Retinal (Ocular) Migraine Symptoms, Diagnosis and Treatment

Woman holding her head
IAN HOOTON/Getty Images

Retinal migraine — sometimes also called ocular migraine — is a migraine attack that includes sparkles or flashes of light, partial loss of vision, and even temporary blindness, but only in one eye. The condition is considered rare, although some researchers believe it may be underdiagnosed.

There's often confusion surrounding the term "retinal migraine" — it's frequently (erroneously) used to describe any migraine that includes an aura or other symptoms involving vision, or a migraine with aura without a headache phase.

I've even heard some physicians misuse the term.

However, to have a true retinal or ocular migraine, you must have specific symptoms (sparkles, flashes, partial blindness or complete blindness in one eye only), and you also must get a headache with the migraine attack. Retinal migraine is most common in women under the age of 45.

Some researchers believe retinal migraines result from spasms in the tiny blood vessels serving your retina. Sometimes, a retinal migraine can cause permanent damage to the vision in the affected eye.

Retinal Migraine Symptoms

If you suffer a true retinal migraine, your migraine attack will begin with the visual disturbances I described above. As I said, these will be based only in one eye.

Your migraine headache will come within 60 minutes of these visual disturbances, and can last between four hours and 72 hours. As with most migraines, the headache usually affects only one side of your head, may feel as if it's pulsing, and will be moderate to severe.

Your pain will be worse during physical activity, and exercise actually can trigger the attack. You'll also suffer at least one of the following: nausea and/or vomiting, sensitivity to light or sensitivity to sound.

Diagnosis, Treatment and Associated Conditions

People who get retinal or ocular migraines usually have a history of other migraine disorders.

The condition may be associated with the autoimmune disease systemic lupus erythematosus, with a rare disease called antiphospholipid syndrome, or with several other rare disorders.

Unfortunately, there aren't any diagnostic tests that can be used to confirm your doctor's diagnosis of retinal or ocular migraine. Your doctor will diagnose you by taking a detailed medical history, discussing your symptoms and examining you.

It's important to rule out other potential causes of transient blindness, which include transient ischaemic attacks — so-called "mini-strokes."

If your doctor does decide you have retinal or ocular migraine, you'll likely discuss whether you need medication to prevent attacks, stop attacks or manage symptoms. The drugs used to treat retinal migraines are the same as the drugs normally used to treat other types of migraine disorder: non-steroidal anti-inflammatory drugs, anti-nausea medications, ergotamines or triptans.

People who get frequent retinal or ocular migraine attacks may want to consider preventive medications.

However, it's not clear whether preventive medications will help you avoid permanent vision loss due to your condition.

Sources:

Doyle E et al. Retinal migraine: caught in the act. British Journal of Ophthalmology. 2004 Feb; 88(2): 301–302.

Grosberg BM et al. Retinal migraine. Current Pain and Headache Reports. 2005 Aug;9(4):268-71.

The International Classification of Headache Disorders, 2nd Edition. Cephalalgia 24 (s1).

Lord RS. Transient monocular blindness. Australian and New Zealand Journal of Ophthalmology. 1990 Aug;18(3):299-305.

Continue Reading