What Are Ocular Migraines? | San Antonio LASIK

A Guide To Ocular Migraines

 

Migraines are a type of headache disorder characterized by recurring episodes of moderate to severe head pain accompanied by other symptoms. According to the American Migraine Foundation, migraines affect “1 in 4 households in the U.S.”. There are several different types of migraines, each with its own unique features and patterns. Here’s a brief description of the most common types:

 

• Migraine without aura: This is the most common type of migraine, accounting for about 70-90% of all cases. It is characterized by moderate to severe head pain that is often throbbing or pulsating, usually on one side of the head. Other symptoms may include nausea, vomiting, sensitivity to light (photophobia), and sensitivity to sound (phonophobia).
• Migraine with aura: About 25% of people with migraines experience auras, which are temporary sensory disturbances that typically occur before the headache phase. Auras can manifest as visual disturbances (such as seeing flashing lights or zigzag lines), sensory changes, language difficulties, or motor weakness.
• Chronic migraine: Chronic migraines are defined as having headaches on 15 or more days per month for at least three months, with at least eight of those headaches being migraines.
• Hemiplegic migraine: Hemiplegic migraines are rare but severe types of migraines that cause temporary paralysis or weakness on one side of the body (hemiplegia). Other symptoms can include vision changes, difficulty speaking, and sensory disturbances.
• Vestibular migraine: Vestibular migraines primarily affect the vestibular system, which is responsible for balance and spatial orientation. The symptoms include dizziness, vertigo (a spinning sensation), balance problems, and sometimes nausea and vomiting.
• Menstrual migraines: Some women experience migraines that are closely linked to their menstrual cycle. These migraines occur in relation to hormonal changes and typically happen in the days leading up to menstruation or during menstruation itself.
• Ocular migraine: Ocular migraines are characterized by temporary vision loss in one eye. The loss of vision is usually accompanied by a headache that occurs before or after the visual disturbance.

 

What Is an Ocular Migraine?

An ocular migraine, also known as a retinal migraine, is a specific type of migraine that primarily affects vision. It is characterized by temporary visual disturbances or even complete vision loss in one eye, typically lasting less than an hour. These visual disturbances can manifest as flickering or shimmering lights, zigzag lines, blind spots, or even temporary blindness in the affected eye. 

 

Ocular migraines are usually accompanied by or followed by a headache, although the headache itself may be milder than in other types of migraines.

 

What Causes Ocular Migraines?

The exact cause of ocular migraines is not fully understood, but there are several factors that are believed to contribute to their development. Ocular migraines are thought to result from a temporary disruption of blood flow or blood vessels in the retina, which is the light-sensitive tissue at the back of the eye. This disruption can lead to the visual disturbances experienced during an ocular migraine episode.

 

Some potential triggers and factors associated with ocular migraines include:

 

Blood vessel changes: It is believed that temporary constriction (narrowing) and subsequent dilation (expansion) of blood vessels in the retina can cause visual disturbances during an ocular migraine. 

Migraine triggers: Ocular migraines can be triggered by various factors that are commonly associated with migraines in general, such as stress, hormonal changes, certain foods or food additives, sleep disturbances, bright lights, and strong odors.

Genetics and family history: There may be a genetic predisposition to migraines, including ocular migraines. 

 

Ocular Migraine Symptoms

Unlike typical migraines, ocular migraines often do not cause severe head pain, but they can still be disruptive and distressing. Here are some common and unique symptoms associated with ocular migraines:

 

• Vision disturbances: Ocular migraines typically cause temporary visual disturbances or changes in vision. These disturbances can manifest as:
• Scintillations or shimmering lights: Many people with ocular migraines describe seeing flickering, zigzagging, or flashing lights, often in a crescent or “C” shape.
• Blind spots: Some individuals experience blind spots or areas of temporary vision loss that can last from a few minutes to an hour.
• Blurred vision: Vision may become blurred or hazy during an ocular migraine episode.
• Visual aura: An aura refers to a set of sensory disturbances that can occur before or during a migraine attack. While auras are more commonly associated with migraines that include head pain, ocular migraines can also have visual auras. These auras may include:
• Geometric patterns: Seeing patterns like lines, dots, or waves that distort or interfere with vision.
• Fortification spectra: Perceiving zigzag patterns that resemble the walls of a fortress or castle.
• Tunnel vision: A narrowing of the visual field, as if looking through a tunnel. Headache or discomfort: Although ocular migraines primarily affect the eyes, some individuals may experience a mild headache or discomfort around the eye or temple on the same side as the affected eye.
• Duration: Ocular migraines usually last for a short period, typically less than an hour. The visual disturbances may occur for only a few minutes, and they typically resolve spontaneously without leaving any long-lasting effects.
• Unilateral occurrence: Ocular migraines typically affect only one eye at a time. The symptoms may be present in the left eye during one episode and then in the right eye during another episode.
• Trigger factors: Like other types of migraines, ocular migraines can be triggered by various factors, such as stress, certain foods or beverages, hormonal changes, bright lights, strong smells, or changes in sleep patterns.

 

Kaleidoscope Vision

Kaleidoscope vision, also known as fortification spectra, is a specific visual phenomenon that can occur during a migraine aura. It is characterized by the perception of vibrant, shimmering, and colorful geometric patterns that resemble a kaleidoscope. 

