A headache accompanied by temporary loss of vision in one eye characterizes an ocular migraine, typically lasting for less than an hour.
Signs and Symptoms of an Ocular Migraine
Symptoms of an ocular migraine are called auras which can present as a variety of disturbances in your vision. Patients often describe their symptoms as heat waves, dark spots, flickering lights or loss of peripheral vision. Other areas of the brain can also be affected by these blood vessel constrictions causing symptoms such as vertigo, hearing loss, nausea, difficulty speaking, or difficulty with concentration. These auras can be very disconcerting, often sending many patients to the emergency room.
What Causes an Ocular Migraine?
A classic migraine scenario involves a trigger in a patient’s environment which causes blood vessel constriction in certain parts of the brain. Triggers can include stress, fatigue, bright lights, certain visual patterns, caffeine or certain foods. Blood supply is then limited to these areas of the brain and their ability to function properly can be affected. If this involves the visual cortex where vision is processed, it is referred to as an ocular migraine. For most patients these auras resolve in a matter of minutes or hours without any headache. However for others, (possibly due to blood vessel over dilation) a classic migraine headache will develop. Patients may experience this migraine scenario only once in a lifetime or it may happen repeatedly.
How is an Ocular Migraine Diagnosed?
There is no specific diagnostic test for ocular migraine. Ocular migraine is a “diagnosis of exclusion” meaning that we must exclude all other (dangerous) options and then conclude that the patient has only had an ocular migraine and nothing more vision threatening. The most important diagnosis to exclude is a retinal detachment which can be visually devastating. An eye doctor must perform a full retinal examination with pupil dilation to ensure that there is no tear or detachment of the retina.
How is an Ocular Migraine Treated?
Ocular migraines can be a nuisance but usually no treatment is required. Often a patient’s first ocular migraine can be very alarming causing anxiety which can trigger further ocular migraines. Simple reassurance from your doctor can often lower anxiety levels and reduce or eliminate the ocular migraines. In other cases when migraine headaches (which can be debilitating) occur with the auras, a referral to your family physician is recommended as there are several migraine relieving medications that they can prescribe.
What Steps Should I Take If I Think I Am Having An Ocular Migraine?
We recommend making an appointment to see Dr. Reinders as quickly as possible to ensure that you are not having a retinal detachment. He has 22 of years of experience treating patients with ocular migraine and other related conditions. The sooner he can check your eyes, the better. All doctors agree that waiting and hoping it will get better is not a prescription for success.