Ocular Migraines – Causes, Symptoms, Diagnosis And Treatment

Ocular migraines refers to the headaches that accompany with visual disturbances. While you suffer vision problems, it can develop with or without the usual pain accompanying migraine. The conditions mostly cause vision problems. So, you tend to see shimmering lights or flashing, stars or zigzagging lines. Some people describe it as psychedelic images. You can also experience blind spots in your field of vision. One in every five people experiencing migraine problems report vision problems, also known as the aura. Apart from the pain, the condition mostly interfered with your ability to complete an activity. So, you find it difficult to read, write, cook or driving. The symptoms only last for a short time.

In the majority of the cases, the condition may not cause severe complications. But, some serious complications like retinal migraine also have the same symptoms. Therefore, it is better to see a doctor and get it evaluated for peace of mind. With prompt diagnosis and medical intervention, you can avoid any complications associated with the underlying health condition.

Ocular Migraine Symptoms

When suffering from ocular migraine, it starts affecting your vision. You can suffer from a variety of sensations. In most cases, the signs you observe visual symptoms. The condition can also trigger other sensations like numbness before or after you suffer from headaches. In some cases, you only experience visual problems without a headache. The symptoms may not last long. But, you can observe the following signs in one or both of your eyes:

• Blind spots
• Flashes of light
• Shimmering stars or spots
• Zigzagging patterns

The signs can affect your vision for a short period. So, it affects certain activities like driving or reading. But, the condition is not serious.

A More Serious Condition: Retinal Migraine

Ocular migraine and retinal migraine are used synonymously. But, both are two distinct conditions. Retinal migraine is a rare condition, which affects just one eye. You can observe the following signs with the condition

• Repeated bouts of vision loss
• Blurred vision or blindness

The signs may come before or with a headache. The problem affects a single eye. So, when you see changes in the vision of one eye, then it is not related to recurrent headaches. Something more serious triggers the problem. Therefore, you need to see a doctor promptly for treatment. With early medical intervention, you can reduce the severity of the condition and manage it.

Causes Of Ocular Migraines

The exact cause of recurrent headaches with a vision problem is still not known. But several factors increase the risk of the problem. It has the same cause as migraines. The risk factors associated with the disease are:

Genetic Factor

Your genetic factor has a link to the condition. If you have a close family member suffering from the problem, then you have more chances of suffering from it.

Fluctuation In Hormone Levels

Ocular Migraine is associated with estrogen hormone. Estrogen is the hormone that controls the chemical in the brain linked to the pain sensation. Women can suffer from hormonal fluctuation due to the following:

• Monthly menstrual cycle
• Pregnancy
• Use of oral contraceptives
• Menopause

Certain Triggers

One factor or several factors combined can cause the problem. In most cases, people just uncover one individual trigger. By monitoring your signs closely, you can find different triggers causing the problem. The triggers vary from one person to another. It includes the following:

• Loud noise/sounds
• Bright lights
• Powerful smell or odors
• Anxiety/Stress/ relaxation after experiencing stress
• Change in weather
• Foods containing nitrates (luncheon meats, hot dogs)
• Excess use of caffeine or withdrawal from caffeine
• Foods containing MSG (monosodium glutamate in seasonings, broths, spices, or fast foods)
• Alcoholic beverages (for example red wine)
• Artificial sweeteners
• Food containing tyramine (like fava beans, soy products, smoked fish, aged cheeses, hard sausages)

Try to maintain a dairy to identify the triggers causing headaches and vision problems. The diary must have information about your diet, sleep habits, menstruation, and exercise.

Secondary Headaches

In some cases, ocular migraines can indicate an underlying condition. The condition causing the recurrent headache includes:

• Brain tumor
• Bursting of an artery in the brain (hemorrhagic stroke)
• Head injury (fall or accident)
• A blocked artery in the brain (ischemic stroke)
• Spinal fluid leak
• Seizures
• Inflammation caused by infections like encephalitis or meningitis
• Trigeminal neuralgia
• Excess buildup of cerebrospinal fluid in the brain (hydrocephalus)
• Structural abnormalities of spine, neck, and head
• Inflammation of blood vessel in your vein (cerebral vasculitis)
• The weakness of the blood vessel causing bulging or widening of a part of an artery (aneurysm)
• The artery supplying blood to the brain suffers a tear (arterial dissection)
• Experience withdrawal symptoms from drugs or other toxic substances
• Tangling of arteries and veins in the brain (arteriovenous malformation)

Complications Associated With Ocular Migraines

In most of the cases, headaches with vision disturbances can trigger painful signs. It can frighten you. But, the episodes last only for a short period. You can recover from it quickly. But, you need to see a doctor for detecting the problem. It can indicate a more serious condition with severe complications or affect your daily activities. The complications associated with the condition are:

Retinal Migraine

A retinal migraine is a serious condition with similar symptoms. It can lead to severe and irreversible vision loss. The condition requires immediate medical assistance. So, you need to see a doctor when you see signs indicating the problem. The symptoms of retinal migraine that are different from ocular migraine include:

• You observe symptoms in just one eye
• Temporary blindness
• Severe vision loss
• See twinkling lights in front of your eyes

Sensitivity To Symptoms

Without prompt treatment, you can become sensitive to the signs caused by the problem. So, you tend to become sensitive to the symptoms as time passes. It can lead to recurrent migraine episodes or chronic daily headaches.

