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Ocular Migraines

Migraine Awareness Month:

An ocular migraine is any migraine headache that involves a visual disturbance such as flashes of light, seeing stars or zigzags or the appearance of blind spots in the visual field. Ocular migraines can interfere with your ability to go about your daily tasks such as driving, reading or writing, however, the visual symptoms don’t last long and do go away completely once the migraine has passed. 

What is an Ocular Migraine?

The term ocular migraine may refer to a couple of different conditions. Firstly, migraines with auras often have eye-related symptoms that precede the actual headache. An aura is a physical symptom that is experienced usually within 5 minutes to an hour before a migraine comes on, and can include:

  • Blind spots (scotomas) or partial vision loss
  • Flashes of light, spots or zigzag patterns
  • Visual, auditory (hearing) or olfactory (smell) hallucinations or disruptions
  • Tingling or numbness
  • Mental fog, trouble finding words and speaking

These types of ocular migraines commonly appear by obstructing a small area of vision which spreads gradually over 5 minutes. 

A second type of ocular migraine is when you actually experience temporary vision loss or disruptions (flashes, blind spots, zigzag lines etc.) during or immediately following the migraine headache. Ocular migraines can also sometimes appear without any head pain at all. They may also be called eye, ophthalmic, or retinal migraines. 

What Causes Ocular Migraines?

Similar to classic migraines, the exact cause of an ocular migraine is unknown. Genetic predisposition seems to be a factor to some extent, and having a family history of migraines does put you at greater risk. 

While they don’t know the cause, experts have seen that spasms in the blood vessels and nerve cells in the retinal lining at the back of the eye are associated with ocular migraine symptoms. 

For some, there are certain environmental triggers, or a combination of factors, that cause migraines. These differ on an individual basis but can include:

  • Stress
  • Bright lights or loud sounds
  • Strong smells
  • A sudden or drastic change in weather conditions
  • Eating, or exposure to, certain food substances such as, alcohol, caffeine, nitrates, MSG (monosodium glutamate), artificial sweeteners and tyramine. 

Since triggers are different for everyone it’s advised to try to identify yours by keeping a journal to track your environment, diet and lifestyle habits, when you experience a headache. 

Treatment for Ocular Migraines

Treatment for ocular migraines is usually not necessary as the symptoms typically resolve themselves within 30 minutes. It is advised to rest and avoid doing things that require vision and concentration until the headache goes away and the vision symptoms cease. If you are experiencing an ocular headache:

  • Lie down in a quiet, dark room when possible
  • Massage or apply pressure to the temples and scalp
  • Apply a damp towel to the forehead

If you experience auras, taking a migraine medication when the aura occurs, can often reduce the intensity of the headache that follows. In other words, you can use the aura as a warning sign that a headache is coming on and treat it preventatively. Your doctor may prescribe a pain reliever for associated head pain and, if migraines are chronic, a preventative medication may be given. 

It’s important to note that if you are experiencing any unusual visual symptoms or an increase in frequency or duration of symptoms, you should see an eye doctor right away to rule out any serious, vision threatening conditions. Symptoms such as floaters or flashing lights can also be a sign of a retinal tear or hole. 

If you get migraines, among the best ways to prevent them are to keep your mind and body healthy by eating nutritious foods, getting enough rest and managing stress effectively. 

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Dear Northwood Vision patient,

Here is what we are asking you to do to make a smaller exposure footprint:

  1. If you have any symptoms of loss of taste or smell, upset stomach/diarrhea coughing, fever, difficulty breathing, running nose please reschedule your appointment in 30 days or more.
  2. Wash your hands or use sanitizer immediately upon entering.
  3. Try not to touch any surfaces in the office you do not have to touch (you can push our door open with your foot! Try not to touch your face!)
  4. If you are trying on glasses, we will collect them from you for proper cleaning.
  5. Contact lenses can be shipped to you at no cost with an active rx (minimum 2 boxes)
  6. We will ask that if possible you come alone to the appointment. Guests can wait outside or in the car unless they need to be with you..
  7. If you have been exposed please wear a mask or reschedule in case you are an asymptomatic carrier, masks are encouraged to be worn by each patient if you have one.
  8. We will extend Contact lens prescriptions up to 6 months if recently expired and can direct ship an order to you if you see clearly and your eyes are feeling healthy.
  9. For a fee, we can ship your glasses to you if desired and you can have them adjusted after the shelter in place order is lifted.

Thank you for your patience and understanding during this stressful and trying time. May God bless each of you and keep you well.

Dr. Christopher K. Keats, OD

What is an Eye Emergency? Read more

Routine Care: “I see pretty well in my glasses or contact lenses. I just want to update my frame and / or get some new lenses to optimize my vision. I don’t have any pain or headaches and my eyes feel good and look normal in the mirror to me. I have never been told I have a disease in my eye that needs to be managed. I should definitely wait to come in until the “Shelter at Home” mandate is over. If I am a contact lens wearer, I understand Dr. Keats will allow me to get 3-6 months of contact lenses mailed to me even if my contact lenses are recently expired or close to expiring.”

Emergent Care: “I see poorly and am having difficulty functioning to drive, read, or see my computer. It is affecting my work. Waiting to be seen in 2 months would be very difficult for me to conduct my life.” Another form of emergent care… “I have other symptoms like headaches, red eyes, discharge, or I might have a disease that threatens my sight like diabetes, macular degeneration, glaucoma, a recent onset of flashes and floaters in my vision and so on.” A final type of emergent care would be a patient who realizes, “I am a patient who has a previously scheduled appointment for a medical condition Dr. Keats is managing to protect my sight, so I should plan on coming in for my visit. However, if my overall health is poor and the benefit to risk ratio says I should push this appointment off until the “Shelter at Home” mandate is lifted, it may be wise for me to reschedule for a later date.” In summary, emergent care means it is important that you be seen quickly for the protection of your visual health and current discomfort, or medical health, so you can function to do your work efficiently now and in the future.