The term migraine is used by many to describe any severe headache, but migraines are one specific type of headache that has particular symptoms that set it apart from other head pain. Imagine how confusing it is, then, to experience a migraine that does not have head pain as one of its major symptoms. Ocular migraine is just that kind of migraine, featuring visual disturbances often without any pain. So how do you know it is a migraine? Here are nine ocular migraine symptoms and 12 ways to treat them.
What is an ocular migraine?
Migraine is a fairly common condition in the U.S., outnumbering both asthma and Type 1 diabetes sufferers and weighing is as one of the 10 most disabling medical conditions in the world.
Ocular migraines are a rare type of migraine, diagnosed in just one out of 200 migraine sufferers. Ocular migraines may also be referred to as the following:
- Optical migraine
- Ophthalmic migraine
- Eye migraine
- Optic migraine
- Visual migraine
All of the different names for this type of migraine are related to the visual ocular migraine symptoms that occur. There can be significant visual disturbances that occur with an ocular migraine, lending this condition its name.
Further, ocular migraines that affect only one eye are referred to as retinal migraine. In some cases, symptoms can be so severe as to cause loss of vision in one eye. This may be a sign of a more serious underlying medical condition.
As with other types of migraine, ocular migraine symptoms don’t necessarily hit all at once. Regardless of the type of migraine, four distinct phases of migraine headache occur.
- Prodromal: This phase occurs in the days or hours before a migraine. Symptoms can include fatigue, irritability, and mood swings. For people attuned to this phase, it is possible to take preventative measures to lessen the duration and intensity of their migraine.
- Aura: Not everyone will experience the aural stage, but if they do, sensory changes occur, as does sensitivity to sound and light. The aural stage is much more common in ocular migraine than in other types of migraine.
- Attack: The attack phase is the acute period of migraine. Whatever symptoms that are unique to your experience of migraine will occur during this phase.
- Postdromal: After an attack has passed, sufferers may feel a sense of euphoria. They may also be tired.
Do I have ocular migraines?
Ocular migraines are challenging to diagnose. Many sufferers are often diagnosed with other conditions such as anxiety due to the nature of the symptoms. An important part of diagnosis is ruling out other conditions with similar symptoms.
Your doctor will conduct a thorough examination of your eyes and symptoms to rule out other possible conditions, such as:
- Amaurosis fugax: This condition causes temporary blindness when a blockage in the artery to the eye decreases blood flow
- Spasms in the artery that supplies blood to the retina
- Giant cell arteritis: This can cause inflammation in blood vessels leading to vision problems and blindness
- Autoimmune disease that cause other blood vessel problems
- Damage from drug abuse
- Sickle cell disease and polycythemia: These prevent blood from clotting normally
- Head injuries (including concussion)
- Tumors: These can block blood flow in the brain and may also mimic stoke symptoms
- Cerebral vasculitis
- Brain inflammation due to an infection
Once these conditions are ruled out, it is easier to determine if you are suffering from ocular migraine.
9 common ocular migraine symptoms
Symptoms of this type of migraine may not necessarily include head pain, but there are a number of characteristic ocular migraine symptoms, including:
- Numbness or tingling in the hands or face
- Mental fog
- Disrupted or distorted sense of touch, taste, or smell
- Blind spots
- Shimmering spots
- Flashing lights
- Zig-zag lines
1. Numbness or tingling in the hands or face
This symptom may be related to how the condition is related to facial nerves. Some ocular migraine sufferers may experience temporary numbness or tingling in the hands and face.
This may begin in the prodromal phase, or it may occur during the migraine attack itself.
2. Mental fog
Mental fog is the most common symptom shared by all migraine sufferers. They may feel mentally fuzzy or less alert than normal, with a sluggish mental state.
3. Disrupted or distorted sense of touch, taste, or smell
A characteristic ocular migraine symptom is disruption to your senses of touch, taste, or smell.
Nausea can be related to or caused by the visual symptoms, or it may appear on its own at any time during any of the four phases of migraine.
Fatigue is often a major symptom before and after the attack phase.
It is difficult to understand why fatigue is such a prominent aspect of migraine, but for many the effort of combatting migraine symptoms completely wipes them out for several days after other symptoms recede.
6. Blind spots
The next group of symptoms defines an ocular migraine. These symptoms are sometimes classified collectively as aura.
Blind spots can occur anywhere in the eye but are often monocular in nature (only affecting one eye).
7. Shimmering spots
These spots appear as wavy patches, somewhat like the waves of heat that come off hot pavement.
8. Flashing lights
Flashing lights can be a sign of stroke, but this is also a characteristic symptom of ocular migraine.
