Ocular Migraine

What is Ocular Migraine?

An ocular migraine causes visual disturbances such as blind spot, wavy lines, or zig-zag lines in the visual field along with vision loss for less than an hour. It’s a type of a migraine that affects the Ocular region and visual acuity.

It is a momentary visual disorder that makes a sensation of peeping out from a cracked window during the daytime. This disturbance attributes to both the eyes in many cases. The disturbances last for about 20-30 minutes and do not need any medical intervention.

Other Names

  • Ophthalmia migraine
  • Retinal migraine
  • Visual migraine
  • Optical migraine
  • Visual aura

As per the data released by WHO (World Health Organization), about 70% people suffering from an Ocular migraine have a genetic reason as the cause. The subtypes include a Migraine with aura and Migraine without aura.

The accurate existing condition of OM is not known yet. However, WHO projects that about 6% of men and 15-18% of women in the U.S are suffering from migraine headaches. As a matter of fact, women are more prone than men. It generally occurs to people below 40 years of age, having depression and sickle cell disease or a family history of migraine headaches.

Causes

Experts believe factors responsible for usual migraines can also result in an Ocular migraine. However, the exact cause is still unknown, but some factors are:

Changes or modifications in nerve cells

The chemical or physical transformations in nerve cells present in retina cause a migraine.

Spasms

They are muscular jerking movements caused due to stress, excessive medication or unhealthy lifestyle. Their presence in blood capillaries of the retina gives rise to this disorder. Spasms restrict the supply of blood from the ocular blood vessels to that part of the brain that regulates vision.

Other Causes

  • Cortical spreading depression
  • Genetic linkage of a migraine
  • Stress
  • Consumption of excessive alcohol or caffeine
  • Migraine
  • Food additives (monosodium glutamate, and artificial sweeteners)
  • Chocolate
  • Smoked meat
  • Red wine
  • Aged cheese
  • Smoke
  • Bright light
  • Loud sound
  • Hormonal misbalance
  • Anxiety
  • Foods containing nitrate

Symptoms

  • Headaches: One-sided pain is a common feature of a headache in context of a migraine. The headaches could remain for a few hours or few minutes initially. But in severe conditions, it lasts for days with a sensation of throbbing pain.
  • Scotoma: It is a small blind spot in the focus vision, i.e., the center of vision. When a person experiences small blind spot that gets enlarged gradually, he/she is in the doubt list of sufferers.
  • Migraine with aura: When the patients experience blind spots and flashing lights visually (aura) along with the symptoms of a migraine, the condition is called Migraine with aura. In such cases, one-sided vision loss occurs.

Other symptoms of OM

  • Sensitive to Sound
  • Tingling or face in hand
  • Vomiting and nausea
  • Sensitive to light
  • Euphoria
  • Seeing shimmering spots
  • Prodrome (It rarely occurs before a week of a migraine It’s a feeling of tiredness, changes in mood and cravings for certain food)
  • A cluster headache (pain in one side of the brain)

Phases of Ocular Migraine

The Premonitory Phase

Also called prodrome or preheadache phase, it is the first stage indicating a retinal migraine so one could be aware of own body changes. The signs are:

  • Food cravings
  • Constipation
  • Increased recurrence of urination
  • Yawning
  • Mood changes like depression, irritation, etc.
  • Tiredness
  • Unusual Sensitivity

The Aura Phase

Different symptoms of this stage are:

  • Seeing sparkles or zig-zag lights in the visual field which move constantly
  • Tingling which migrates from one face to one arm or vice versa
  • It gives rise to speech or language difficulties

The Headache Phase

This phase is characterized by:

  • A headache on any side of the brain at a time. It may be unilateral or bilateral
  • A headache normally persists for 4 to 72 hours.
  • In children, it lasts for a maximum of two hours.
  • Nausea

It develops Phonophobia (sensitive to sound), Photophobia (sensitive to light), Osmophobia(sensitive to odors).

The Postdrome Phase

The symptoms are:

  • Feeling of hang-over
  • Lower concentration
  • Tiredness
  • Depression
  • Anger and irritation

Diagnosis

  • Doctors perform physical examinations
  • Check up of eye’s blood vessels
  • Spasms present in vessels or any artery  gets diagnosed
  • Analysis of symptoms and vision problems
  • Evaluation of drug abuse habits

Differential Diagnosis of an Ocular Migraine

Differential diagnosis helps to differentiate between Ocular migraine’s condition and other similar conditions. Some of them are:

  • Arterial spasms: Denotes the spasms present in the artery that transports blood to the retina.
  • Amaurosis Fugax: Condition of temporary blindness due to inadequate flow of blood to the eye.
  • Giant cell arteritis: Inflammation in arteries (blood vessel) around scalp or in the head that causes difficulties in vision and sometimes blindness. It is also called temporal arteritis.
  • Blood vessel complications: Differential diagnosis evaluates the other factors linked with blood vessel complications. The Blood clotting, Drug abuse, Pituitary tumor, Polycythemia and sickle cell anemia, Stroke and Detached retina are some examples.

Treatment & Prevention

Simply avoid Ocular migraine’s triggers or stimulators. Consequently, it will give a relaxed feeling because OM lasts for a maximum of thirty minutes. But to counter an aura migraine, there are few prescribed medications and remedies including:

  • Ibuprofen or Excedrin
  • Beta-blockers (to relax the blood vessels)
  • Antidepressants (to control a migraine)
  • Calcium channel blockers (to prevent the blood vessels from contraction/constriction)
  • Antiepileptic or tricyclic medications
  • Cognitive behavioral therapy
  • Non-steroidal anti-inflammatory drug (NSAID)
  • Migraine Nasal spray

On a personal level, an individual can try to control an aura migraine by:

  • Taking care of proper healthy diet
  • Consulting a dietician or physician to prepare a diet chart
  • Avoiding the possible triggers
  • Practicing Yoga and exercises to reduce the stress
  • Avoiding the stress and tension
  • Getting required amount of sleep
  • Massage on a regular basis
  • Controlling obesity
  • In case of having an episode of attack, stop driving

When to contact the doctor?

OM stroke is very similar to other kinds of migraines, seizures, silent migraines and transient ischemic attack. Therefore, assessment by a specialist is required. Whenever one feels depressed, anxious, suffer from a headache, and unusual vision disturbances, he/she should consult the doctor immediately. An ocular migraine is a common genetic and neurological disease which is curable by proper prevention at the initial level backed by consistent treatment.

References

 

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