Understanding Ocular Migraines: Signs, Causes & When to Seek Help

An ocular migraine is a rare condition that often affects your central field of vision. It may appear as a small blind spot and gradually increase in size. This brief vision problem typically resolves within an hour or less.

These vision episodes share the name of migraine, but they are not exactly the same as other migraines. They do not usually cause vomiting, nausea, pain, or light sensitivity. 

As these events may be signs of other health conditions, it is important to talk with your doctor if you experience an ocular migraine.

Symptoms of Ocular Migraines

The symptoms of ocular migraine vary depending on individual experience. These are some common symptoms:

• Loss of vision in one spot
• Loss of vision off to one side of the visual field
• Seeing lights shimmering or colored
• Seeing zig-zag patterns and lines 

The symptoms tend to occur in one eye. The visual symptoms generally resolve within about 60 minutes. 

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Ocular Migraine (Retinal Migraine) vs. Migraine With an Aura (Visual Migraine)

Ocular migraines are often mistaken for visual migraines. Both migraines cause changes in the vision, however, ocular migraines tend to be limited to one eye. 

An ocular migraine usually resolves within an hour. Although an ocular migraine may only last a short time, it could be a sign of other health issues. Talk with your medical provider to determine what may be the root cause and to rule out more serious problems.

An aura or visual migraine involves different types of visual disturbance that many people compare to looking through a kaleidoscope or cracked window. You may have visual symptoms such as flashing lights, blind spots, or zigzags. 

Generally, a visual migraine affects both eyes, with changes in vision lasting less than 30 minutes. 

Most commonly, the aura phase of the migraine comes before experiencing migraine pain. Many patients report that the aura resolves as the pain starts. An aura can last anywhere from 10 to 60 minutes.

Aura symptoms may also include physical numbness, temporary sight loss, speech changes, and weakness on one side of the body. You may notice additional sensory symptoms such as feeling pins-and-needles sensations throughout the body.

Many people who have migraines also experience other symptoms, such as nausea, vomiting, confusion, numbness, and dizziness. The pain level and frequency vary greatly across individuals.

Causes of Ocular Migraines

The precise causes of ocular migraines are still not known. This type of headache is not technically a problem with the eyes. It may be related to blood flow in the brain or changes in the brain’s biochemistry. 

According to the World Health Organization (WHO), the cause of migraines may be a mechanism in the brain that releases pain-producing substances around the nerves and blood vessels. This mechanism results in the release of substances that cause inflammation around the blood vessels and nerves in the head. The outcome is what many people experience as migraine or painful headaches.

Ocular Migraine Risk Factors

Some of the risk factors for ocular migraines are similar to risk factors for migraine headaches. These are the top risk factors: 

• Family history: If your parents and close relatives have ocular migraines, you are more likely to have them too. They tend to run in families.

• Stress: Increased stress at work or home as well as emotional, physical, or financial stress may be a risk factor for ocular migraines. Stress can also trigger poor sleep patterns and fatigue, which can make migraines more likely. 

• Nutrition: Some individuals are sensitive to certain foods, such as cheese, chocolate, or red wine. Other people notice that preservatives such as nitrates or MSG are migraine triggers. Evaluating your diet can help you identify which foods seem to be associated with your ocular migraines.

• Smoking: If you smoke, it could be contributing to the severity and frequency of your ocular migraines. Talk to your doctor about steps to stop smoking. 

• Environmental changes: Fluctuations in the weather can trigger migraines for some individuals. Track the weather changes in conjunction with your migraines. You may discover a link, such as a change in barometric pressure, wind, or temperature that affects you.

Diagnosis

If you suddenly experience what you think is an ocular migraine, see a doctor. They can rule out other issues that have similar symptoms. 

The doctor will ask about your medical history, recent symptoms, life changes, and any prior experience with ocular migraines. Your doctor may perform tests to make sure that a more serious blood flow problem is not the underlying cause.

If you experience symptoms of unexplained visual loss, talk with your doctor about options for advanced diagnosis. You may wish to consult with a neuro-ophthalmologist. These physicians are trained to treat unexplained visual loss, headaches, and migraines.

Treatment of Ocular Migraines

Ocular migraine episodes usually pass in about an hour or less. Rest is often the recommended treatment.

Migraine management methods may help to promote a sense of ease and calm. Try these methods:

• Rest quietly in a dark room.
• Place a cool compress on your closed eyes. This can be soothing and relaxing.
• Massage your scalp gently. Gently circle the area around the temples.
• Try yoga postures.
• Take an over-the-counter or prescription pain medication.
• Try calm, meditative breathing techniques.
• Consider biofeedback, which can help you recognize early signs of migraine and limit pain.