9. Zig-zag lines
These lines are wavy as with the shimmering spots above, but they may cover the entire field of your vision instead of being contained into spots.
What causes ocular migraines?
Abnormal electrical activity that involves the cortex (outer surface) of your brain spreads across the cortex at approximately three millimeters per minute. This gradual spreading disturbance contributes to the development and movement of the visual symptoms during the attack phase of an ocular migraine.
Ocular migraines may have the same risk factors as migraines with headache. Genetics seem to play a role in who develops ocular migraine without headache. A family history of migraine in general but ocular migraine in particular increases your chances of developing them.
Hormones and hormonal changes are also linked to both migraine and ocular migraine without headache.
This may explain why women are three times more likely to experience migraine than men. Approximately 70% of migraine sufferers are women, generally between the ages of 25 and 55. This age range marks the childbearing years and many women’s entrance into menopause. Fluctuating levels of estrogen, the hormone that affects the sensation of pain in the brain, means an increased risk of developing migraine during this time.
Common ocular migraine triggers
The cause of ocular migraine is not the same as its triggers. Causes are what prompt the condition in the first place, but triggers provoke the electrical disturbance and mark the beginning of each migraine episode.
Optical migraine triggers may include:
- Bright lights
- Excessive screen use (e.g., television, computer, or smartphone)
- Loud or abrupt sounds
- Powerful odors, whether pleasant or unpleasant
- Relaxation after a stressful event
- Changes in barometric pressure (weather-related)
- Alcohol, especially red wine
- Caffeine or withdrawal from caffeine
- Nitrates and nitrites (commonly added to hot dogs and lunch meats)
- Monosodium glutamate (MSG), a flavor additive found in many prepared foods such as fast foods, seasonings, spices, broths, and chips
- Tyramine found in aged cheeses, hard sausages, smoked fish, soy products, and fava beans
- Artificial sweeteners (aspartame especially)
- Changes in hormones during or before a menstrual cycle
These triggers may not always cause ocular migraine symptoms. Often migraines occur as a result of many triggers occurring at once.
Are ocular migraines small strokes?
Although strokes have similar characteristics and symptoms as ocular migraine, stroke is not necessarily a cause of ocular migraine. Conversely, ocular migraines are not small strokes. The similarity in symptoms make this a common concern, but there are subtle differences.
- Stroke is sudden, ocular migraine occurs gradually
- A stroke takes away vision, while ocular migraine adds visual stimuli
- Stroke is not genetic, but ocular migraine often reflects family history
Knowing the difference between ocular migraine and stroke can save your life.
How to get rid of ocular migraines
Ocular migraine prevention is the most powerful treatment. If you know what triggers ocular migraine for you, avoiding those triggers is your best defense against ocular migraine symptoms.
Further, ensure you:
- Get plenty of rest
- Stay hydrated
- Exercise regularly
- Manage stress
- Improve overall physical health
If you do find yourself in the attack phase of ocular migraine, there is good news. Unlike some types of migraine that can last for hours and even days, many ocular migraine sufferers find that their symptomatic period is brief: usually an hour or less as the visual symptoms spread and gradually recede.
You can manage your visual ocular migraine symptoms by taking the following steps:
- Remove visual stimulation: Rest in a dark, quiet room or use an eye mask if that’s not possible
- Scalp massage: Use extra pressure in the temples and areas around the eyes
- Cold compress: A cold compress can feel soothing during ocular migraine attacks
- Take break from screens: Prevent a full attack by removing any screens from your field of vision, including laptops, TVs, and smartphones
- Do not drive: If you find yourself experiencing visual disturbances, pull over until they pass
Ocular migraine medications
For those who suffer for longer than hour or find their symptoms unrelieved by the above preventative treatments, there are other interventions and ocular migraine medications that can help prevent migraines and treat attacks.
Ocular migraine medications may include:
- Beta blockers: Relaxes blood vessels
- Calcium channel blockers: Prevents constriction of the blood vessels
- Anti-epileptics or antidepressants: For treatment and prevention
- Anti-nausea medications: These treat nausea that can result from visual symptoms
- Non-steroidal anti-inflammatory drugs (NSAIDS): For treatment of ocular migraine with headache
- Anti-anxiety medications: Used during an attack to help calm and rest
In the postdromal phase, allow your body to rest and recover for a few days, limiting strenuous activity, stressful situations, or other potential triggers. You may feel tired and disoriented, and if you do experience head pain there may be some lingering soreness. Take care of yourself so you can fully recover.
Your first step for managing ocular migraine symptoms is to get a diagnosis. You can find a highly-qualified pain doctor in your area by clicking the button below or looking for one in your area by using the tips here: https://paindoctor.com/pain-management-doctors/.