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What Is a Retinal Migraine?

Medically Reviewed by Alan Kozarsky, MD on June 22, 2020

Retinal migraine is a rare type of migraine that causes visual disturbances in only one eye before the headache comes on.

The term doesn’t refer to all migraines with visual symptoms, such as auras. Also, it’s a little different than ocular migraine and migraine with aura, even though people sometimes use the terms interchangeably.

Ocular migraine generally means any headache that causes temporary changes in vision. Migraine with aura causes vision changes in both eyes. Retinal migraine describes a more specific condition: it’s monocular, which means that it affects just one eye.

We don’t know how many people are affected by retinal migraine, but experts think that not everyone who has it reports it. If you have certain medical conditions, you may be more likely to have retinal migraine. Those include lupus, atherosclerosis, and sickle cell disease.

Symptoms of retinal migraine may include:

● Seeing twinkling lights, also known as scintillations

● Areas of lessened vision, also called scotoma

● Temporary loss of vision, or blindness

● Any of the above happening repeatedly

If you have these symptoms, you can test them by closing one eye at a time. For example, with retinal migraine, if you close your left eye and look through your right eye, you might see twinkling lights. But if you close your right eye and look through your left, your vision may be normal. Or vice versa.

A 2004 study found that about half of its subjects with retinal migraine had total loss of vision in one eye, and 20% said their vision was blurry, but not gone.

The headache part of the migraine starts within an hour of the visual symptoms. But some people don’t have a headache with the visual symptoms.

If you see symptoms in both eyes, you don’t have retinal migraine. It’s important to make sure of this so you can move forward with the right treatment.

Diagnosis

There isn’t a test that can diagnose retinal migraine. Your doctor will look at your medical history and also your family medical history, as half of those with this condition have a family history of migraines. Your doctor also will give you a physical exam, ask about your symptoms, and try to rule out other causes for them.

Other conditions may cause temporary vision loss, such as amaurosis fugax, or transient vision loss (TVL). This is temporary blindness due to a lack of blood flow to the retina. This is sometimes called a stroke of the eye.

If you have vision loss, talk to your physician or eye doctor right away. Usually, loss of vision in just one eye isn’t related to migraine. It may be a symptom of a more serious issue, such as a stroke about to happen. If you don’t treat it, temporary vision loss due to retinal migraine could become permanent.

Treatment

If you are diagnosed with retinal migraine, ask your doctor about the right treatment for you. There isn’t a single suggested treatment program as it varies by person.

If you don’t get retinal migraines often, your doctor may suggest that you take over-the-counter NSAIDs, such as aspirin and ibuprofen, when you have an episode. Your doctor also may recommend:

● Anti-nausea medication

● Calcium channel blockers, which lower blood pressure

● Anti-epileptic medications, which prevent seizures

● Tricyclic antidepressants, which change your brain’s chemistry

Doctors don’t usually use traditional migraine treatments such as triptans and ergotamines for people with retinal migraine. Triptans, for example, aren’t safe if you’re at risk for a stroke, which may be the case for people experiencing temporary blindness in one eye.

Prevention

If you have retinal migraines, you may want to try to stay away from certain triggers, such as:

● Emotional stress

● High blood pressure

● Contraceptive pills

● Smoking

Dehydration

● Being at higher altitudes

Low blood sugar

● Hyperthermia

Show Sources

SOURCES:

American Migraine Foundation: “Retinal Migraine,” “Understanding Ocular Migraine.”
National Center for Biotechnology Information, StatPearls: “Retinal Migraine Headache.”
Mayo Clinic: “Ocular Migraine: When To Seek Help,” “Calcium Channel Blockers,” “Migraine with Aura.”
American Academy of Ophthalmology: “Amaurosis Fugax (Transient Vision Loss).”
The Royal Children’s Hospital Melbourne: “Antiepileptic Medications.”
 

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