Excess Use Of Pain Relievers

The excess use of over-the-counter pain relievers can put your health at risk. It can lead to additional headaches. These headaches are known as rebound headaches.

Increase Risk Of Stroke

In women, ocular migraines can increase your risk of stroke. It is especially true for women who smoke or take estrogen-based medications for other conditions.

Affect Regular Tasks

You can find it difficult to complete regular tasks like reading, caring for young children, working or driving. People experiencing a severe headache with eye problems must stop their activity when they experience the problem. They need to rest until the symptoms have passed. It is specifically necessary when you drive. You need to pull your vehicle safely to the side of the road until you feel better. Resuming the journey after you feel better will avoid any accidents or unwanted incidents.

Diagnosing Ocular Migraines

If you feel so much pain causing severe discomfort and affecting your daily routine, then you need medical assistance. While you have no permanent solution for the condition, you can manage it with medical help. For getting medical help, you need to see a doctor. You need to undergo several tests as a single test alone cannot conclusively uncover the condition. The doctor can use the following to detect the problem:

Physical Examination

Your doctor performs a physical assessment to detect the cause of the symptoms. During the assessment, you need to tell the doctor about the symptoms and your lifestyle factors. Using all the information provided, the doctor can use a guideline that will help diagnose your condition.

Medical History

You need to tell your doctor about your medical history. Inform your doctor about the symptoms you suffer, the disease you have, and the medications you take to manage the problems. Reviewing a person’s complete medical history can help the doctor understand the actual cause of your condition more.

Rule Out Other Eye Condition

When you suffer at least five headaches causing visual issues, which can last from four hours to seventy-two hours without treatment is considered an ocular migraine. Due to the condition, you can also suffer other symptoms. The visual symptoms must have consistency with migraine symptoms to conclusively diagnose the condition. During the diagnosis, your doctor tries to rule out other eye conditions triggering such as pain and symptoms. The conditions to rule out before confirming the diagnosis are:

Amaurosis Fugax

It is the condition causing temporary loss of vision in one or both of your eyes. People suffering from the problem can feel as if a black curtain appears before your field of vision. The vertical block affects your ability to see properly. The condition usually occurs due to the block in one of the arteries leading to the eye. The temporary blindness occurs as a result of a lack of blood flow to your eye.

Spasms

When you experience spasms in the retinal artery, the artery that brings blood to your retina in the eye, then you can suffer from vision problems. The spams can occur in one or both eyes simultaneously.

Giant Cell Arteritis

GCA is a problem causing inflammation in the blood vessels. It can lead to vision problems as well as other problems like facial pain, headaches, joint pain, and fever. You can experience loss of vision in one or both permanently due to the condition.

Autoimmune Diseases

The disease affecting your immune system can cause complications in every inch of your body. So, your eye can also become affected by the diseases. You can experience several signs like blurred vision, cloudiness, dry eyes, pain, or light sensitivity due to the problem. It is because the immune system starts attacking the blood vessels in the back of your eye and causes inflammation of the retina. So, you can suffer from various vision problems.

Recreational Drug Abuse

People who use recreational drugs are reported to experience chronic headaches along with visual disturbances. Abuse victims tend to lead a dependent state, which makes the problem worse. The compounds in the drugs lead to such issues.

Health Conditions With Blood Clotting Issues

Some health conditions like polycythemia and sickle cell disease can restrict your blood from clotting normally. In such cases, you tend to suffer from low hemoglobin levels. These conditions can also increase your pain levels. So, without treatment, the conditions can lead to recurrent headaches with vision problems.

Treating Ocular Migraines

You need to understand that like migraine, ocular migraine has no cure. Your doctor cannot provide you with a magical pill to alleviate the condition. When you suffer from chronic headaches with visual disturbances, see your doctor. The doctor can determine if an underlying condition causes the problem or it exists alone. As the problem can have a huge impact on your life, you need to take steps to manage them. Visual disturbances along with headache can affect your regular activities like driving. So, you need to follow the suggestion provided below:

Wait Until It Fades Away

In most of the cases, the headaches with vision disturbances go away on its own within thirty minutes. So, you need to take rest and avoid any triggers that can worsen the problem. Try to keep away from bright lights until the pain and vision problem fades away. When you are experiencing pain, try to follow the pointers:

• Lie down or sit in a dark room with no noise.
• Massage your scalp by putting a lot of pressure.
• Place your fingers with pressure on your temples.
• To feel comfortable, place a damp towel or cold compress over your forehead.

