Ocular Migraine: A Relief Guide (w/ Visual Examples)

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Ocular Migraine: A Relief Guide (w/ Visual Examples)

While the throbbing, insistent pain of most migraine events might be the overriding symptom for most, a relatively small portion of migraine sufferers – about one of every 200 – will experience visual symptoms without headache. This is commonly known as an ocular migraine. 

So, what the heck is an ocular migraine and why do they occur? How do you know if you’re having one, and what you can do about it? This article will give you the low-down on all of it. Let’s dive in.

What Is Ocular Migraine?

An ocular migraine causes temporary vision loss or visual disturbance. It usually lasts under an hour, and usually affects just one eye. 

Ocular migraine may be called optical migraine, visual migraine, retinal migraine, ophthalmic migraine, or visual aura. But the official name and classification according to institutions like the American Migraine Foundation and International Headache Society is migraine aura without headache. We’ll just call it ocular migraine. Yeah, that’s easier.

At Axon Optics, we get a lot of questions about ocular migraines. This has made us more aware that our precision-tinted lenses can help a wide reader base. Our commitment to providing the most current research findings on migraine-related disorders includes ocular migraines. 

Lots of people who wear our glasses have seen a reduction or other improvements in their ocular migraine. We hope this article addresses some of your questions about ocular migraines.

Ocular Migraine Symptoms

Ocular migraine symptoms are visual in nature, and can include the following: 

Appearance of twinkling, shimmering, or flickering light

Ocular migraine symptom twinkling, shimmering, or flickering light

Starbursts or zigzagging lines in your visual field

Ocular migraine symptom starbursts or zigzagging lines

Blind spots (areas where vision is reduced or completely absent)

Ocular migraine symptom blind spots

Tunnel vision

Ocular migraine symptom tunnel vision

Temporary blindness

Image coming soon

Many people only experience the symptoms above. For others, the visual symptoms also come with symptoms of migraine having nothing to do with head pain, including: 

  • Nausea
  • Fatigue
  • Confusion
  • Irritability    

Especially if you’ve never had one before, ocular migraine attacks can be downright frightening. Suddenly seeing these visual symptoms and not knowing why could really freak you out. You might fear you’re having a serious vision problem, or even a stroke.

Ocular migraine doesn’t receive nearly as much attention in medical literature and the media as painful migraine does, so it’s less familiar to most people. 

Ocular Migraine, But No Pain? Here’s Why.

The medical community hasn’t quite figured out why some migraine sufferers may experience visual symptoms alone, without a headache either before or after. 

What researchers do know is that light plays a role in most migraine events, and that this role can be played out even in patients who are blind. Yeah, you read that right. This indicates that additional nerve pathways play a role in migraine symptoms — pathways not even associated with vision. 

This revelation also underscores the need for further research into migraine. Fortunately, today’s science has begun focusing on migraine pain and aura as two disparate events that can be studied separately.

Some patients have a migraine aura without a headache

Ocular Migraine Is Not Migraine With Aura

Ocular migraine symptoms are sometimes confused with migraine with aura, but they aren’t the same thing. 

Migraine with aura refers to visual symptoms that occur before a headache and other migraine symptoms develop. This can begin up to several hours before onset of a migraine. Aura occurs in about 20 percent of all migraine sufferers, and most of those people go on to develop the throbbing, deep headache usually associated with the migraine experience. 

With ocular migraines, or migraine aura without headache, visual symptoms still occur, but they are not followed nor accompanied by the headache. 

Ocular Migraine Is Not Retinal Migraine

Sometimes people use the terms retinal migraine and ocular migraine interchangeably, but they are two different conditions. While they do share some symptoms, the nature of the attack itself and how the vision is affected are the most obvious ways to distinguish the two. 

Retinal Migraine vs Ocular Migraine

  • Retinal migraine – Vision disturbance occurs in both eyes which may lead to temporary blindness.
  • Ocular migraine – Vision disturbance occurs in just one eye and may include zig zag lines, blind spots, flashing lights, visual blurring, “seeing stars,” or visual dimming.

There has long been controversy in the medical community about retinal migraine. Some researchers question whether it’s a valid condition or a misdiagnosis of something else. 

Ocular migraine, on the other hand, has been widely accepted as a type of migraine. There is evidence, though, that there are two distinct conditions, each with its own symptoms.

