How Migraine With Aura and Ocular Migraine Differ

If you get migraines, you might wonder if your symptoms are from a "migraine with aura" or from a similar condition called "ocular migraine." Both problems involve changes in vision, but there are ways to tell them apart. The key difference is that an ocular migraine affects one eye only.

Symptoms of Migraine With Aura vs. Ocular Migraine

The most common symptoms of migraine with aura are visual changes that affect both eyes and include seeing things like:

  • Light flashes
  • Zigzags
  • Floating dark spots
  • Sparkly or shimmering dots
  • Stars

You could also get nausea or feel numbness and tingling down one side of the body. You might have changes in the way you talk, such as trouble coming up with the correct word or slurring your speech. Sometimes you have trouble with coordination.

Often these problems will come before the head pain. Sometimes you have the symptoms without any pain.

Ocular migraines, like migraines with aura, may also involve changes in your vision, but the important difference is that they happen only in one eye.

Also known as retinal migraines, ocular migraines are less common than migraines with aura. But they can be more serious. If you don't get treatment, there's a small chance that the vision loss in one eye could become permanent.

In an ocular migraine, a change in vision can happen in one eye before, during, or after a headache. The symptoms include:

One way to tell if the vision changes are only happening in one eye is to close each of your eyes and check if you only see the changes in one of them.

Diagnosis

To check if you have migraine with aura, your doctor will ask about your symptoms and your history with headaches. If you are having vision changes without any pain, then your doctor may want to do more tests, such as an eye exam, CT scan, or MRI, to rule out any other, more serious, illnesses.

To see if you have ocular migraine, your doctor will also ask detailed questions about your symptoms and your history. He will probably recommend an eye exam by an ophthalmologist to look for the cause of your vision changes.

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Treatment of Migraine With Aura

When you get treated for migraine with aura, the main goal is to prevent and manage pain.

Your doctor may suggest medications to prevent migraine with aura, including:

Your doctor may also suggest you take magnesium or riboflavin (vitamin B2) to prevent migraine with aura.

To stop a migraine with aura once it has started, you can try over-the-counter pain relievers such as acetaminophen, ibuprofen, or a combination of caffeine and acetaminophen.

Your doctor may also suggest prescription drugs called triptans and ergotamines. If the pain is severe, you may need to get treatment in an emergency room with medications you take through an IV.

If you are vomiting, your doctor may recommend anti-nausea drugs.

Treatment of Ocular Migraines

Your doctor may suggest treatment to prevent ocular migraines from happening, especially to avoid the chance of permanent vision loss. Medicines you may need to take include:

Some medicine to treat ocular migraine are the same as those for migraine with aura, including over-the-counter pain relievers such as ibuprofen and acetaminophen, or anti-nausea medications. Unlike migraine with aura, your doctor won't prescribe triptans or ergotamine medications.

WebMD Medical Reference Reviewed by Sabrina Felson, MD on October 23, 2019

Sources

SOURCES:

Mayo Clinic: "Ocular migraine: When to seek help," "Migraine with aura."

The Journal of Headache and Pain: "Clinical features of visual migraine aura: a systemic review."

American Migraine Foundation: "Understanding Migraine with Aura."

National Headache Foundation: "Aura."

American Migraine Foundation: "Retinal Migraine."

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