What is a migraine? Why migraine happens. Who gets migraines? Treating migraines.

Ocular Migraine

The word "migraine" brings to mind a severe headache. But there's a type of migraine that comes on as visual disturbances, with or without headache pain. People call these ocular migraines or eye headaches, but the medical profession calls them ophthalmic migraines. This type of migraine is thought to be related to changes in blood flow to the brain.

Migraines are produced by neurological responses to triggers such as chemicals in foods or medications, flashing lights, or hormonal changes. One migraine response is intense headache that may last for hours or days. However, at the time a migraine occurs, there may also be changes taking place in blood flow to the visual cortex or occipital lobes, areas of the brain responsible for vision. When that happens, an ophthalmic migraine occurs, producing visual symptoms independent of headache.

Those with ocular migraines may experience any of a number of visual disturbances.

Classic Signs

The classic sign of this condition is a small, expanding blind spot or scotoma in your central vision, along with bright, flickering lights (scintillations) or zigzag lines shimmering within the blind spot (metamorphopsia). As the blind spot expands, it travels across your visual field. The episode may last a few minutes, or take up to 45 minutes to resolve.

While ocular migraines do no harm, cause no pain or permanent damage, and require no treatment, you should consult your eye doctor if you have eye symptoms. Your doctor will want to rule out detached retinas and other conditions that require immediate treatment.

Your eye doctor will not have many answers for you in terms of treating the symptoms of ocular migraines and this is because the phenomenon is not related to the eyes but rather to migraine activity in the visual cortex of the brain. The exact mechanism of how migraine activity originating at the back of the skull, where the visual cortex is located, impacts on vision is not yet clear.

Don't Drive

Since your vision is compromised during an ocular migraine, you will want to avoid activities or work in which sharp vision is essential. If you're driving and an attack comes on, pull over and wait until the visual symptoms pass and your vision is once again clear. It helps to stay still and rest during an attack.

If ophthalmic migraines become more frequent or severe, consult your physician about treatment options. Some doctors believe that ophthalmic migraines are the result of narrowing capillaries which impede blood flow, making blood thinning drugs a choice method of treatment. A long-term course of aspirin or clopidogrel (Plavix) may be indicated to prevent a recurrence of your symptoms.

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