Visual Auras: Causes & Treatment

A visual aura can be scary and uncomfortable, creating visual disturbances for a short period. According to experts, although it is uncomfortable, a visual area is not generally dangerous. 

Some people experience visual auras without a migraine, while others deal with visual auras just before a migraine attack. Typically, after resting in a dark room, the symptoms subside.

As the symptoms can be similar to other serious medical conditions, such as stroke or transient ischemic attack (TIA), it is very important to seek medical care if you have visual auras.

Symptoms of Visual Auras

Visual auras generally appear in both eyes. The symptoms may start as small spots, zigzag lines, or flashes. Sometimes, the small spot slowly expands outward, affecting a bigger area of vision. 

These are common symptoms of visual auras:

• Blind spots
• Geometric designs

• Zigzag lines
• Shimmering spots, sparkles, or stars
• Light flashes

The exact appearance of visual auras varies for different people. 

Some individuals also have physical symptoms, such as dizziness, tingling, or numbness. In some cases, speech or language may be affected. 

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How Does an Aura Impact Vision?

An aura creates temporary changes in your vision. These are characteristically zigzag lines, flashing lights, or bright spots. 

For some people, an aura creates a temporary partial blockage in the field of vision. Other people describe the sensation as looking at objects through heat waves or water.

Causes of Visual Auras

The precise cause of visual auras is not fully understood. According to some sources, visual auras and visual migraines may be caused by an electrical wave that moves in the brain. As a result of this movement, visual symptoms appear.

Risk Factors

Migraines are generally more common in women than in men. They also appear to run in families that have a family history of migraines. 

According to the American Academy of Ophthalmology, several risk factors may be involved, including obesity, diabetes, stress, and head injury. 

In addition, migraines with aura can be triggered by specific factors, such as stress, emotional stress, bright lights, lack of sleep, and hormonal changes. Specific foods such as red wine, cheese, or chocolate may trigger migraine with aura. Preservatives such as MSG and nitrates may also be factors that can bring on a migraine.

How Long Do Visual Auras Last?

According to the American Migraine Foundation, a migraine aura generally lasts 5 minutes to an hour. The aura is distinctly visible. Seeing the aura often has a clear starting and finishing point. 

Migraine With Aura Progression

A migraine headache is often described as having four stages: prodrome, aura, attack, and postdrome. You may experience headaches with all four stages, or you may only experience a couple stages.

1. Prodrome: The prodrome phase includes subtle changes one or two days before the event. Some common symptoms include depression, constipation, diarrhea, irritability, drowsiness, or cravings. It is also possible that you won’t experience any of these changes.
   
2. Aura: The aura phase often is quite distinct, with a noticeable start and finish. The most common auras are visual. These visual changes can look like patterns such as a fortification spectrum, resembling a medieval fort. You may also see geometrical shapes, lines, and patterns.
   
   Sometimes, the visual aura moves, grows, or shifts shape. It may also include a partial loss of vision, called a scotoma.
   
   Auras tend to last 10 to 30 minutes.  It is possible to experience a migraine aura that is not followed by headache pain.
   
3. Attack: The attack phase of a migraine headache can last from several hours to a few days. This is when you experience the actual intense headache pain.
4. Postdrome: The postdrome phase is often compared to feelings of a hangover. You may feel wiped out, drained, or depleted. 

What to Do if You Experience a Visual Aura

Migraine aura symptoms generally start gradually and last between 20 and 60 minutes. 

If you notice a visual aura or other headache symptoms, stop what you are doing and find a cool, quiet, dark room to rest. If your doctor has recommended medications, take them as soon as possible. 

Do not drive, operate equipment, or add any additional stress to your environment. If you find that a cool compress is helpful on closed eyes, rest and use a cool compress.

Diagnosis

Visual auras often overlap with other health conditions. According to the American Migraine Foundation, various symptoms of aura can be difficult to describe. One of the most telling signs of an aura is a clear beginning and end.

It’s very helpful to keep track of the details of your experience, so your doctor can correctly diagnose the causes. 

In a journal, keep track of details related to your headaches and visual auras, such as these:

• What you are feeling and seeing
• Any emotional stress
• Medication, including the timing and dosage
• Weather
• Timing of seeing the visual aura

By keeping a headache journal, you can begin to see patterns in potential triggers for the headaches.

Treatment for Visual Auras

Migraine aura treatment is focused on two things: easing symptoms and prevention. 

Easing Symptoms

If you begin to see visual auras, immediately take action. Move to a cool, dark area and rest.

Pain relief with over-the-counter medications, such as aspirin, ibuprofen, or acetaminophen, is often the first response to stop migraine auras. If you get migraines regularly, talk to your doctor about prescription options that can acutely relieve pain and nausea related to migraines. 

Triptans can block pain pathways in the brain and reduce headache pain. They can be taken as pills, nasal spray, or injections. 

Dihydroergotamine may ease symptoms if taken at the beginning of a migraine. This drug is available as a nasal spray or injection.

