Ocular migraine causes and triggers include reading small text, harsh lights, being tired, or not drinking enough water.
Genetics is also a major cause of ocular migraines, as they tend to run in families.
Ocular migraines can be treated with medications like ibuprofen, Excedrin, or prescription drugs — or prevented with daily medications like anti-seizure drugs and antidepressants.
An ocular migraine refers to any type of migraine that causes changes in your vision with or without an accompanying or subsequent migraine headache. Ocular migraines can disrupt your daily life by causing you to see flashing lights or colorful lines moving across your field of vision.
In some cases, your symptoms can be more serious and you may temporarily or permanently lose sight in one eye. There's no cure for ocular migraines, but there are steps you can take to treat them.
Here's what you need to know about the two types of ocular migraines and how you can treat your symptoms.
What is an ocular migraine?
Ocular migraines are migraine-related vision changes that may occur with or without an accompanying or subsequent migraine headache.
Migraine with aura. About 25% to 30% of Americans with migraines experience an "aura" phase that can happen before or during their headache. An aura causes disturbances in your senses, making you see or feel things that aren't really there.
In most cases, the aura is visual, and you may see bright, zigzag lines or colorful patterns moving across your view. "This usually occurs right before the headache phase of the migraine and can last anywhere from 5 to 60 minutes," says Nada Hindiyeh, MD, a professor of neurology at Stanford University.
You may also have aura symptoms that aren't visual. "Some people have changes in sensation on one side of the body like numbness or tingling, or changes in their speech and comprehension," Hindiyeh says.
Rarely, a visual aura may be a manifestation of other disorders, including, but not limited to a seizure disorder, circulatory disorder, inflammatory disorder, or even a brain tumor, so it is advisable to discuss your aura with your physician.
Retinal migraine. Retinal migraines also affect your vision before or during a migraine headache, but they only cause symptoms in one of your eyes. Retinal migraine symptoms tend to be more severe than regular aura symptoms - during a retinal migraine, you may partially lose vision or even go temporarily blind in one eye. In other cases, you may just see twinkling lights in one eye.
Temporary loss of vision or a portion of the vision of one eye, lasting seconds to minutes, may also be an indication of a circulatory disorder or swelling of the optic nerve and should be discussed with a physician at the start of the occurrence.
It's important to see a doctor to determine which type of migraine you're experiencing. If you have a retinal migraine, it's possible for your vision loss to become permanent.
What causes an ocular migraine?
Ocular migraines, like other types of migraines, tend to run in families. "People are born with a hereditary predisposition to having a hyper-excitable brain which underlies migraine," Hindiyeh says.
In other words, your brain overreacts to factors like stress or dehydration, causing abnormal electrical activity that can lead to a painful migraine headache. People with ocular migraines tend to have abnormal activity in areas of the brain related to vision.
When you have a migraine with aura, an electrical disturbance moves across the outer layer of your brain called the cortex. This disrupts the areas of your brain that process vision and other senses like touch, causing visual disturbances.
If you have retinal migraines, you may have electrical disturbances in your retina, a layer of tissue at the back of your eye that senses light and takes in visual information. You may also have retinal migraine symptoms when there isn't enough blood flow to your retina.
There are many activities that can trigger these electrical disturbances that cause ocular migraines, such as:
Staring at digital screens for long periods of time
Driving long distances
Being in harsh lightings, such as fluorescent lights, strobe lighting, or reflected glaring light
Doing anything that requires intense visual focus, like reading small text or playing video games
Regular migraine triggers can also set off ocular migraines, including:
Being overly tired
Being hungry or dehydrated
Strong smells like smoke or perfume
Eating certain foods including alcohol, chocolate, and some artificial sweeteners
How to treat an ocular migraine
Ocular migraines are treated the same way as other migraines, and both medications and lifestyle changes may help to cut down symptoms and reduce the number of migraines you have.
Migraine medications fall into two categories: drugs that help stop migraines when they happen and drugs that prevent migraines.
Medications you can take when you get a migraine include:
Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or acetaminophen
NSAIDS with caffeine like Excedrin
Prescription triptan drugs like sumatriptan or rizatriptan
Medications you can take daily to prevent migraines include:
Beta-blocker medications like propranolol
Certain antidepressants like amitriptyline
Anti-seizure drugs including topiramate (Topamax) and Valproate (Depacon)
There are also new prescription monoclonal antibody drugs which may be self-injected monthly or every few months which have been effective for many people in preventing migraine.
Lifestyle changes are also a key way to prevent migraines. "I generally recommend that people maintain a routine lifestyle because the brain thrives on a regular routine," Hindiyeh says.
Hindiyeh recommends several helpful lifestyle changes, including:
Sleeping and waking up at the same time every day and avoiding naps
Eating regular meals
Staying well hydrated
It's also important to avoid ocular migraine triggers like bright digital screens as much as possible.
Ocular migraines cause visual symptoms that can disrupt your life and, in severe cases, even lead to vision loss. There is no cure for migraines, but there are many important lifestyle changes you can make to help prevent and manage ocular migraines.
"Talk to your doctor about options for treatment of migraine and if you notice any new or different symptoms with your migraine," Hindiyeh says.
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