zigzag lines, blind spots, or temporary vision loss in one or both eyes. These symptoms typically last 10 to 30 minutes or more and then gradually fade away.

The term “ocular migraine” can be confusing. In the past, it commonly denoted a migraine with visual disturbances. Yet, the terms migraine with aura and retinal migraine, both of which have the potential to be severe conditions, are sometimes used interchangeably. When referring to migraine with aura, the phrase “ocular migraine” had previously been used.

The visual alterations in retinal migraine are intermittent and only affect one eye. When only one eye experiences visual alterations, this could indicate a severe condition that must be treated immediately.

Thus, there are two types of migraine and they are slightly different

  1. Migraine 
  2. Ocular Migraine

What are Ocular Migraine Symptoms?

Studies have shown that

  1. 50% of retinal migraine patients said they experienced a complete loss of vision in one eye,
  2. 20% said it was just a blurred vision,
  3. 12% reported an incomplete loss,
  4. 7% experienced just dim vision, and
  5. 13% experienced black patches, also known as scotoma.

It also found that over 75% of patients had a headache on the same side as the vision disturbance within an hour of experiencing an aura.

Migraine aura affecting your vision

An aura associated with a migraine is a wave of activity moving across the brain. The type of aura is determined by where the wave of electrical activity originates in the brain. The most typical kind of aura is a visual aura. This visual aura is caused most likely due to the constriction or spasms of the blood vessels of the eye and then gradual dilation of blood vessels. These auras are also sometimes a precursor of headaches, i.e., the individual knows that the headaches will start before they get a headache because they experienced a visual aura. About 90% of people who have migraines with aura have this type.

Some studies say that auras are visual because of alterations in oxygen levels in visual processing units of the brain. Another theory states that the number of neurons firing to the brain’s visual cortex increases due to a specific trigger that causes the individual to see visual auras.

The person might experience sensory auras such as a tingling sensation in the tongue, face, or arm or language auras if the wave of activity passes via other parts of the brain, such as the sensory or language centres. Auras often last between five minutes and one hour. Sometimes an aura would occur but there would be the absence of head pain.

It is typical for a migraine aura to impair eyesight; however, the vision symptoms are transient. Your vision will be affected in both eyes or one eye by a migraine aura, and you can notice the following:

  • Lightening strikes or Zigzag patterns
  • The blind spots
  • Glistening stars or spots
  • Scintillating scotoma
  • Flashes of light

These symptoms may momentarily make it challenging to read or drive. Yet, migraine with aura isn’t typically regarded as severe.

Sometimes migraine headaches occur without any aura and this is known as silent migraine

*To make you experience what a visual aura might look like, you can try this to experience one; close your eyes and, with the little finger, gently put some pressure on the eyeball from the side. Be careful not to put a lot of pressure. Soon after you press the eyeball, you will start seeing some dark spots and designs of lights; these are called “phosphenes” However, auras look somewhat similar to these, except there is no pressure on the eye, and the individual’s eyes are open during the visual auras in migraine.

What is Retinal Migraine?

Retinal migraine is occasionally used interchangeably with “ocular migraine.” A retinal migraine is an uncommon illness that can develop in someone with migraine symptoms. Recurrent attacks of temporary vision loss or blindness characterise retinal migraines. These episodes could come before or after a headache. Unlike a migraine aura, a retinal migraine affects only one eye, not both. But usually, vision loss in one eye isn’t related to migraines. It’s generally caused by some other, more severe condition. So, if you experience vision loss in one eye, see a healthcare provider immediately for prompt treatment.

How do I know if it’s a Retinal Migraine?

Retinal or ophthalmic migraines usually affect one eye. They usually appear suddenly, and signs include:

  1. Vision loss often lasts between 10 and 20 minutes; however, it can occasionally last up to an hour.
  2. A visionary blind spot
  3. A headache you might experience concurrently with or shortly after the eye symptoms.
  4. Other eye symptoms include seeing flashing lights, Zigzag patterns, or coloured dots or lines, as well as blurred vision.
  5. Being or feeling unwell

Sometimes, visual symptoms are not associated with headaches.

