Optical Migraine – Signs, Symproms, & Treatment | Eye Love Cares

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Optical migraines are migraines that are characterized by temporary blindness, or a temporary loss of vision, in one eye. While their exact cause has yet to be pinpointed, they’re believed to be caused by blood vessel spasms or a reduction of blood flow to the retina, or the area behind the eye. Luckily, if you suffer an optical migraine, vision in your affected eye usually goes back to normal within an hour or so.

These migraines may be painless, or they could occur alongside or following a migraine headache. Unfortunately, optical migraines are often associated with a harmless and common condition known as a visual migraine, or migraine aura, that has very similar symptoms.

In addition, optical migraines have other names used to describe the experience. This is a breakdown of the terms that are often used to describe conditions that temporarily cause disturbances to your vision:

  • Eye migraine (same as optical)
  • Ocular migraine (same as an optical)
  • Retinal migraine (same as optical)
  • Visual migraine (same as optical)
  • Ophthalmic migraine (same as optical)
  • Migraine aura; a harmless and common condition characterized by disturbances to vision that are temporary and usually go away within thirty minutes. The difference with migraine aura is that it affects both eyes. You’ll also know you’re experiencing migraine aura if you see blind spots or flashing lights.
  • Migraine with aura; a migraine headache that is accompanied by disturbances to vision. Usually, the disturbance occurs up to a half an hour before the onset of headache pain.

Luckily, optical migraines are a rare problem. Research that has been conducted suggests that in most cases, the symptoms that occur during optical migraines are due to other health problems. To discuss these potential problems, you should see your doctor. They can help you to rule out conditions that lead to similar symptoms and determine whether you’re truly suffering from optical migraines. Be ready to describe your symptoms and experiences with as many details as you can provide.

If you experience any kind of disturbances to your vision, you shouldn’t take any chances. Visit an eye doctor immediately to determine what’s causing these disturbances. Not only could it be a cause for concern, but it’ll also help you to pinpoint the best type of treatment.

What’s the Difference Between a Migraine and a Headache?

optical migraine

Oftentimes, the terms “headache” and “migraine” are used interchangeably, but one of the most important things to know to manage and treat migraines is to learn that there is a difference. The pain that’s experienced during tension headaches will be moderate or mild, and the headache itself will be very distracting, but not debilitating; it won’t prevent you from performing everyday activities. In rare cases, tension headaches cause sensitivity to sound or light.

However, if you’re experiencing a migraine, the pain will be moderate or severe. Many people experience a throbbing or pounding that’s intense and persistent. Usually, this pain is debilitating and prevents you from doing activities. Some people also experience vomiting and nausea alongside their migraine, as well as sensitivity to sound and light. Sometimes, an aura occurs before the migraine happens itself.

Treating and coping with migraines is a little more difficult than doing the same with headaches. Migraines often make a negative impact on your life, even if the migraines exist by themselves and aren’t a symptom of other underlying conditions. For example, if you experience disturbances to your vision, you need to wait until they’re over before you can drive.

Luckily, optical migraines go away within a half an hour all on their own. Even after the associated pain fades, you should rest and make sure you avoid any triggers, like bright lights, until disturbance to your vision is completely gone. If you think you’re experiencing an optical migraine, you can:

  • Sit or lie down in a room that’s quiet and dark
  • Put pressure on your scalp by massaging it
  • Put pressure along your temples
  • Put a towel that’s cool (or warm, according to preference) and damp over your forehead

Beyond these remedies, both prescription medications and over the counter treatments are available to help you treat recurring migraines. OTC drugs such as Excedrin and ibuprofen can help reduce your symptoms, once you’re already exhibiting them. Besides those, your doctor can give you a prescription for:

  • Beta blockers, which help to relax the blood vessels
  • Calcium channel blockers, which prevent constriction in the blood vessels
  • Antidepressants or anti-epileptics, which are often used to prevent and treat migraines

Depending on the prescription, you’ll either take your medication on a regular basis, or as needed when you begin to experience symptoms.

Are There Different Types of Optical Migraines?

optical migraine

There are different kinds of optical migraines, and depending on which type you are experiencing, your treatment and management will be different as well. There are two main types of optical migraine:

  • Migraine with aura. This type of optical migraine impairs your vision and comes with symptoms such as blind spots, seeing stars, flashes of light, patterns, and other small issues with sight that naturally fade away after a short period of time. The most acute symptoms are disruptions to your vision. However, aura can impact your other senses and also interfere with motor skills, speech, or other aspects of your central nervous system.

