Ocular Migraines

A 51 year-old woman presents to the emergency room fearing she is having either a stroke or a retinal detachment.
She states while working on her computer that morning she noted the onset of jagged flashing lights in her peripheral vision.
It lasted about 20 minutes then slowly faded back to normal. She has had a slight headache since.


What are ocular migraines?

Ocular migraines (also called ophthalmic, visual, or eye migraines) are temporary distortions in the vision of one or both eyes. They can precede a migraine headache or occur without a headache at all.

What are symptoms of ocular migraines?

Most people describe a bright, flickering zig-zag pattern of distorted vision, usually off to the side of the central vision, typically in both eyes, and visible with the eyes open or closed. The area may intensify and migrate prior to it fading away. Other times, there may be a blind spot that slowly enlarges before disappearing. The symptoms generally resolve in 10-30 minutes, and may or may not be associated with a headache.

What causes ocular migraines?

The mechanisms of ocular migraines and migraine headaches are not fully understood. In general, migraines likely involve alterations of blood flow to certain regions of the brain. In the case of ocular migraines, the involved area is the vision center of the brain. Ocular migraines are often triggered by bright or flickering lights (such as a computer screen or sunlight through a window), or even by certain foods (strong cheeses, red wine, chocolate, peanuts among others).

Are ocular migraines dangerous?

No. Ocular migraines will not cause damage to your vision. They are not a sign of any type of serious disease. They do not require treatment, but medications used to treat migraine headaches can be used if the symptoms are frequent or associated with severe headaches.

What symptoms would indicate a more serious disease?

“Mini-strokes” or “TIAs” typically involve total darkness of either the top half, bottom half, or entire vision of one eye for a few minutes. These symptoms usually indicate a blockage of blood flow to the eye by some sort of clot. Retinal tears, detachments, or floaters are often accompanied by a brief (<1-2 second) flash of light in the outer peripheral vision of one eye. The flash occurs sporadically, and often in the dark. If symptoms such as these occur you should be examined right away by an eye care specialist.