What Causes Ocular Migraine? Triggers and Risk Factors

Whether your migraine attack is painful in nature, ocular without pain, or both, the cause is likely the same.

Not that long ago, researchers believed migraines were related to problems with blood flow in the brain. Thankfully, more recent advances have led to a much more comprehensive understanding. We now know a lot more about migraine disease and the underlying processes that cause it. 

Today, medical researchers and doctors believe migraine attacks are caused by an interaction between the nerves and the blood vessels in the brain, classifying them as neurovascular events. These events occur when nerve activity causes changes in the circulation in the brain. 

Whether these neurovascular events bring on a headache or not, any type of migraine can be triggered by the same specific stimuli across the board. These may include:

  • Illness
  • Stress
  • Allergies
  • Food sensitivities
  • Sleep problems
  • Exposure to bright lights or loud noises
  • Caffeine or alcohol consumption

Sometimes, there are specific risk factors that also contribute to ocular migraine. If you can’t identify specific triggers, consider whether you have some of these risk factors.

Risk Factors for Ocular Migraine

There are several factors that could have an impact on your risk for ocular migraine. 

  • Gender – Ocular migraine tends to be more prevalent in women than men
  • Age – Ocular migraine typically occurs in people under age 40. 
  • Genetics – A family history of ocular migraine, migraine, or chronic headache
  • History of Migraine – A personal history of migraine or chronic headache
  • Medical Conditions
    • High blood pressure
    • Hardening of the arteries
    • Epilepsy
    • Lupus
  • Lifestyle factors
    • Smoking
    • High stress
    • Physical exertion (overheating, dehydration, etc.)
    • Oral contraceptives

What Causes Visual Aura?

Ocular migraine visual aura

Most migraines occur in different “phases,” with the aura phase occurring before the headache (if the headache develops), nausea, and other symptoms. 

Researchers believe auras develop when the nerves in the brain are hyper-stimulated. Those nerves then enter a depressed state of low activity called cortical spreading depression. This low activity spreads throughout the top layer (cortex) of the brain. As it travels, it comes to and affects the part of the brain responsible for vision. 

It’s this wave of altered neural activity that researchers believe is responsible for the visual symptoms present during the aura phase of a migraine. They believe it’s also responsible for any symptoms affecting hearing that sometimes occur in the aura phase.

Hopefully, this leads to more studies focusing on ocular migraine (migraine aura without headache) to improve our understanding of these events. 

No matter what the underlying cause of these relatively unusual and “painless” migraines, the symptoms of ocular migraine can be just as disruptive to daily activities. They can be just as worrisome and stressful for those who suffer from them. 

Even though there may be no associated pain, ocular migraine still requires optimal treatment to make them less frequent and less severe.  

Diagnosing Ocular Migraine 

Historically, diagnosing ocular migraine has been difficult. Unfortunately, this has also made getting appropriate and effective treatment more complicated. 

Just as most patients associate migraines with headache, many healthcare practitioners also have a low level of awareness of the symptoms of ocular migraine when it occurs without the headache. 

In the absence of headache symptoms, some healthcare practitioners seek other possible causes for visual symptoms. They may investigate eye problems like retinal detachment or dry eye, eye disease such as diabetic retinopathy, or even chronic stress. In many cases, misdiagnosis leads to delayed care.

When to See Your Doctor for Ocular Migraine

Even though the symptoms can be scary, in the vast majority of cases ocular migraines are harmless. They don’t typically last very long, and then you can get on with your day. 

It’s rare for ocular migraine to indicate a serious health condition, such as carotid artery disease or risk for stroke. This is why it’s critical to seek medical attention if:

  • Your eyesight suddenly deteriorates
  • You suddenly lose your eyesight for the first time

If this happens to you, see your ophthalmologist or optometrist ASAP for a comprehensive eye exam. They can help you diagnose and treat any underlying conditions that could be related to your ocular migraines.

Treatment and Prevention

Several medications have been developed to aid in the treatment of migraine symptoms. Some could potentially prevent migraines from occurring or reduce their severity. Many of these drugs are used to treat ocular migraine as well. 

However, finding the right combination of medications has proven problematic. For some people these medications are ineffective, and long-term use may cause side effects, including rebound headaches

More recently, studies have focused on the effects of light as a migraine trigger. They’ve also studied using special lenses to filter out the light wavelengths related to increased migraine activity. Studies dating back to the mid-1980s have demonstrated that specially-tinted lenses can reduce the occurrence of migraines, and limit the symptoms and duration of the migraines that occur. 