Over-The-Counter Medication

You can take over-the-counter medication available to treat pain and discomfort associated with the condition. When you feel distressed due to pain caused by the headaches take drugs like ibuprofen to reduce the symptoms. You can also take other OTC medications like the following to alleviate the symptoms associated with the condition:

• Acetaminophen
• Aspirin
• Nonsteroidal anti-inflammatory drugs

When the over-the-counter medication fails to offer you relief, then you need to talk to your doctor about taking prescription pain relievers to manage the distress caused due to headaches.

Prescription Medications For Ocular Migraines

Prescription medication is provided when the OTC medication fails to relieve the symptoms. The medication only focuses on reducing and preventing the symptoms. You need to take the prescription medication either regularly, unlike the OTC medication that you take on an as-needed basis.

Erenumab (Aimovig)

It is a medication that targets a specific molecule known as calcitonin gene-related peptide in your body. The activity of the molecule can play a role in preventing recurrent headache episodes.

Blood Pressure Medications

Your doctor can also suggest medications that in normal cases can treat high blood pressure. The medication used to deal with headache and vision disturbances are:

Beta-Blockers

It is the prescription medication used to block certain hormones. The medication can make your heartbeat slowly with less force. It can offer relief from headaches and prevent its frequency.

Calcium Channel Blockers

This medication keeps calcium out of the walls of your blood vessels and heart cells. So, they relax vessels and widens it. Calan and Cardene are the common drugs used to open the blood vessels.

ACE Inhibitors

Angiotensin-converting enzyme (ACE) inhibitor can prevent the enzyme from making a chemical, which narrows the blood vessels. So, it can reduce the frequency of headaches and visual distortions.

Epilepsy Medications

The medication used to treat convulsive conditions like epilepsy can also relieve the distress caused due to the headache.

Depression Medications

Anti-depressants alter a chemical called neurotransmitter in your body. These chemicals carry messages between the cells present in your brain. The neurotransmitter also plays a role in recurring headaches. So, using anti-depressants can prevent headaches. But, it is not effective in treating active ocular migraines.

Hormone Therapy

Hormone Replacement Therapy is the best treatment for women who are undergoing menopause. The treatment reduces the intensity of the symptoms caused due to menopause. It also is highly effective in controlling headaches and vision problems.

Botulinum Toxin

The doctor prescribes botulinum toxin A for recurrent headaches as it is an approved medication. It is a neurotoxin made by bacteria Clostridium botulinum. But, in small amounts, the poison can help manage several conditions. You need a specialist’s recommendation to get the injections.

Lifestyle Changes For Ocular Migraines

You can try some lifestyle changes along with the therapies to reduce the frequency and severity of ocular migraines. The simple changes can reduce the number of episodes you suffer due to the issue. So, follow the steps suggested below:

Avoid Staring At Screens

Looking at a computer screen or mobile phone for several hours can trigger headaches as well as eye problems. So, you need to avoid looking at the screen for a long duration. Take a break to offer some relief to your eyes.

Manage Stress

Emotional and physical stress can trigger headaches and vision problems. So, when you feel overwhelmed or feel anxious, then you need to deal with it by trying some techniques. The best methods are:

• Acupuncture
• Relaxation techniques
• Biofeedback mechanism
• Exercise

Track Migraine Triggers

You need to keep a track of events or issues that can trigger your headaches with visual disturbance. Keeping the list of triggers will help you avoid them.

Lose Weight

Excess body weight can trigger several problems in your body. You need to follow a successful weight loss plan to reduce the excess body fat. You need to follow some workout routine along with the weight loss plan to get good results.

Quit Smoking

Smoking can only worsen the symptoms and trigger recurrent headaches. So, try to quit bad habits to avoid distress.

Stay Hydrated

Dehydration can trigger headaches. So, you need to stay hydrated by drinking water throughout the day.

Limit Caffeine/ Alcohol

Try to limit your alcohol or caffeine consumption. It can worsen the headaches or its severity.

Establish Sleep Routine

You need to follow a consistent sleep routine. Sleep at the same time every day and wake up at the same time. A good sleep routine can avoid recurrent headaches.

Conclusion

When you suffer from ocular migraine, you feel pain and distress. But, most of the time, you may not need treatment to deal with the condition. When pain and vision disturbances start affecting your regular life and increases in frequency, then you need to see a doctor. With medical assistance, you can ensure no serious health problem causes the problem. The doctor can prescribe medication to reduce the intensity and frequency of the symptom associated with the condition. Without treatment, serious complications can escalate and lead to permanent vision loss in or both eyes. So, see a doctor to relieve the symptoms and improve your quality of life.

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