Ocular Migraines (Ophthalmic or Eye Migraines)

The term "migraine" usually brings to mind a severe type of headache. But visual disturbances with or without headache pain also can accompany migraine processes thought to be related to changes in blood flow in the brain. These visual problems associated with migraines technically are known as ophthalmic migraines, but are much more commonly (though incorrectly) called ocular migraines. Because most lay people better understand the term, this article refers to the condition as "ocular migraine."

Migraines can be produced by the body's neurological responses to certain triggers such as hormonal changes, flashing lights or chemicals in foods or medications. One result of these triggers may be an intense headache that, if untreated, can last for hours or even days. During migraine processes, changes also may take place in blood flow to the area of the brain responsible for vision (visual cortex or occipital lobe). Resulting ophthalmic or ocular migraines commonly can produce visual symptoms even without a headache.

People with ocular migraines can experience a variety of visual symptoms. Classically, you will see a small, enlarging blind spot (scotoma) in your central vision with bright, flickering lights (scintillations) or a shimmering zig-zag line (metamorphopsia) inside the blind spot. The blind spot usually enlarges and may move across your field of vision. This entire migraine phenomenon can resolve within only a few minutes, but usually lasts as long as about 20-30 minutes.

Ocular migraines generally are considered harmless. They are typically painless, cause no permanent visual or brain damage and usually do not require treatment. Nevertheless, always consult your eye doctor when you have unusual vision symptoms, because it's possible that you have another condition requiring treatment, such as a retinal detachment, which should be checked out immediately.

Unfortunately, a visit to the eye doctor may produce few answers in terms of how to treat or prevent ocular migraines. This is because processes that trigger ophthalmic migraines are poorly understood. The vision symptoms accompanying painless ocular migraines are not related directly to the eyes. Instead, these visual symptoms occur as a result of the migraine "activity" in the visual cortex of the brain located in the back of the skull.

As described above, your vision and visual acuity will be significantly compromised during an ophthalmic migraine attack or episode. If sharp vision is essential for your safety, then you should stop what you are doing immediately, if possible. If you are driving, pull over until the ocular migraine passes and your vision has cleared. Stay still until the ocular migraine resolves. If you have concerns about unusual or lingering vision symptoms, visit your eye doctor or other physician for a checkup.
 

Typically, ophthalmic migraines do not require treatment. However, if these symptoms recur on a regular basis or with increasing frequency, then treatment in the form of medications (consult your doctor) may be necessary to reduce the frequency and/or severity of attacks. You may need to continue taking these medications for extended periods of time to prevent recurrence of ophthalmic migraines.