Axon Optics is a leading provider of these lenses, thanks in part to their rigorous quality control standards. If you have migraine aura with or without headache, Axon Optics’ migraine glasses could be just what the doctor ordered for helping you reduce your symptoms. To learn more about Axon Optics, explore our website, like us on Facebook, or ask your eye doctor if Axon Optics’ therapeutic lenses are right for you.  

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15 thoughts on “Ocular Migraine: A Relief Guide (w/ Visual Examples)

  1. Khayrie says:

    Thank you for sharing this article about ocular migraine. This is a very informative and it’s really nice to know things like this so we can also share it with our families and friends.

  2. Dede Wurl says:

    My neurologist told me the opposite of your article above. He said o liar migraines effect both eyes, retinal migraines usually one eye.

    • Lori Glover says:

      It can be confusing and there is certainly a lot of information available. Regular migraine attacks with vision problems usually appear in both eyes. If you have ocular migraine, you may get vision loss or blindness in one eye for a shorter period of time. You can actually have it along with a regular migraine headache. We always recommend to seek the advice of your doctor or possibly another medical provider.

    • Erin says:

      These symptoms can be super confusing, and there are so many different ways you can experience migraine. For example, my diagnosis is chronic migraine without aura but sometimes I do experience auras. Just not every time. I definitely experience ocular migraines from time to time. And because of reading this article, I realize I also experience retinal migraine at times. But because these symptoms are not the norm for my migraines, I do not have that diagnosis. Generally, I have pain and all of the other typical symptoms of chronic migraine. The visual symptoms come and go for me. I hope this helps!

  3. Debbie Will says:

    This is very helpful information. I do get the ocular migraine. And yes, it is in one eye. I get it mostly in the right eye but occasionally in the left eye. I have explained the symptoms to my eye Dr. and they have never heard of the symptoms. I did tell them they should study up on ocular migraines! I think I need to see a different eye Dr.!!!

  4. Karen Teter says:

    I had cataract surgery and one eye is having ocular migraines without a headache usually when looking at computer screen or any brightly lit area. It’s partial with some of my vision being blocked. I haven’t been back to get my eyeglass prescription yet. Can you tell me what you might have to help me with my vision problem . Thank you

    • Lori Glover says:

      We have a very lenient return policy so you can determine if the lenses are effective for you. Most non prescription frames ship within 24 business hours. If you wear glasses, the Cover Rx is a great choice as your trial. Feel free to email [email protected] for more information.

  5. Kahlia Blake says:

    I have been diagnosed with visual migraines by an ophthalmologist although the short quiz included here says that because I only have 1/4 symptoms that I don’t have it. I’ve had several different tests done on my vision and my eyes and they cannot find any other explanation for what I’m seeing. Rather than lasting for an hour or more these shapes (black and white blobs) I see last less than a second and occur spontaneously without any certain trigger over a dozen times a day. It is always in the top right of my right eye and nowhere else and always the same shape, moving quickly across my vision. Are there any other records of visual migraines occurring in short bursts rather than lasting for hours?

    • Lori Glover says:

      Working with an ophthalmologist and/or neuro-ophthalmologist is very important when managing chronic symptoms and diagnosis. Your doctor is the best resource and we always encourage ongoing dialogue with all your eye care providers. Symptoms, frequency and severity vary greatly among those suffering. Thank you for participating in the conversation.

    • Erin says:

      I also experience these symptoms! They come and go throughout the day for me as well and are generally not very disturbing, well I guess because I am used to it! As I have recovered, they have gotten less intense that are still generally triggered by the same things. If I get too much glare in my eyes or spend intense time on a screen, the visual flares start happening. Generally I can ignore them for a bit, but will need to rest my eyes. Obviously I can’t give you medical advice, but what helps me is to rub the muscles around my eyes, my temples and forehead. Those are the muscles that tense up when you get migraine. I LOVE CBD for reducing this muscle tension, and Axon makes a Migraine CBD oil that I CANNOT WAIT to try!

  6. Baker says:

    I have one eye . Left eye – I started getting ocular migraines ( sux) Ive been to several Docs/opt ( little help) . I’m very interested in your glasses w/ prescription. Your info here has been great .

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