Preventative Treatments 

Preventative treatments can be very effective in reducing the frequency or intensity of visual migraines. Treatments for preventing visual auras and migraines with visual auras are typically the same as those used to prevent other types of migraines. 

Preventative treatments may include vitamins and herbal remedies. Vitamin B2 (riboflavin) is thought to improve migraine headaches. The approximate dosage of 100 mg daily may be useful in preventing migraines. Herbal remedies used to reduce migraines include feverfew and butterbur.

Preventative prescription medicines include low doses of amitriptyline, gabapentin, and topiramate. Some patients find Botox injections in the scalp and forehead help prevent migraines.

Lifestyle Modifications

According to the American Migraine Foundation, a brain that is susceptible to migraines prefers routine. Recommendations often relate to establishing regular routines, such as sleeping the same amount every night, eating regular meals, and drinking water consistently. 

Lifestyle modifications such as refining one’s diet, improving nutrition, and getting regular exercise may help manage symptoms and reduce migraine frequency. Practices that reduce stress could be helpful, including yoga, mindfulness meditation, and calming breathing techniques. 

Getting quality sleep is a big factor. A recent study confirmed that 85 percent of participants living with migraines reported poor sleep quality associated with headache frequency. Lifestyle changes can include sticking to a sleep schedule, relaxing before sleep, and having no screens in the bedroom.

Talk with your health care provider to understand practical steps that may help to reduce headache symptoms, relieve pain, prevent migraines, and enhance overall quality of life.

When to See a Doctor for Visual Auras

See your doctor right away if you have any new signs of migraine with aura. These may include temporary vision loss, speech loss, difficulty with language, or experiencing muscle weakness on one side of the body. If you experience a dramatic change in your symptoms, see your doctor to evaluate potential causes.

Your doctor needs to rule out more serious medical conditions, such as stroke or TIA. Your doctor may conduct a physical exam and imaging.

During the diagnostic process, your doctor may run several tests to rule out eye conditions and underlying medical conditions. These could include the following:

• An eye exam to evaluate if eye conditions could be causing visual auras
• A CT scan to see detailed images of your brain, ruling out a brain bleed, tumors, and other issues
• An MRI to capture images of your internal organs and tissues to see signs of a stroke or other brain event

With these results in hand, your physician is better equipped to confirm your diagnosis.

Visual Aura FAQs

What causes aura in the eyes?

While the precise cause is unknown at this time, a visual aura may be caused by an electrical wave moving across the visual cortex of the brain. The electrical changes in the brain appear as visual symptoms.

How common are visual auras?

Only 25 to 30 percent of people who get migraines experience auras. Of this group, the most common type of aura experienced is a visual aura. Among people who get migraines, 90 to 99 percent develop temporary visual symptoms. 

Is a visual aura dangerous?

Generally, no, a visual aura is not dangerous. You may lose your balance or have an accident, so move to a cool, dark place to stay safe until the aura passes.

How can you stop a visual aura?

Move to a cool, dark space and lie down. Close your eyes, and place a cool compress on your head. Take an over-the-counter painkiller like naproxen or ibuprofen to help the pain. Drink water.

If you get migraines regularly, talk to your doctor about prescription medication that can reduce their frequency. 

References

1. Ophthalmologic Manifestations of Migraines. EyeWiki, American Academy of Ophthalmology.

2. Types of Aura. American Headache Society.

3. Visual Aura and Scotomas: What Do They Indicate? (September 2015). Review of Optometry.

4. Migraine Visual Aura. American Academy of Ophthalmology (AAO)

5. Migraine Aura: What Is It, Symptoms, Causes & Treatments. Cleveland Clinic.

6. Patient’s Guide to Visual Migraine. Brigham and Women’s Hospital.

7. Your Brain With a Migraine: Effect of Electric Currents. (June 2018). Penn State.

8. Demystifying Migraine With Aura. American Migraine Foundation.

9. Stress and Migraine: How to Cope. American Migraine Foundation.

10. Headache. John Hopkins Medicine.

11. A Closer Look at the Different Types of Migraine Auras. Will Erwin Headache Research Foundation. 

12. Diet, Nutrition, and Lifestyle Interventions for Migraine Relief. University of California Irvine (UCI).

13. Complementary and Integrative Medicine for Episodic Migraine: An Update of Evidence From the Last 3 Years. (February 2019). Current Pain and Headache Report.

14. Sleep Disturbance and Affective Comorbidity Among Episodic Migraineurs. (June 2013). Headache: The Journal of Head and Face Pain.

15. Sleep, Insomnia, and Migraine. American Migraine Foundation.

16. Dihydroergotamine (DHE) – Then and Now: A Narrative Review. (January 2020). Headache.

17. Migraine Prevention Diet. John Hopkins Lupus Center.

18. CT Scan (Computed Tomography): What Is It, Preparation & Test Details. Cleveland Clinic.

19. Magnetic Resonance Imaging. Cleveland Clinic.