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All About Ocular Migraine: An Optometrist’s Perspective

by | Aug 1, 2022 | Manuscripts | 0 comments

Kheyali Mondal, B.Optom

Fellow Optometrist, Dr. Shroff’s Charity Eye Hospital

 

Overview

Ocular migraine is a temporary or permanent monocular visual disturbance accompanying a migraine attack or with a history of migraine episode or without any history of several migraine attacks. (1) Ocular migraine generally occurs in both eyes.

Stages of Ocular migraine

It is difficult to say when ocular migraine is going to happen but there are patterns of ocular migraine that help to differentiate it from other types of migraine. (2)

The episode of ocular migraine typically begins with a small scotoma near the fixation area which gradually increases towards the peripheral vision and then breaks up. (3)

Figure 1: Stage of Ocular Migraine (3)

Total cycle of ocular migraine lasts around 30 minutes to one hour. An episode of visual eclipse needs proper evaluation of other conditions such as “Mini stroke” or “Transient Ischemic Attack” (TIA). (3)

What causes ocular migraine

The exact reason for ocular migraine is unknown. However, some theories state that spasms of the blood vessels in the retina cause a temporary lack of blood flow to the eye and induce symptoms. (4)

  1. Genetics play an important role in the case of migraine. Researchers suspect that a family history of migraine increases a person’s chances of having migraine.
  2. Hormonal changes in females may also lead to several episodes of migraine: due to the fluctuations of oestrogen levels during the menstrual cycle, pregnancy & menopause.

Common migraine triggers (5)

  • Bright/Poor illumination and Long screen time.
  • Loud noises, Strong fragrance, and Excessive heat or High altitude.
  • Alcohol and Caffeinated drinks consumption.
  • Food additives like MSG (Monosodium Glutamate) and Tyramine, Nitrates, etc.
  • Stress, Depression, Lack of sleep, and Anxiety.

Cope up with Ocular Migraine

As stated already, visual disturbances due to Ocular Migraine typically disappear within one hour or less without seeking any treatment. Although, if you are facing visual disturbances daily, you should seek consultation with your Eye consultant.

Tips to reduce the risk of severe ocular migraine (5,6)

 

References

1) https://www.uptodate.com/contents/pathophysiology-clinical-manifestations-and-diagnosis-of-migraine-in-adults. Accessed on July 2, 2017.
2) Lauritzen, M. (1994). Pathophysiology of the migraine aura: the spreading depression theory. Brain, 117(1), 199-210.
3) Arunagiri, G., & Santhi, S. (2003). Migraine: an ophthalmologist’s perspective. Current opinion in ophthalmology, 14(6), 344-352.
4) Al Khalili, Y., Jain, S., & King, K. C. (2021). Retinal migraine headache. In StatPearls [Internet]. StatPearls Publishing.
5) Puledda, F., & Shields, K. (2018). Non-pharmacological approaches for migraine. Neurotherapeutics, 15(2), 336-345.
6) Silberstein, S. D. (2008). Treatment recommendations for migraine. Nature Clinical Practice Neurology, 4(9), 482-489.

 

 

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