Ocular Migraines
Ocular Migraines

Author - Samantha Camilleri (Optometrist)  

How do I know if I’m having an Ocular Migraine? What causes migraines? 

OCULAR migraines are caused by reduced blood flow or spasms of blood vessels in the retina or behind the eye. It is a rare occurrence and is often confused with the more common VISUAL migraine (a.k.a. migraine with aura) or a HEADACHE which can be a symptom of a different issue. 

Am I having an OCULAR migraine or a VISUAL migraine? 

One can differentiate between an OCULAR (rare) and VISUAL (more common) migraine by the effects or symptoms they have on vision. 

An OCULAR migraine is characterized by temporary vision loss in ONE eye. The small blind spot generally affects central vision and gets larger, making it impossible to do things such as drive safely read. 

A VISUAL migraine may cause any of the following visual problems to BOTH eyes:  

  1. A flickering blind spot ( either central or paracentral)  

  2. A zigzag pattern of coloured light surrounding a central blind spot: "looking through a cracked window" 

  3. A migrating blind spot that slowly moves across the visual field 

The disturbances caused by any migraine will typically resolve after 1 hour. 

Am I having an OCULAR MIGRAINE or am I having a different HEADACHE? 

The difference is that an ocular migraine is the ILLNESS, whilst a headache is a SYMPTOM for something else. Headaches can be indicators for more serious issues (this may also include headache behind eyes).  Hence, it is important to know the difference. 

The next time you believe you are having an ocular migraine, ask yourself the following questions to determine the migraine symptoms: 

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1. Is the pain one sided or on both sides of my head? 

Migraines are always ONE SIDED; any visual effects will only be to one eye (this may include blurry vision in one eye).

2. What kind of pain am I feeling?

Migraines are typically a THROBBING sensation rather than a dull ache. 

3. How long does my headache last? 

Ocular migraines will cause headache symptoms during or after (within 60 minutes) of visual disturbances and  attacks lasting 4-72 hours. 

4. Are there any other associated symptoms?

Ocular migraine is accompanied by at least one of the following: 

Nausea/vomiting, photophobia/phonophobia. 

If the nature of your headache does not sound like a typical visual migraine or ocular migraine, it is important to have it checked with your optometrist or primary health physician to rule out a more serious cause. 

Treatment and Prevention of Ocular Migraines:

You may try to abort the event by the use of nonsteroidal anti-inflammatory drugs (NSAIDs), (ask your doctor for recommendations).

Identifying and avoiding triggers is another method of preventing subsequent migraines. Ocular and visual migraines have common “triggers” that can cause an attack. 

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Great Tip:

Keep a headache journal; this is a helpful tool to help you and your optometrist accurately diagnose an ocular migraine against a more serious headache. Keep a record of the following characteristics

- Time of headache

- Location of headache e.g. frontal, back of neck

- Duration of headache

- Foods, stress or other triggers associated with headache

- Type of pain: dull vs stabbing

- Other symptoms e.g. nausea

For other questions regarding ocular migraines, or if your migraines increase in frequency / intensity,  please consult your optometrist or healthcare professional.

By Samantha Camilleri 

Optometrist at 1001 Optical 

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