Ophthalmic (eye) migraines are quite common and often painless, although the solo term “migraine” usually brings to mind a severe type of headache.
But with eye-related migraines, visual disturbances with or without headache pain also can accompany migraine processes thought to be related to changes in blood flow in the brain.
These visual problems associated with migraines technically are known as ophthalmic migraines, but are much more commonly (though incorrectly) called ocular migraines. Because most laypeople understand the term better, this article refers to the condition as “ocular migraine.”
Migraines can be produced by the body’s neurological responses to certain triggers such as hormonal changes, flashing lights or chemicals in foods or medications. One result of these triggers may be an intense headache that, if untreated, can last for hours or even days.
During migraine processes, changes also may take place in blood flow to the area of the brain responsible for vision (visual cortex or occipital lobe). Resulting ophthalmic or ocular migraines commonly can produce visual symptoms even without a headache.
Ocular Migraine Symptoms
People with ocular migraines can have a variety of visual symptoms. Typically you will see a small, enlarging blind spot (scotoma) in your central vision with bright, flickering lights (scintillations) or a shimmering zig-zag line (metamorphopsia) inside the blind spot. The blind spot usually enlarges and may move across your field of vision. This entire migraine phenomenon may end in only a few minutes, but usually lasts as long as about 20-30 minutes.
Generally, ocular migraines are considered harmless. Usually they are painless, cause no permanent visual or brain damage and do not require treatment.
Still, always consult your eye doctor when you have unusual vision symptoms, because it’s possible that you have another condition requiring treatment, such as a detached retina, which should be checked out immediately.
What Should I Do if I Have an Ocular Migraine?
Unfortunately, a visit to the eye doctor may produce few answers in terms of how to treat or prevent ocular migraines. This is because processes that trigger ophthalmic migraines are poorly understood.
The vision symptoms accompanying painless ocular migraines are not related directly to the eyes. Instead, these visual symptoms occur as a result of the migraine “activity” in the visual cortex of the brain located in the back of the skull.
Painless ocular migraines can appear suddenly, creating the sensation of looking through a cracked window. The accompanying visual distortion spreads across the field of vision and usually disappears within about 20 minutes.
As described above, your vision and visual acuity will be affected significantly during an ophthalmic migraine attack or episode.
If sharp vision is essential for your safety, then you should stop what you are doing immediately. If you are driving, pull over until the ocular migraine passes and your vision has cleared.
Stay still until the ocular migraine resolves. If you have concerns about unusual or lingering vision symptoms, visit your eye doctor or other physician for a checkup.
Ocular Migraine Treatments
Normally, ophthalmic migraines do not require treatment.
But if these symptoms recur regularly or with increasing frequency, then you may need medication to reduce the frequency and/or severity of attacks, so consult your doctor. You may need to take these medications for extended periods of time to prevent recurrence of ophthalmic migraines.