Migraine aura can happen with or without a headache and will usually last for a short period of time. If they appear alongside head pain, aura usually occurs between the premonitory phase and the phase of peak pain–between the symptoms that will warn you an attack is coming, and when the pain itself occurs in your head. Migraine with aura occurs in 25-30% of people who have migraines, and less than 20% of people who experience auras have them during every single migraine attack.

  • Retinal migraine. This term refers to visual symptoms that take place in just one eye either before or during the headache part of a migraine attack. Symptoms of retinal migraines will be more intrusive than symptoms of aura. Retinal migraine symptoms include a decrease in vision, the appearance of sparkling lights, and blindness temporarily.

It often is very difficult to tell the difference between retinal migraine and migraine with aura, so this is another reason why it’s so important to consult your eye doctor if you think you’re experiencing symptoms of optical migraine. 

What Are the Symptoms of Optical Migraine?

optical migraine

Whether your doctor calls your optical migraine by another name, such as ocular, retinal, ophthalmic, visual, or monocular migraine, all symptoms are the same for migraines that are distinguished for their visual disturbances. Warning signs that an optical migraine is about to occur are:

  • Problems with your vision that impacts only one eye. This may also accompany the experience of an aura, and it could occur for a couple of minutes, or occur for up to a half an hour. It may be difficult to determine if you’re having symptoms in just one eye and whether the blindness or flashing lights are only affecting one side. If you’re unsure, you can cover one eye and then the other to determine.
  • A headache that lasts anywhere from 4 to 72 hours. And this headache will:
    • Impact only one side of your head
    • Pulsate or throb
    • Cause either moderate or intense pain
    • Worsen if you move around
  • Other symptoms that impact areas other than your head:
    • Vomiting
    • Nausea
    • Sensitivity to sound or light

Generally, symptoms of your optical migraine will involve a small blind spot that will impact one eye and influence your central vision. Over time, this blind spot will get bigger and bigger, until it’s impossible for you to read or safely drive with the affected eye. Sometimes, the entire field of vision will be affected for the eye. Overall, this episode of blind spot will last an hour or less.

Optical migraines typically appear quite suddenly, and many people describe the sensation as looking through a cracked window. The aura may move across your field of view before it disappears within a half an hour. Symptoms of this include:

  • A blind spot that moves slowly across your field of vision
  • A central blind spot being surrounded by a ring of colored light that’s wavy or zigzagging
  • A scintillating scotoma (flickering blind spot) that’s located near the center, or directly in the center, of your field of view

The experience of these symptoms varies; some people experience a migraine headache shortly after these symptoms fade away, and sometimes, no headache occurs at all. If you experience a blind spot or other kind of visual disturbance, a good way to tell whether it’s an optical migraine or a visual migraine is to cover one eye at a time; if it’s happening to both eyes, it’s a visual migraine. However, no matter which type of migraine you’re suffering from, you should contact your doctor right away. The migraines may be harmless, but sometimes, they’re an indication that something more serious is happening, such as an eye stroke or a retinal detachment.

Symptoms of Optical Migraine with Aura

Your optical migraine may occur alongside an aura. Some people experience these auras 10-30 minutes before the onset of a migraine; in a way, auras can be a symptom or warning sign themselves that pain is coming. Symptoms of auras include:

  • Tingling or numbness in your face or hands
  • Feeling fuzzy or foggy mentally
  • A disrupted sense of smell, taste, or touch
  • Seeing flashing lights, zig-zagging lines, or shimmering spots

Keep in mind that not all people who have optical migraines will experience auras as well. You may also experience disturbances to your vision, without accompanying headache pain. The varying symptoms and experiences are part of the reason why it’s important to reach out to your doctor; it’s essential to pinpoint what is going on and what it may be caused by, in order to treat it.

What are the Causes for Optical Migraines?

optical migraine

Many doctors believe that optical migraines have many of the same causes as migraine headaches. Migraine headaches tend to impact people on a genetic basis; studies have shown that as many as 70% of people who suffer from migraine headaches have a family history of the disorder.

According to the World Health Organization (WHO), these migraine headaches seem to be triggered by the activation of a mechanism that’s located deep in the brain, and this mechanism releases substances that are inflammatory to the blood vessels and nerves in the brain and head. Imaging studies have observed that when someone suffers an optical migraine and/or migraine aura, there are changes to the way blood flows to the brain. However, why this happens, and what causes it, is still unknown.

