Ocular migraine: symptoms, causes & treatment

Quick overview: Frequently asked questions and answers

What are the symptoms of an ocular migraine? Typical symptoms include visual disturbances such as flickering, flashes of light, zigzag lines, tunnel vision and, in rare cases, temporary blindness in one eye.

How long does an ocular migraine last? A migraine attack usually lasts 10 to 30 minutes, but can last up to an hour.

Is an ocular migraine dangerous? In most cases, symptoms are temporary and do not cause long-term damage. However, if attacks are frequent or severe, medical attention should be sought.

Can ocular migraines be prevented? Preventive measures include avoiding known triggers, stress reduction and the use of relaxation techniques such as Yoga or meditation.

Article contents at a glance:

What is ocular migraine?

Migraine without headaches? This is not unusual with ocular migraines, also known medically as ophthalmic migraines. This form of migraine is characterized by various visual disturbances, also known as flickering scotomas. Since it is often not accompanied by headaches, sufferers sometimes misinterpret the symptoms as an eye disease, not a migraine.

Retinal migraine is a rare special form

A rare form of ocular migraine is retinal migraine, which affects the retina. This also causes temporary visual disturbances such as loss of visual field or, in rare cases, temporary blindness. However, this only occurs in one eye and not in both.

A lack of blood flow to the retina or optic nerve is probably responsible for the symptoms.

Eye migraine: These symptoms are typical

The most common symptoms of ocular migraines are those that affect vision and are usually very detrimental. They usually appear suddenly and only last for a few minutes. In rare cases, however, the symptoms can last up to an hour.

The following complaints often occur:

• Flickering (with eyes open and closed)
• Flicker
• Visual field loss (scotoma)
• Flashes of light
• Double images
• Photosensitivity
• Paralysis of the eye muscles (very rare, mostly affects children)
• nausea
• dizziness
• Rarely headaches (sometimes only after the visual disturbances)

Difference between ocular migraine and migraine with aura

Even though the two types of migraine are difficult to distinguish from one another, there are clues as to which type is present. The aura symptoms such as visual disturbances typically occur before the headaches. In addition, the visual symptoms can be accompanied by other neurological symptoms such as speech disorders or sensory disturbances. In contrast, headaches rarely occur with ocular migraines; visual disturbances predominate here.

If you experience symptoms, you should consult a doctor to get an accurate diagnosis.

Causes of ocular migraines

The causes of ocular migraines have not yet been clearly identified. Circulation disorders in the visual cortex, where visual stimuli are processed, are possible. If the blood and oxygen supply there is insufficient, the optical stimuli can no longer be processed correctly and visual disturbances arise.

In addition to blood circulation, the optic nerve can also be a possible cause: if there is a disorder here, the visual stimuli are not transmitted and processed correctly. Nerve disorders can be intensified or even triggered by certain triggers. Most of the time, these are lifestyle habits or environmental influences such as:

• Alcohol
• lack of sleep
• Stress
• Magnesium deficiency
• Medicines
• certain foods such as nuts
• Hormonal fluctuations
• bright light

In order to find out whether and which triggers exist for a migraine attack, those affected should observe their lifestyle habits and the external circumstances during an attack.

Diagnosis of ophthalmic migraine

Anyone experiencing visual disturbances or other symptoms of an ocular migraine should seek medical help. Since visual disturbances such as flashes of light or loss of visual field can also occur in other diseases, the cause should be examined by an ophthalmologist and differential diagnoses such as retinal detachment or stroke should be ruled out.

The ophthalmologist can determine whether an ocular migraine or another eye disease is present using various examinations. First, the medical history is taken, in which questions are answered about current symptoms, possible previous illnesses, lifestyle habits and medication intake.

The slit lamp can be used to examine the fundus of the eye, and can also detect damage to the retina and loss of the visual field. If this examination does not provide a clear diagnosis, further imaging procedures such as magnetic resonance imaging (MRI) or computer tomography (CT) are useful.

Treating ocular migraines

Usually, ocular migraines are not dangerous and an attack passes on its own within a few minutes. In the case of an acute attack of ocular migraines, darkness and rest can help. As with other types of migraines, sufferers often find it helpful to lie down in a quiet, darkened room until the symptoms subside. Relaxation techniques such as Jacobson’s progressive muscle relaxation can also help here.

Some people also find it soothing to place a cloth soaked in cold water on their eyes or forehead.

If headaches occur in addition to visual disturbances, painkillers containing the active ingredients acetylsalicylic acid (ASA) and ibuprofen can relieve these. Those affected should consult a doctor to find the right dosage for them. Drug treatment with ergotamine, triptans, beta-blockers or amitriptyline, for example, as is the case with migraines, is usually not necessary.

Can an ocular migraine attack be prevented?

There are several ways to prevent the occurrence of ocular migraines:

• Identify and avoid triggers: One of the most important measures is to identify and avoid individual triggers. It can be helpful to keep a diary in which you record factors such as diet, stress levels, sleep quality, alcohol consumption and medication intake.

• Reduce stress: Since stress is a common trigger, relaxation techniques such as autogenic training sometimes help prevent seizures.

• sufficient sleep: Lack of sleep can cause ocular migraines, so it is important to maintain good sleep hygiene.

• Magnesium: After consulting a doctor, magnesium supplements may be considered, as magnesium deficiency may be associated with ocular migraines.

• healthy lifestyle: A balanced diet, regular exercise and avoiding excessive alcohol consumption are also preventive measures.