As you explore integrative treatments, keep an open mind and a spirit of investigation. For example, when learning new yoga postures, it may take some time to feel comfortable and familiar with the moves. With practice, you’ll discover which poses help you feel a sense of calm relaxation. 

Do not drive or operate equipment while you have migraine symptoms.

Medications for Migraines

Depending on the severity and frequency of the ocular migraines, both over-the-counter and prescription medication can help. OTC options include ibuprofen, acetaminophen, naproxen, and aspirin. 

Prescription options may be used as needed to take away pain or to reduce nausea and other migraine symptoms. Some medications can be taken on an ongoing basis to reduce the frequency and severity of migraines.

Migraine Prevention

Migraines can impact every part of your life, so it is helpful to take preventative measures to manage symptoms and reduce triggers. 

Take precautions to avoid excessive stress, bright lights, or specific foods that seem to be linked with your ocular migraines. 

Preventative measures are most often linked to lifestyle modifications. To reduce stress and improve health, focus on practical steps in your diet and lifestyle choices.

• Stop smoking.
• Reduce, limit, or stop alcohol consumption.
• Avoid foods with MSG or nitrates.
• Eat a healthy diet with plenty of fruits and vegetables, promoting balanced nutrition.
• Be alert to changes in the weather if these seem to trigger your migraines.
• Learn stress management skills and practice them during times of high stress.
• Practice yoga and relaxation techniques

Many people find it useful to keep a migraine journal. By journaling, you can begin to identify specific triggers in your daily life, such as stress, fatigue, smoking, certain medications, and hormonal changes. You may also see a connection with specific triggers by tracking your sensitivity to foods, caffeine, preservatives, or weather changes. 

A migraine journal can also be useful when talking with your health care provider. You can help your provider make an accurate diagnosis by pinpointing specific patterns, triggers, and timing of the events.

Once you better identify certain triggers with this tracking process, you can take steps to avoid or limit exposure to them.

Ocular Migraine FAQs

Why am I suddenly getting ocular migraines?

You may be suddenly getting ocular migraines due to an increase in stress in your life. Perhaps you are working more and exercising less. You may have been seeking comfort with unhealthy choices, such as smoking or drinking a lot of alcohol. You might have recently changed your diet or developed sensitivity to specific foods that are triggering migraine symptoms. 

Talk with your doctor to evaluate the possible causes for this sudden change.

Is an ocular migraine serious?

An ocular migraine generally resolves within about 60 minutes. They are not generally considered medically serious, but they can greatly affect your quality of life if they occur regularly. 

Talk to your doctor about your experience to determine the source of your ocular migraines.

What does an ocular migraine feel like?

You may notice changes in your vision, such as a blind spot in your center field, typically in one eye. Some people experience that this small spot increases in size. Generally, these symptoms dissipate in about an hour if you rest.

How do you get rid of an ocular migraine?

Rest. Go to a dark, cool room and lie down. Resting your eyes completely helps the ocular migraine to pass more quickly. If needed, take a pain reliever and use a cool compress on your closed eyes.

Is an ocular migraine the same as a stroke?

No, they are separate conditions. Ocular migraines are associated with a slightly increased risk for stroke, but on their own, ocular migraines are not considered medically serious.

Can dehydration cause an ocular migraine?

Yes, dehydration can trigger an ocular migraine. Make sure to stay hydrated.

References

1. Ocular Migraine. Tufts Medical Center Community Care, John Hopkins Medicine.

2. Migraine Headaches. Cleveland Clinic.

3. Migraine Headaches. John Hopkins Medicine.

4. A to Z: Migraine. John Hopkins Medicine.

5. Headache Disorders. World Health Organization.

6. Migraine Aura Pathophysiology: The Role of Blood Vessels and Microembolisation. (August 2010). The Lancet Neurology.

7. Diet and Weather as Triggers of Migraine. (March 2021). The Migraine Patient Journey: Episodic Migraine and CGRP Inhibitors. 

8. Retinal Migraine Headache. (2022). StatPearls.

9. Clinical Features of Visual Migraine Aura: A Systematic Review. (May 2019). The Journal of Headache and Pain.

10. Symptoms Related to the Visual System in Migraine. (July 2019). F1000 Research.

11. What Is Migraine? American Academy of Ophthalmology.

12. Neuro-Ophthalmology. University of Rochester Medical Center.

13. Impact of Migraines. The Migraine Trust UK.

14. Biofeedback and Relaxation Training for Headaches. (November 2016). American Migraine Foundation.

15. Diet, Nutrition, and Lifestyle Interventions for Migraine Relief. (March 2021). Susan Samueli Integrative Health Institute. University of California Irvine.

16. The Relationship Between Migraine and Nutrition. (November 2016). Turkish Journal of Neurology.

17. The Relation Between Migraine, Typical Migraine Aura and “Visual Snow”. (May 2014). Headache: The Journal of Head and Face Pain.