Luckily, there are some commonly known “triggers” that cause people who are susceptible to optical migraines, to suffer an attack. These triggers include:

  • Consumption of certain foods, like caffeinated drinks, smoked meats, chocolate, red wine, or aged cheese
  • Consumption of food additives, like:
    • MSG (monosodium glutamate), found in soups/broths, spices, seasonings, and fast food
    • Artificial sweeteners
    • Nitrates, found in lunch meats and hot dogs
    • Tyramine, found in hard sausages, aged cheese, soy products, fava beans, and smoked fish
  • Hormone levels. Migraines have been linked to estrogen. The estrogen hormone controls chemicals in the brain that impact the sensation of pain. Women experience fluctuating levels of hormones due to pregnancy, menopause, and their menstrual cycle. Levels may also change with hormone replacement therapies and oral contraceptives.
  • Other potential migraine triggers, such as:
    • Perfumes
    • Strong odors
    • Cigarette smoke
    • Flickering or glaring lights
    • Emotional stress
    • Lack of sleep
    • Loud sounds
    • Anxiety
    • A change to the weather
    • Alcoholic beverages
    • Too much caffeine, or a caffeine withdrawal
    • Looking at a screen for a long period of time
    • Driving long distances
    • Taxing visual activities

There may be an individual trigger that sets off your migraine, or a combination of factors. Triggers vary from person to person and identifying your triggers is key to your treatment. To keep track of what triggers your pain or visual disturbances, you can keep a headache diary and write down when, where, and how your optical migraine occurs. Take careful note of your diet, exercise, menstruation, and sleep habits as well.

When it comes to optical migraines specifically, experts aren’t completely sure what causes them. However, the problem has been linked to:

  • Spasms in blood vessels that are located in the retina (the lining within the back of the eye)
  • Changes to the nerve cells across the retina

Aura is considered to be caused by abnormal electrical activity across certain regions of the outer surface, or cortex, of the brain. This activity goes across the cortex slowly, at a rate of 3mm per minute. As it spreads, this causes the growth and movement of the visual disturbance over the period of time that the aura lasts.

People who suffer from optical migraines can potentially have a higher risk of permanent loss of vision to one eye. It’s unclear whether medications that can help to prevent migraines, such as anti-seizure medications or tricyclic antidepressants, can also help to prevent loss of vision. Even if your optical migraine goes away all on its own, you should speak with your doctor about what you’re experiencing.

How Optical Migraine is Diagnosed

optical migraine

When you report your symptoms to your doctor, they will go through everything with you and examine your eyes. One of the most important things your doctor will do is to rule out any other conditions that could cause similar problems, but which mean that you do not have optical migraine. These similar problems could be:

  • Spasms in the arteries that could cause blood flow to the retina
  • Drug abuse
  • Giant cell arteritis, which is a problem that causes inflammation in your blood vessels and can sometimes lead to blindness and other visual problems
  • Amaurosis fugax, which is temporary blindness that’s caused by a lack of blood flow to your eyes, which happens often because of a blockage in one of the arteries that lead to the eyes
  • Other blood vessel issues that are related to autoimmune diseases
  • Conditions that prevent your blood from clotting normally, such as polycythemia and sickle cell disease

How Optical Migraine is Treated

optical migraine

Usually, symptoms of optical migraines go away on their own within half an hour. Due to this, many people don’t require treatment for their optical migraine. If you experience one, it’s best to stop what you’re doing and lie down or at least rest your eyes, until your vision returns to normal. This is especially important if you’re performing tasks that require good vision, such as driving. If you are driving, pull over as soon as you safely can and wait in your car until the disturbances to your vision pass completely.

If your symptoms include a headache, you can take either over the counter pain relievers such as ibuprofen, or a pain reliever that your doctor has recommended or written a prescription for. If you experience vision loss, this may be due to a very serious condition that requires prompt treatment from either your doctor or an emergency room. Visual disturbances that accompany migraine headaches should be followed by a visit to your family doctor or neurologist, so they can evaluate your episodes of migraine.

Your doctor will give you advice concerning the most current medicines that treat migraines, including medication that is designed to prevent you from having optical migraine attacks again in the future. People who have migraine headaches that last a long period of time (24 hours or more), or who have at least two migraines every month, generally do receive preventative medical treatment.

