Ocular Migraine has been used to refer to a number of migraine subtypes that are characterized by a variety of visual disturbances including visual loss, blind spots, zig-zag lines, or seeing stars. This type of migraine may occur without any accompanying head pain and it’s also not uncommon for a single patient to experience a wide range of visual symptoms. 

Types of Ocular Migraine

Unfortunately, “ocular migraine” often is used to describe a much more common condition known as a visual migraine or migraine aura. Visual migraines can cause temporary vision disturbances. These vision problems caused by visual migraines affect both eyes, not just one, and tend to be somewhat shorter usually lasting around 20 minutes in duration. Now, let’s take a closer look at ocular migraines (retinal migraines) and visual migraines (migraine auras).

Migraine with Aura

Migraine with Aura impairs vision, with symptoms like flashes of light, blind spots, seeing stars or patterns and other minor sight issues that go away after a short period. While the most noticeable symptoms are visual disruptions, aura can also affect other senses and interfere with speech, motor skills or other central nervous symptoms. Migraine aura can occur with headache or without, and is typically short in duration. When aura symptoms appear in conjunction with head pain, they usually occur between the premonitory phase and the peak pain phase of migraine, between the symptoms that warn of an impending attack and when the head pain itself hits. 

Retinal Migraine

Retinal Migraine refers to visual symptoms that occur in only one eye before or during the headache phase of a migraine attack. Retinal Migraine symptoms tend to be more intrusive than aura symptoms, and include decreased vision, the appearance of twinkling lights and temporary blindness. It can be difficult for patients to distinguish between Migraine with Aura and Retinal Migraine, so it’s important to consult a doctor if you think you may be experiencing Retinal Migraine symptoms.  Irreversible visual loss may be a complication of Retinal Migraine.

What causes ocular and visual migraines?

The exact cause of an ocular migraine can be difficult to pinpoint. It’s believed they occur for the same things that cause migraine headaches. Migraine headaches have a genetic basis, and some studies say that up to 70% of people who suffer from the disorder have a family history of migraines. Common migraine “triggers” that can cause a person to have a migraine attack (both ocular migraines and visual migraines) include:

• Certain foods 
• Caffeinated drinks
• Chocolate
• MSG (and other processed food additives)
• Artificial sweeteners
• Cigarette smoke
• Perfume
• Bright or flickering lights
• Stress and lack of sleep 

Treating and Preventing Migraine With Aura or Retinal Migraine

If you are performing tasks that require clear vision when an ocular migraine or visual migraine occurs, stop what you are doing and relax until it passes. If you’re driving, pull off the road, park your vehicle and wait for your vision to return to normal. It’s also a good idea to keep a journal of your diet and daily activities. Doing so can help you identify possible triggers of your ocular migraines or visual migraines.

Since many migraine attacks are often stress-related you might be able to reduce how often they occur by:

• Avoiding common migraine triggers
• Eating a healthful diet
• Getting plenty of sleep
• Trying stress-busters such as yoga and massage

For infrequent attacks, medications that target symptoms can be effective, from NSAIDs for pain to anti-nausea medications. Preventative therapies including calcium channel blockers, antiepileptic or tricyclic medications can also be effective in eliminating attacks. Some options for relief without drugs can include:

• resting your eyes
• removing yourself from bright sunlight or other harsh lighting
• taking a break from looking at a screen. 

Migraines can be successfully managed so they are less frequent and debilitating. The first step is to see a doctor to discuss your symptoms — including vision problems — and discuss treatment and prevention options.