Ocular migraine (OM) is a temporary visual disorder that makes you feel like looking through a cracked window at odd times of the day. Get to know the condition in detail, including its symptoms, causes, diagnosis and treatment among other things.
What is an Ocular migraine?
It is a temporary disturbance of vision that can be experienced in or both eyes. Although quite scary, these typically go away within 20-30 minutes without use of any medication.
The condition is also known by various other names, like:
Picture 1 – Ocular migraine- Retinal migraine
- Ophthalmic migraine
- Visual migraine
Ocular migraine Incidence
The exact prevalence of this condition is not known. However, as per WHO (World Health Organization), around 6% men and 15-18% women in the U.S are said to suffer from migraine headaches. Ocular migraine is generally seen to be more common in women than men. It occurs in individuals below 40 years of age and those suffering from other conditions like Depression and Sickle Cell Disease. It is also common in people with a history of migraine headaches.
Ocular migraine Symptoms
This is generally a painless syndrome but can give rise to a number of physical problems in its sufferers. These include:
Scotoma
It refers to a tiny, enlarged blind spot in the centre of vision experienced by patients. This may be accompanied by wavy lines originating from the focal point of vision. Many sufferers experience problems in differentiating between one-sided blindness and flashing lights.
Migraine with aura
Many patients experience an aura (blind spots and flashing lights in vision) along with a regular migraine. This condition affects approximately 20% migraine sufferers. In such cases, however, the one-sided vision loss generally occurs in both eyes and one side of the field of vision.
Headaches
Scotoma may or may not be accompanied by headaches in sufferers. At times, headaches may be characterized by a throbbing pain on the same side of head which arises at about the same time when blind spot begins to occur.
In some cases, the headaches may persist for a long period that may range from 4-72 hours. The pain may worsen when an affected person is physically active.
Some of the other characteristic symptoms of this disease include:
- Vomiting
- Nausea
- Abnormal sensitivity to sound or light
Ocular migraine Causes
The condition is believed to result from the same factors that give rise to common migraine headaches. Although experts are not sure about the exact causes of either ocular or common migraines, the possible causative factors are said to be:
Spasms
Spasms in the blood capillaries located in the retina are said to give rise to this disorder. Vascular spasm are said to affect the supply of blood from the ocular blood vessels to the section of the brain that controls vision. It is the changes in blood flow in the blood capillaries that lead to the pounding or severe throbbing that the headaches are characterized by.
Changes in nerve cells
Changes occurring in the nerve cells situated in the retina are also believed to be a possible cause.
Ocular migraine Risk Factors
The risk factors for this condition are believed to be nearly similar to common migraines. These involve:
Foods
Some foods, such as, chocolate, smoked meats and aged cheese as well as drinks like red wine and caffeinated products can act as triggers for the disease. Additives, such as artificial sweeteners and monosodium glutamate (MSG) can also trigger the disorder in some people.
Smoking
Cigarette smoke can also trigger this disease, possibly by reducing the supply of oxygen to the brain and affecting the seat of vision regulation.
Odors
Strong odors and even perfumes and fragrances can work as a trigger factor for the disorder.
Strong light
Exposure of the eyes to flickering or glaring lights can also give rise to an episode of this disease.
Lack of sleep
In some individuals, the condition can also arise due to lack of proper sleep which can cause stress and cause visual disturbances.
Stress
Emotional stress might also a play a role in the development of this disorder, as has been observed in certain cases.
Ocular migraine Diagnosis
The diagnosis of the disease is mainly done by asking patients about the symptoms that they experience. This is usually followed by a physical examination of the eyes. In case patients begin to experience symptoms during visits to doctors, they might be told to close one eye and report which eye they are experiencing the loss of vision in. This can help doctors confirm a one-sided blindness. If headaches arise at the same time, the disease can be confirmed.
Ocular migraine Differential Diagnosis
The differential diagnosis of the disease involves differentiating it from conditions like:
Amaurosis fugax
This is temporary blindness due to lack of blood flow to the eye. The symptoms can be due to a blockage in an artery leading to the eye.
Arterial spasms
It refers to spasms in the artery that supplies blood to the retina.
Giant cell arteritis
It gives rise to inflammation in blood vessels and leads to problems in vision and even blindness.
Blood vessel problems
It refers to problems in blood vessel associated to autoimmune diseases.
Differential diagnosis should also aim at ruling out underlying causes like
- Blood clots
- Detached retina
- Drug abuse
- Pituitary tumor
- Stroke
- Conditions that encourage abnormal blood clotting, such as Polycythemia and Sickle Cell Disease
Ocular migraine Treatment
Generally, sufferers of this condition do not require any treatment. This is because the disease is typically harmless and tends to resolve within half-an-hour. In case of prolonged retinal migraines, however, treatment becomes necessary.
The treatment of this disease depends on understanding the actual cause or trigger factors of this disorder, such as lack of sleep, stress or food sensitivity. In some cases, NSAIDs, Aspirin and medications that lower blood pressure are used. Physicians may also use drugs such as Topamax or Depakote that are typically used to treat epileptic conditions. Beta-blockers and Tricyclic antidepressants like Pamelor or Elavil might be used in curing or preventing the occurrence of this disorder.
If patients experience extremely painful headaches, doctors might prescribe painkillers to manage the symptoms. However, this is only true in rare cases.
Patients are also asked about their lifestyle and food habits, making changes in which has been found to be effective in many cases.
Ocular migraine Prognosis
The outcome of this condition is similar to migraine headaches accompanied by typical aura.
Ocular migraine Management
The condition can be managed in the following ways:
Picture 2 – Ocular migraine Image
- Stopping driving, if an episode occurs while you are running a car by yourself
- Practicing yoga and other non-strenuous exercises that reduce stress
- Undergoing massage from time to time, as a de-stress measure
- Avoiding the common triggers for migraine headaches
- Making dietary changes, after having proper consultation with your physician
If you are experiencing vision spots and suffering from headaches as well, do not panic. Get in touch with an ophthalmologist or optometrist to undergo an immediate medical diagnosis. If the condition is treated in time, you can be assured of a faster recovery and better management of the disease without suffering much. This is especially recommended if you are suffering from persistent cases of this disorder.
