Migraines are one of the most feared forms of headaches as they can interfere, to a great extent, in one’s everyday life and work. Migraine is a severe form of headache that tends to affect one side of the head and brings life to a stand still because of the excruciating pain and the associated disturbing symptoms. Sometimes, Migraines are associated with sensory disturbances, called ‘auras’, most of which are visual disturbances, the duration of which may vary from a few minutes to few hours.
Ocular migraines are those which affect the eye and may not necessarily be accompanied by headaches, but are no less severe. It is also known by other names such as Visual Migraine and Ophthalmic Migraine. Ocular migraines are not very common. They cause visual disturbances for short periods of time, but sometimes can extend for up to an hour, resulting in temporary loss of sight. Ocular migraines are different from aura experienced during migraines in the fact that ocular migraines tend to affect only one eye, whereas migraines auras affect both the eyes.
Causes of Ocular Migraines
This type of migraine is caused due the constriction of the blood vessels that supply to the eye. As a result of the constriction, the blood supply to the eye is reduced or cut off and the muscles around the eye weaken, which results in the temporary disturbances and loss of vision experienced.
Some factors may act as triggers that aggravate the intensity and duration of the distress. Factors that trigger normal migraine are responsible for aggravating ocular migraine as well. This list of triggers include excessive stress, alcohol consumption, hormonal imbalances, oral contraceptive use as well as premenstrual changes in the case of women. Certain food stuff such as red wine, caffeine, heavy meat and chocolate are also believed to play a part in triggering the initiation of the symptoms.
Excessive strain to the eye may also be an important factor resulting in the visual disturbances related to ocular migraines. Excessive television watching, working near flickering and blinding lights as well as long hours in front of the computer effectively contribute to causing stress and strain to the muscles that hold the eyes in place.
Family and heredity are important links as ocular migraines may run in families and the patient’s family history should be considered while diagnosing the problem.
Signs and Symptoms of Ocular Migraine
A range of visual symptoms are presented by patients suffering from ocular migraines. It is very rare that persons suffer irreversible and permanent damage due to migraine attack. Usually, they are painless and there is complete restoration of vision after the attack bout is over.
- As mentioned earlier, Ocular Migraines tend to affect only one eye.
- Localized pain experienced around the affected eye
- Temporary loss of vision in the affected eye is common and this loss of vision is total and complete for the affected duration
- Sensitivity to light is not uncommon. The person experiences peripheral sight disturbances. Dizziness and confusion also accompany the other symptoms of Ocular Migraines
- Sometimes, when there is no complete loss of vision, other visual disturbances such as perception of flashes of bright light streaks, blurring, dimming as well as partial loss of vision are experienced
- Ocular migraines last for very short durations. Visual disturbance and the related effects are experienced for as short as five to ten minutes. On few occasions, however, they may last up to 20 or 30 minutes, but mostly the symptoms present themselves for durations less than an hour
- Mostly ocular migraines are not associated with headaches, but in some cases, when the headache appears, it appears on the same side as the affected eye and is usually throbbing pain that is experienced
- Nausea is most often accompanies the other symptoms of ocular migraine
Ocular Migraines and Scintillating Scotomas – The Difference
Ocular migraine is most often confused with another condition of the brain called Cortical Spreading Depression affecting the visual cortex. This is the one that causes auras during a migraine attack, the most common of which is the Scintillating Scotoma. Scintillating Scotomas also may occur without a headache.
Ocular Migraines originate in the socket of the eyes or the eyeballs, whereas, Scintillating Scotoma is due to abnormalities at the back of the brain, in a region known as the occipital cortex, and are nowhere related to the eye or the associated structures. Scintillating Scotomas tend to affect both the eyes, whereas, this is not the case in ocular migraines.
Ocular Migraines and Auras Related to Migraines
Migraine auras are a part of the process of progression in a migraine attack. Auras are usually temporary sensory deprivations as well as abnormalities, usually visual disturbances, that worsen the effect of the migraine. Auras are usually followed by headaches, as the progression of migraine is usually is in a pre set sequence. Ocular Migraines and migraine auras can be confused, but differ in a few respects.
- A migraine aura may last for a period ranging from a few minutes to a few hours and sometimes the effects may last up to 24 hours. Ocular Migraines occur for shorter duration, usually for around five minutes and the maximum duration being less than a hour.
- Migraine auras are necessarily followed by migraine headache, whereas, Ocular Migraines need not necessarily be accompanied by headache. It may present itself just as visual disturbances and need not be accompanied by headache. Headaches also present themselves, sometimes, along with the other symptoms of Ocular Migraines.
- Migraine auras are a result of electrical activity in the brain whereas Ocular Migraines are mainly caused due to the constriction of blood vessels supplying to the eyes as well as the associated muscular spasms.
Diagnosing Ocular Migraines
It is essential that you accord paramount importance to the existing condition and consult the doctor to get the doubts cleared and fix the problems. The symptoms should be accurately described to the doctor for effective diagnosis.
Usually, ocular migraines are not life threatening or chronic. It results only in temporary disturbances and are usually not taken too seriously. However, to rule out any serious underlying condition that might be the core reason behind such attacks, the doctor might require certain specific tests to be done to eliminate any permanent damage that might be caused to the eye.
Managing Ocular Migraines
When a person is diagnosed with ocular migraine, the most effective prophylactic measure would be to reduce the triggers that give rise to the condition. Stress management is key as stress is one of the most important triggers of ocular migraine. Adequate rest and proper sleep habits help in reducing the attack’s frequency as well as the intensity. Food stuff that trigger the condition may also be avoided to minimize the frequency of the bouts.
Treatment Options
Ocular migraines are simple to treat as the pain, if present, responds to normal over the counter analgesics such a Aspirin and Ibuprofen. Extra cranial Vasoconstrictors are also used to treat the symptoms.
It can be managed without any medical intervention as the condition is rather harmless and in most cases does not require any invasive procedures. Calcium channel blockers are the most preferred treatment option as they relax the blood vessels. Quick acting analgesics usually do the trick. Triptans are not preferred as they act rather slowly and sometimes may lead to further constriction of the blood vessels. However, it is essential that you consult a doctor and get the condition diagnosed in a proper manner.
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