Ocular migraines, also known as visual migraines, are brief episodes of visual disturbances that may or may not be accompanied by head pain. These episodes can be alarming, but in many cases, they are temporary and benign. However, because they affect vision, it’s important to distinguish them from more serious eye conditions and understand when to seek medical attention.

What Is an Ocular Migraine?

An ocular migraine is a type of migraine that primarily affects vision. There are two main forms:

Retinal Migraine

• Affects only one eye
  

• Causes temporary vision loss or visual disturbances such as flashing lights or blind spots
  

• Often followed by a migraine headache
  

Migraine with Visual Aura (Visual Migraine)

• Affects both eyes
  

• Involves visual phenomena like zigzag lines, shimmering lights, or kaleidoscope-like images
  

• May or may not be followed by a headache
  

Though sometimes used interchangeably, retinal migraines are rare and involve true vision loss in one eye, whereas visual migraines involve visual effects without full loss of vision and affect both eyes.

What Causes an Ocular Migraine?

The exact cause of ocular migraines is not fully understood, but it is believed to involve changes in blood flow or electrical activity in the brain or retina. Common ocular migraine triggers include:

• Stress or anxiety
  

• Bright lights or glare
  

• Hormonal changes
  

• Certain foods (e.g., chocolate, aged cheese, processed meats)
  

• Caffeine or alcohol
  

• Dehydration
  

• Skipping meals
  

• Lack of sleep
  

Genetics may also play a role, as migraines tend to run in families.

What Are Symptoms of an Ocular Migraine?

Symptoms of ocular migraines vary but may include:

• Flashes of light or shimmering spots
  

• Zigzag patterns or blind spots (scotomas)
  

• Temporary loss of vision (usually less than 30 minutes)
  

• Headache (moderate to severe), typically on one side
  

• Nausea or light sensitivity (if accompanied by a migraine)
  

It's crucial to determine whether the symptoms are affecting one eye (retinal migraine) or both (visual migraine), as this influences diagnosis and management.

How is an Ocular Migraine Diagnosed?

A thorough medical history and eye examination are essential. Your doctor may also:

• Use visual field tests
  

• Perform a dilated fundus examination
  

• Order neuroimaging (MRI or CT scan) to rule out other causes of vision loss, such as retinal detachment or stroke
  

• Refer you to a neurologist if migraines are frequent or disabling
  

How is an Ocular Migraine Treated?

Most ocular migraines resolve on their own without lasting effects. However, treatment can help manage and prevent future episodes.

Acute Treatments:

• Rest in a dark, quiet room
  

• Over-the-counter pain relievers (ibuprofen, acetaminophen)
  

• Prescription migraine medications (triptans)
  

Preventive Measures:

• Avoid known triggers
  

• Maintain a regular sleep and eating schedule
  

• Use stress management techniques (yoga, meditation)
  

• Prescription preventive medications (beta-blockers, calcium channel blockers, anticonvulsants)
  

If ocular migraines are frequent or associated with significant vision changes, further evaluation is necessary and a visit to a neurologist is recommended.

When Is it Important to Seek Medical Attention?

Seek immediate medical care if you experience:

• Sudden vision loss in one eye
  

• Visual symptoms lasting longer than an hour
  

• Frequent or severe headaches
  

• Other neurological symptoms (e.g., weakness, speech difficulties)
  

These could signal more serious conditions such as a retinal vascular event, stroke, or optic nerve disorder.