Unfortunately, there isn’t very much research on the best way to prevent or treat optical migraines. There are however some available drugs that have been shown to have a positive effect when it comes to managing optical migraines. Your doctor might recommend some of the following drugs:

  • Drugs that treat epilepsy (Depakote, Depakene, Topamax)
  • Tricyclic antidepressants, like amitriptyline (Elavil) or nortriptyline (Pamelor)
  • Beta blockers, which are blood pressure medicines

It’s also recommended that you keep a journal of your activities and diet, as well as a log of when you suffer optical migraine episodes. Show your doctor this journal; together, you might be able to identify triggers that possibly cause the onsets of optical migraine in you personally. Once you identify these, you can work on avoiding them to prevent migraine from occuring in the future. Depending on your triggers, you might be able to manage your migraine attacks and reduce both the frequency and severity of them, without the help of medication, by following these prevention methods:

  • Getting plenty of sleep
  • Eating healthy meals, on a regular basis
  • Attempting to manage your stress by doing activities such as yoga or getting massages
  • Avoiding certain triggers by:
    • Preventing yourself from being around cigarette smoke
    • Installing dimmer or more soothing lights in your living space
    • Avoiding the consumption of certain foods, such as fast food, soups, fish, and meat
    • Not drinking any alcohol
    • Taking breaks from your screens
    • Avoiding driving for long periods of time
    • Not applying perfume
    • Not drinking caffeine
    • Keeping track of and preparing yourself ahead of time for changes in the weather

How Migraine with Aura is Treated

If your optical migraines have accompanying auras, treatment is slightly different but follows the same basics as treatment for general optical migraine. If your attacks are very infrequent, you may find medications that target specific symptoms to be helpful. For this, you can take medication that alleviates pain or is anti-nausea. Other preventative therapies include antiepileptic medications, tricyclic medications, or calcium channel blockers.

To reduce the severity and frequency of your migraine with aura without needing to take drugs, you can also:

  • Quit smoking, or avoid being around cigarette smoke
  • Cease taking oral contraceptives
  • Remove yourself from harsh lighting or bright sunlight
  • Take breaks from looking at a screen
  • Avoid triggers such as dehydration, stress, low blood sugar, high altitude, and excessive heat

Symptoms of migraine with aura are understandably distressing and disorienting. Luckily, though, as with many symptoms of optical migraine, they’re typically short lived, and there are things you can do to manage them, so you are in control. Always wait for symptoms to fade, and ensure you take some time away from triggers, or take care to avoid them completely. There are also many resources for you, such as the American Migraine Foundation, which can give you advice on how to live with your migraine. Overall, you will find both support and information, as many people suffer from migraine and you are not alone.

Conclusion

Optical migraines are distinguished from other types of migraines due to the severity and experience of visual disturbances. During optical migraines, you’ll see blind spots, flashing or shimmering lights, or zigzagging lines. These will impact only one eye, and you can test this by covering one eye, then another. Sometimes, this leads to a temporary loss of vision, especially if blind spots are occurring. Luckily, any of these symptoms will naturally fade away after a half an hour or so. You may or may not experience the pain of a classic migraine as you suffer an ocular migraine attack.

As with any migraine, optical migraines will impact your ability to perform daily tasks, such as driving, reading, or working. It is not considered a serious condition and symptoms are temporary, however, if you feel one coming on, you should take care to stop what you are doing and lie or sit down in a comfortable and dark area, until all symptoms pass, and your vision returns to normal.

It’s unclear what exactly causes optical migraines, but a family history of migraine is a big risk factor, as genetics play largely into their occurrence. It’s theorized that optical migraines have the same causes as a classic migraine, which means that there are certain triggers that lead to an attack. You should attempt to pinpoint these triggers for yourself, and then take care to avoid them. Your doctor will help you do this and will help you with further treatment. If you experience any kind of vision loss or visual disturbance, you need to seek medical help, as there could be other and more serious underlying conditions at work.

For many people, avoiding their triggers is a great way to manage their optical migraine without medication. Your optical migraine may not really need treatment, as the symptoms tend to fade on their own after a short period of time. However, you should speak with your doctor if your migraines are happening frequently, are increasing in their frequency, or increasing in their severity. There are medications available that may help to reduce the intensity of your optical migraines and how often they occur.

Overall, optical migraines can be painful, and they do cause a disturbance to daily activities. However, they are manageable, and you can find many resources to manage your migraine and live comfortably.

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