An ocular migraine (also called a retinal migraine) is a rare type of migraine headache that causes visual symptoms in one of your eyes. The problem isn’t with your eyes; it’s a problem with the way your brain is processing visual signals from your eyes. You may be able to tell if you close your eyes. If you still have symptoms with your eyes closed, then the problem is likely coming from your brain, not your eyes.
Migraine visual aura vs. ocular migraine
People sometimes mistake an ocular migraine for migraine visual aura. Both cause similar symptoms, such as flashing lights and blind spots, but with migraine visual aura, you usually have visual disturbances in both eyes. With ocular migraine, you usually only have symptoms in one eye.
Talk to your doctor if you think you have ocular migraine. Any changes in your vision, even if only temporary, warrant a trip to the doctor. They will need to rule out other conditions that cause similar symptoms. Be ready to describe your symptoms and any patterns you notice to help them figure out what’s really going on.
Ocular Migraine Symptoms
An ocular migraine usually starts with vision symptoms in one of your eyes. These visual symptoms will generally last 5-60 minutes. Your visual symptoms may include:
Areas of lower or lost vision (also called scotoma) that may cause partial or total blindness in that eye
Seeing shimmering or twinkling lights
Seeing zigzag patterns
Seeing floating lines
These symptoms may increase over time. You may also have a headache at the same time, or your headache may start within an hour of your visual symptoms. Untreated, your headache may last between 4 and 72 hours.
Symptoms of migraine headache include:
Moderate-to-severe pain that’s pounding, throbbing, pulsing, or dull. The pain may also happen behind your affected eye.
Sensitivity to light, noise, and smells
Nausea and vomiting
Loss-of-appetite
Feeling very tired (fatigue)
Pale skin (pallor)
Sweating a lot or having chills
Ocular Migraine Causes
Experts aren’t sure exactly what causes ocular migraine, but they have some theories, including:
Spasms in the blood vessels in your retina that decrease blood flow in your optic nerves. Your retina is the light-sensitive layer of tissue at the back of your eye that converts images into electrical signals and sends them to your brain via the optic nerve.
Pressure on the neuron in your retina that spreads.
Possibly genetics because about 50% of people with ocular migraines have a family history of them.
It’s rare, but people who have these types of migraine may have a higher risk of permanent vision loss in one eye. Experts don’t know whether medications that prevent migraines — such as tricyclic antidepressants or anti-seizure medications — can help prevent that vision loss. But if you have ocular migraine, even if it goes away on its own, it’s a good idea to talk to your doctor about your symptoms.
Related:
Common Misdiagnoses of Migraine
Why am I Suddenly Getting Ocular Migraines?
In general, migraines are more common in women and people assigned female at birth (AFAB) than in men and those assigned male at birth (AMAB). It’s also most common in White people compared to Black people and people of Asian ancestry. And Black people tend to get them more often than people of Asian ancestry.
Children as young as 7 can get ocular migraine, but most people start getting them in 20s and have them until their 40s.
Migraine triggers include:
Stress
High blood pressure
High heat
Smoking
Alcohol
Caffeine
Birth control pills
Dehydration (not enough water in your system)
Low blood sugar
Ocular Migraine Diagnosis
There’s no test that can diagnose ocular migraine. Your doctor will need to rule out other primary headache disorders and conditions that may cause visual symptoms. They may refer you to an ophthalmologist to screen you for eye conditions before they diagnose you.
Your doctor will likely start by asking about your symptoms and your personal and family medical history. They’ll likely perform a physical exam to assess for other medical issues, such as a stroke that affects blood flow to one of your eyes.
Other conditions that could cause similar symptoms include:
Amaurosis fugax, temporary blindness due to a lack of blood flow to the eye. It can happen because of a blockage in an artery that leads to the eye.
Spasms in the artery that brings blood to the retina
Giant cell arteritis, a problem that causes inflammation in blood vessels. It can lead to vision problems and blindness.
Other blood vessel problems related to autoimmune diseases
Substance use disorder or overusing illicit drugs
Conditions that keep your blood from clotting normally, like sickle cell disease and polycythemia
Stroke or transient ischemic attack (TIA)