There’s no doubt about it. Migraines are extremely painful and can hinder your ability to function in your everyday life. What’s worse is that the debilitating pain is often accompanied by nausea, photophobia, and sensitivity to sound. Migraines that have auras or which affect your vision are especially terrible. These are called ocular migraines. However, your doctor may also refer to them as retinal, visual, optical, monocular, or ophthalmic migraines.
Symptoms of Ocular Migraines
Ocular migraines refer to intensely painful headaches that are accompanied by auras. For some people, this takes place during a headache, while for others, the symptom remains even after a headache is gone. Approximately 25 percent of people suffer from migraines with an aura and may have the following forms of vision impairment during an episode.
- Wavy lines interrupting field of vision
- Flashing lights
- Spots of light
- Blind spots
Causes of Ocular Migraines
Unfortunately, experts are still trying to understand what causes ocular migraines. One theory is that these migraines are caused by changes spreading across sensitive nerve cells in the lining at the back of the eye, called the retina. Others propose that spasms taking place in the blood vessels located in the retina may be at fault. While not a cause, per se, some patients who suffer from migraines also report that their head pain often begins after exercise.
Diagnosing Ocular Migraines
There is no lab test for ocular migraines. As a result, physicians must use the process of elimination. To further complicate matters, there are many other conditions that display similar symptoms to ocular migraines.
In fact, here are some other types of headaches and migraines that may be accompanied by auras.
- Brainstem aura: This includes not just visual but sometimes also speech and sensory impairment. More specifically, patients who suffer from brainstem auras complain of a ringing in the ears, nausea, extreme sensitivity to sound, and double-vision.
- Hemiplegic: The aura of this headache includes paralysis that affects only one side of the body. Because the symptoms are similar to a stroke, this condition is especially dangerous. However, symptoms usually disappear within 24 hours.
- Menstrual: Some women suffer from migraines two days or so before the beginning of their period, which may continue for three days after their period has started. While it is not usually accompanied by an aura, visual impairment is still a possibility.
The physician must also eliminate the possibility of other illnesses creating migraine symptoms. These include the following:
- Amaurosis fugax: Temporary lack of blood flow in the eye due to a blockage of an artery leading to the eye can lead to temporary blindness. Sight is then typically restored in seconds or minutes. This is often a sign of an oncoming stroke or permanent blindness and should not be taken lightly.
- Blood conditions: Specific conditions of the blood that prevent normal clotting, such as polycythemia and sickle cell, can create symptoms similar to ocular migraines.
- Drug addiction: Substance abuse can mimic many of the symptoms of ocular migraines, during use and withdrawal. Similar symptoms include vertigo, flashing lights (often from hallucinations), and migraines.
- Giant cell arteritis: This is a condition that leads to inflammation of the lining of your arteries.
This can cause problems with your vision, including blindness.
Because of these similarities, it is important to see your doctor and seek an accurate diagnosis. You may have a simpler condition and could get instant relief once this is resolved, or it may be indicative of a much bigger problem that needs immediate treatment.
Treatment
Because ocular migraines usually stop within a half an hour or so, few people require treatment. Best practice during a migraine is to stop and rest your eyes until your vision returns to normal. This is especially important if you are driving or operating heavy machinery. Painkillers may also help to provide temporary relief.
When ocular migraines become chronic and/or begin to interfere with work, many people may then seek professional help. Physicians may prescribe one or more different types of drugs to provide relief.
- Beta-blockers usually used to treat high blood pressure.
- Drugs typically used to treat epilepsy.
- Tricyclic antidepressants.
Sometimes patients request preventative medication at which point the doctor may prescribe any of the following.
- Amitriptyline: used to treat depression.
- Topiramate: used to treat seizures.
- Verapamil: used to treat an irregular heartbeat, high blood pressure, and chest pain.
- Triptans: used to treat migraines and cluster headaches.
There are also devices that may be used to reduce pain associated with migraines, such as SpringTMS, Cefaly, and gammaCore. Additionally, some patients report success with acupuncture, massages, and biofeedback.
A migraine headache and vision problems can be a scary as well as a painful combination. Though very little research has been done on the causes of ocular migraines and how to cure them, varying methods of treatment have proven successful over the years. If you’re ready to get relief from your migraines, contact the National Headache Institute for more information.