*Please note that if you experience any sudden decrease of vision or a complete blackout, also known as “Amaurosis Fugax ” in medical terms in one eye, it must be reported to your nearest Eye Care Practitioner. Usually, these symptoms are treated as an ocular emergency and must be addressed immediately.

What are retinal migraine causes?

The exact cause of ocular migraines is poorly understood, but it is believed to be related to changes in blood flow or oxygen supply to the brain’s visual cortex. Various factors, including lifestyle choices, medical conditions, and environmental factors, can trigger ocular migraines. Here are the top five causes of ocular migraine:

  1. Stress: High anxiety levels are a common trigger for migraines, including ocular migraines. When you are stressed, your body releases hormones that can cause blood pressure and heart rate changes, affecting the blood flow to the brain.
  2. Lack of sleep: Lack of sleep can also trigger ocular migraines. When you get disturbed sleep, your body may release stress hormones, primarily cortisol, that can cause changes in blood flow and lead to a migraine. It’s important to build a consistent sleep schedule in your daily life.
  3. Certain foods: Certain foods, such as chocolate, caffeine, and aged cheeses, can trigger ocular migraines. Other food triggers may include alcohol, processed meats, and foods with high levels of sodium or MSG.
  4. Hormonal changes: Hormonal changes can also trigger ocular migraines, especially in women. Hormonal fluctuations during the menstrual cycle, pregnancy, or menopause can cause changes in blood flow and lead to a migraine.
  5. Environmental factors: Environmental factors, such as bright or flashing lights, strong smells, or loud noises, can trigger ocular migraines in some people. Changes in the weather, such as temperature or barometric pressure, can also trigger migraines.

Other possible causes of ocular migraines may include medical conditions like high blood pressure, diabetes, atherosclerosis, or medications like birth control pills or blood pressure medications. Identifying potential triggers and making lifestyle changes to avoid them whenever possible is essential. If you experience frequent ocular migraines or severe symptoms, consult your doctor to rule out any underlying medical conditions and explore treatment options.

What should I do if I experience an Ocular Migraine?

Here are certain Do’s usually recommended when you experience an ocular migraine:

  • During a migraine, try lying down or sleeping.
  • Drink lots of water to keep your body hydrated
  • Have a balanced diet and eat meals at regular intervals.
  • Exercise frequently and get plenty of rest.
  • Try to manage the stress levels
  • Avoid consuming things you know to be migraine triggers, like caffeine and alcohol.

What are Migraine Attacks treatment options?

The treatment of Migraine headaches focuses on relieving the symptoms and reducing the frequency of the episodes. There is no cure for ocular migraines, but various treatment options are available to manage the condition. Here are some of the most common treatment options for ocular Migraines:

  1. Lifestyle factors: Making lifestyle changes can help reduce the frequency and severity of ocular migraine episodes. This may include avoiding triggers like stress, sleep deprivation, certain foods, regular exercise, and relaxation techniques like yoga or meditation.
  2. Pain relievers: Over-the-counter pain medications can help relieve the pain associated with ocular migraines. These medications work best if taken as soon as the symptoms begin. If they persist, please consult your healthcare practitioner.
  3. Triptans: Triptans (Migraine Medications) are a class of prescription medications that can help relieve the pain and other symptoms of migraines, including ocular migraines—Triptans constrict the blood vessels in the brain and reduce inflammation.
  4. Preventive medications: If you experience frequent or severe ocular migraine episodes, your doctor may recommend preventive medications, such as beta-blockers, calcium channel blockers, or antidepressants. These medications are taken daily to help reduce the frequency and severity of migraine episodes.
  5. Botox injections: In some cases, Botox injections may be used to treat ocular migraines. Botox works by blocking the release of chemicals that cause pain and inflammation in the brain.
  6. Complementary therapies: Complementary therapies, such as acupuncture, biofeedback, or massage, may also help manage the symptoms of ocular migraines. These therapies can help reduce stress, promote relaxation, and improve overall well-being.

Before starting treatment, please discuss your symptoms, severity, frequency, and intensity with your eye doctor. Based on your description of symptoms, the eye doctor will prescribe you medication and help you manage your ocular migraine.

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