What is an ocular migraine? Is it a sign of something serious?

Answer From Narayan Kissoon, MD

The term “ocular migraine” can be confusing. Headache specialists don’t use this term anymore, but it has been used to describe migraines that occur with changes in vision. The term often is used to refer to two different conditions that cause visual changes: Migraine with aura and retinal migraine.

Most commonly, when people use the term “ocular migraine” today, they use it to describe what is now called migraine with aura. A migraine with aura can affect vision for a short time. It usually isn’t serious.

Sometimes people use the term “ocular migraine” to refer to a retinal migraine. This type of migraine is very rare and causes visual changes in one eye. When visual changes are only in one eye, they could signal something serious and may need treatment right away.

Migraine with aura

During a migraine with aura, a wave of electrical or chemical activity moves across the brain. Symptoms depend on the area of the brain where the activity occurs. The most common type of aura is a visual aura. About 9 in 10 people who have migraines with aura have this type. It’s thought that auras are usually visual because such a large portion of the brain processes visual information.

A migraine aura involving your vision affects both eyes. Visual symptoms don’t last long. You may see:

  • Flashes of light.
  • Zigzagging patterns.
  • Blind spots.
  • Shimmering spots or stars.

These symptoms can get in the way of certain activities, such as reading or driving. But a migraine with aura isn’t usually serious.

If the wave of activity goes through the sensory or language centers of the brain, a sensory or language aura occurs. Symptoms of a sensory aura include tingling in the tongue, face or arm. Symptoms of a language aura may include trouble speaking, slurred or slowed speech, or not being able to understand speech.

A migraine aura usually lasts for about five minutes to an hour. An aura can sometimes happen without a headache.

Retinal migraine

A retinal migraine is a rare condition that usually affects people who also have other symptoms of migraine. Retinal migraine involves repeated bouts of short-lasting partial vision loss, such as blind spots. These bouts may happen before or during the headache.

A retinal migraine — unlike a migraine with aura — affects only one eye, not both. But usually vision changes that affect only one eye aren’t related to a retinal migraine. Vision changes in one eye can be caused by more-serious conditions that need treatment.

See a healthcare professional right away if you have visual symptoms that haven’t been looked at before, such as:

  • Visual changes in only one eye.
  • Visual changes that last less than five minutes or more than 60 minutes.
  • Visual changes without a headache.
  • New headaches or new visual changes.
  • Headaches or visual changes that begin after age 50.
  • New weakness on one side of the body or speech changes.

These symptoms may suggest a more serious cause of your visual symptoms and need medical attention.

 

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