Ocular Migraine

Ocular migraines cause vision loss or blindness in one eye that lasts less than an hour. You can have them along with or after a migraine headache. Experts sometimes call them visual, retinal, ophthalmic, or monocular (meaning one eye) migraines.

This problem is rare. It affects about 1 out of every 200 people who have migraines. Some research suggests that in many cases, the symptoms are due to other problems.

Regular migraines can also cause vision problems, called an aura, which can involve flashing lights and blind spots in your vision. But these symptoms usually appear in both eyes.

See your doctor to find out if you have ocular migraines. He can rule out other conditions that can cause similar symptoms. Be ready to describe your symptoms as completely as you can -- that will help your doctor know what’s really going on.

Symptoms

Warning signs of an ocular migraine include:

Vision problems that affect one eye, such as flashing lights, blind spots in your field of vision, or blindness. You might have them for only a few minutes or up to 30 minutes. These problems affect just one eye, which makes ocular migraines different from other types.

It can be hard to tell the difference between flashing lights or blindness in one side of your vision -- but involving both eyes -- and having these symptoms in only one eye. If you can’t tell, cover one eye and then the other.

Headache that lasts from 4 to 72 hours. It tends to:

  • Affect one side of your head
  • Feel moderately or very painful
  • Throb or pulsate
  • Feel worse when you move around

Other symptoms include:

Causes

Experts aren't sure what causes ocular migraines. Some feel that the problem is related to:

  • Spasms in blood vessels in the retina, the lining in the back of the eye
  • Changes that spread across the nerve cells in the retina

It’s rare, but people who have these migraines may have a higher risk of permanent vision loss in one eye. Experts don't know if medications that prevent migraines -- such as tricyclic antidepressants or anti-seizure medications -- can help prevent that vision loss. But if you have ocular migraines, even if they go away on their own, it’s a good idea to talk to your doctor about your symptoms.

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How It's Diagnosed

Your doctor will ask you about your symptoms and examine your eyes. He’ll try to rule out other conditions that could cause similar problems, such as:

  • Amaurosis fugax, temporary blindness due to a lack of blood flow to the eye. It can happen because of a blockage in an artery that leads to the eye.
  • Spasms in the artery that gets blood to the retina
  • Giant cell arteritis, a problem that causes inflammation in blood vessels. It can lead to vision problems and blindness.
  • Other blood vessel problems related to autoimmune diseases
  • Drug abuse
  • Conditions that keep your blood from clotting normally, like sickle cell disease and polycythemia

Treatment

Ocular migraines usually go away on their own within 30 minutes, so most people don’t need treatment for them. It’s best to stop what you’re doing and rest your eyes until your vision goes back to normal. If you have a headache, take a pain reliever that your doctor recommends.

There's been little research on the best way to treat or prevent ocular migraines. But, your doctor may recommend one or more meds:

WebMD Medical Reference Reviewed by Brian S. Boxer Wachler, MD on 3/, 016

Sources

SOURCES:

International Headache Society, Cephalalgia, May 2004.

Hill, D. Journal of Neuro-Ophthalmology, March 2007.

Grosberg, B. Cephalalgia, November 2006.

Boes, C. Bradley: Neurology in Clinical Practice, 5th ed.

Evans, R. Headache, January 2008; vol 48.

Ahmed R. Neurologic Clinics, August 2010.

Hedges, T. Yanoff, M., Duker, J.S., eds. Ophthalmology, 3rd ed.

American College of Rheumatology: "Giant Cell Arteritis."

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