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Ocular migraine refers to repeated attacks of transient one-sided vision disturbance or blindness that is associated with minimal or no headache.
The definitive reason behind ocular migraines is not well understood. The condition results due to changes in the blood vessels or nerves that supply the eyes. This may occur due to a combination of genetic factors, lifestyle, and environmental conditions.
If you are suddenly getting ocular migraines, you must consult with your doctor to rule out any serious cause and prevent permanent vision loss.
Risk factors for ocular migraines
Ocular migraines are generally more common in women and the age group of 30 to 39 years.
Certain factors may trigger frequent ocular migraine attacks in susceptible individuals, which include:
- Too much sleep or sleep deprivation
- Bright lights
- Emotional stress
- Skipping meals
- High blood pressure
- Weather changes such as hot weather
- High altitude
- Certain movements such as bending over
- Hormonal changes in women
- Strong odors
- Strenuous physical activity
- Alcohol, particularly red wine
- Smoking
- Straining at stools
- Sexual intercourse
- Dehydration
- Hormonal birth control pills
Can food trigger migraines?
Certain foods are known to trigger different types of migraine headaches. Studies, however, report that they are less likely to trigger ocular migraines.
Foods that may trigger migraines include:
- Soy products
- Baked goods
- Yogurt
- Kefir
- Vinegar
- Tomatoes
- Onions
- Olives
- Nuts and nut butter
- Aged cheese
- Artificial sweeteners
- Caffeine
- Foods containing monosodium glutamate
What is an ocular migraine?
Ocular migraine, also called an ophthalmic migraine or a retinal migraine, refers to repeated attacks of transient (lasting from a few minutes to an hour) one-sided (unilateral) vision disturbance, or blindness that is associated with minimal or no headache.
Research suggests that ocular migraines may occur due to transient spasm (narrowing) of the arteries supplying blood to the eye tissues (choroidal or retinal arteries). The affected person often gives a history of migraines to one or more blood relatives.
Are ocular migraines serious?
Symptoms of ocular migraines are generally described as gradual vision disturbances that may begin as blind spots (scotomas) in the field of vision and slowly enlarge, leading to total unilateral vision loss. In some people, repeated attacks may lead to a permanent loss of vision.
The term ocular migraine is sometimes used for vision changes during a migraine aura. These vision changes, unlike true ocular migraine, are generally not serious and affect both the eyes (bilateral). They may include symptoms such as flashes of light, zigzag lines, shimmering spots, or blind spots in the field of vision. These symptoms precede a migraine headache and may be accompanied by other symptoms such as numbness, tingling, weakness, nausea, vomiting, and intolerance to lights and sounds.
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How is ocular migraine diagnosed?
The diagnosis of ocular migraine is done by the doctor based on the following:
- Medical history: The doctor will take a detailed medical history about the onset of symptoms, whether loss of vision occurred in one or both the eyes, family history of migraines, and personal history of underlying health conditions such as high blood pressure. The vision loss may or may not be accompanied by a headache.
- Physical examination: The doctor will perform a detailed physical examination and may refer you to an ophthalmologist (eye specialist) to examine the health of the retina and blood vessels in the eyes.
- Investigations: The doctor may recommend certain investigations to assess the general health of the person and confirm the diagnosis and rule out other conditions that may mimic ocular migraine. These investigations mainly include:
- Blood investigations such as blood counts, erythrocyte sedimentation rate, and coagulation tests
- Carotid duplex ultrasonography
- Transcranial Doppler ultrasonography
- Magnetic resonance angiography
- Computed tomography angiography of the brain
- Fluorescein or cerebral angiography