 

Kaleidoscope vision can be disorienting and may interfere with normal vision temporarily. It usually lasts for a short period, ranging from several minutes to an hour, and is followed by the headache phase of the migraine.

 

It’s important to note that kaleidoscope vision is specific to the visual experience during a migraine aura and may not occur in every migraine episode or in all individuals who experience migraines.

Diagnosing Ocular Migraines

 

Diagnosing ocular migraines involves a thorough evaluation by a healthcare professional, typically an ophthalmologist or a neurologist. The diagnosis is usually made based on the individual’s medical history, symptoms, and ruling out other potential causes of similar eye-related issues. Here are the steps involved in diagnosing ocular migraines:

 

Medical history: The healthcare professional will ask about your medical history, including any previous episodes of migraines, headaches, or visual disturbances. They may inquire about the frequency, duration, and specific characteristics of your symptoms.

Symptom description: You will be asked to describe your visual disturbances in detail, such as the type of visual aura experienced, any associated headache or discomfort, and whether the symptoms affect one or both eyes.

Physical examination: The healthcare professional will perform a comprehensive eye examination to assess your visual acuity, eye movements, and the overall health of your eyes. They may also check your blood pressure and perform a neurological examination to rule out other potential causes.

Diagnostic tests: In some cases, additional tests may be recommended to rule out other eye conditions and confirm the diagnosis of ocular migraines. These tests may include:

Visual field test: This test assesses your peripheral vision and can help identify any blind spots or abnormalities.

Ophthalmoscopy: The healthcare professional examines the inside of your eyes, including the retina and optic nerve, using specialized instruments.

Imaging tests: In certain situations, imaging tests like MRI (magnetic resonance imaging) or CT (computed tomography) scan may be ordered to rule out other underlying causes.

 

While there is no specific test that definitively confirms the presence of ocular migraines, the diagnosis is primarily based on the characteristic symptoms. This could be the exclusion of other potential causes, and the individual’s medical history. 

Ocular Migraine Treatment Options

The treatment of ocular migraines focuses on relieving symptoms during an episode and preventing future episodes. The specific treatment approach may vary depending on the severity and frequency of the migraines, as well as individual factors. Here are some common treatment options for ocular migraines:

 

Medications: In cases where ocular migraines are frequent or significantly impact daily life, a healthcare professional may recommend over-the-counter pain relievers or prescribe preventive medications. These medications may help reduce the frequency and severity of migraines. Examples of preventive medications include beta-blockers, antiepileptic drugs, tricyclic antidepressants, and calcium channel blockers.

 

Anti-nausea medications: Ocular migraines can be associated with nausea, and medications like metoclopramide (Reglan) or ondansetron (Zofran) may be prescribed to manage this symptom.

 

Lifestyle modifications: Making certain lifestyle changes can help prevent or reduce the frequency of ocular migraines.

How To Prevent Ocular Migraines

Preventing ocular migraines involves identifying triggers and making lifestyle modifications to reduce the frequency and severity of episodes. Here are some strategies that may help prevent ocular migraines:

 

Identify triggers: Keep a migraine diary to track your symptoms and potential triggers. Note down activities, foods, beverages, environmental factors, and emotional or physical stressors that coincide with your ocular migraines. Once you identify specific triggers, try to avoid or minimize exposure to them.

Manage stress: Stress is a common trigger for migraines, including ocular migraines. Implement stress management techniques such as deep breathing exercises, meditation, yoga, or engaging in hobbies or activities that promote relaxation. Regular exercise can also help reduce stress levels.

Maintain regular sleep patterns: Irregular sleep patterns or lack of sleep can trigger migraines. Establish a consistent sleep schedule by going to bed and waking up at the same time each day. Ensure that your sleeping environment is conducive to quality sleep, and practice good sleep hygiene habits.

Stay hydrated: Dehydration can contribute to migraines. Drink plenty of water throughout the day to stay adequately hydrated. Avoid excessive consumption of caffeine and alcohol, as they can dehydrate the body.

Ditch the dirty glasses & uncomfortable contacts: Consider getting Lasik Eye Surgery to enjoy the beauty of life without the crutch of glasses and contacts.

Manage screen time and bright lights: Prolonged exposure to screens, such as those from computers, smartphones, or TVs, can strain the eyes and potentially trigger migraines. Take regular breaks from screen time and ensure proper lighting conditions in your environment. 

Hormonal management: For individuals whose ocular migraines are associated with hormonal fluctuations, such as those experienced during menstruation or menopause, hormone therapy or contraceptives may be considered.

Discuss preventive medications: If your ocular migraines are frequent or significantly impact your daily life, preventive medications may be considered. These medications are taken regularly to reduce the frequency and severity of migraines. 

 

Remember, everyone’s triggers and responses can vary, so it’s important to identify your personal triggers and work with a healthcare professional to develop an individualized prevention plan to minimize migraines in the future.

 

It’s important to note that this is not an exhaustive list, and some individuals may experience combinations of different migraine types. If you suspect you have migraines, it is recommended to consult with a healthcare professional for an accurate diagnosis and appropriate treatment.

Be sure to talk to one of our doctors about not only the benefits of LASIK, but also any risks of LASIK that may pertain to your individual needs and circumstances.