What is an ocular migraine? Is it a sign of something serious?
Answer From Narayan Kissoon, MD
The term "ocular migraine" can be confusing. Headache specialists don't use this term anymore. In the past, it generally meant a migraine that was accompanied by changes in vision. But the term is often used interchangeably to refer to two different conditions: migraine with aura, which usually isn't serious, and retinal migraine, which could signal something serious.
Most commonly the term "ocular migraine" had been used to describe what is now called migraine with aura. Retinal migraine is extremely rare, and the visual changes are in only one eye. When visual changes are only in one eye, they could signal something serious and require immediate treatment.
Migraine aura affecting your vision
Migraine aura is a wave of activity in the brain traveling through the brain. The location of the wave of activity in the brain determines the type of aura. The most common type of aura is a visual aura. About 90% of people who have migraine with aura have this type. It's thought that auras are usually visual because such a large portion of the brain processes visual information.
If the wave of activity goes through other areas of the brain such as the sensory or language centers, then the person would have sensory (for example, tingling in the tongue, face or arm) or language auras. The auras usually last for about five minutes to an hour. Aura can sometimes occur without a headache.
A migraine aura that affects your vision is common. Visual symptoms don't last long. A migraine aura involving your vision will affect both eyes, and you may see:
- Flashes of light
- Zigzagging patterns
- Blind spots
- Shimmering spots or stars
These symptoms can temporarily get in the way of certain activities, such as reading or driving. But migraine with aura isn't usually considered serious.
Ocular migraine sometimes is used as a synonym for the medical term "retinal migraine." A retinal migraine is a rare condition occurring in a person who has experienced other symptoms of migraine. Retinal migraine involves repeated bouts of short-lasting diminished vision or blindness. These bouts may precede or accompany a headache.
A retinal migraine — unlike a migraine aura — affects only one eye, not both. But usually, loss of vision in one eye isn't related to migraine. It's generally caused by some other, more serious condition. So if you experience visual loss in one eye, be sure to see a health care provider right away for prompt treatment.
If you have visual symptoms that have not previously been evaluated by a health care provider, you should see a provider if you have any of the following:
- Visual changes in only one eye
- Visual changes that last less than five minutes and more than 60 minutes
- Visual changes without a headache
- New headaches or changes in vision
- Onset of headaches or changes in vision later in life (after the age of 50)
- New weakness on one side of the body or speech changes
These symptoms would suggest a more serious cause of your visual symptoms, and you should see a provider right away. Any new changes in vision also should be checked by your provider.
Sept. 29, 2022
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See more Expert Answers
- Cutrer MF, et al. Pathophysiology, clinical manifestations, and diagnosis of migraine in adults. https://www.uptodate.com/contents/search. Accessed July 19, 2022.
- Kissoon NR (expert opinion). Mayo Clinic. July 20, 2022.
- Aminoff MJ, et al. Headache & facial pain. In: Clinical Neurology. 10th ed. McGraw-Hill; 2015. https://www.ovid.com/site/index.jsp. Accessed Accessed July 5, 2017.
- Ropper AH, et al. Headache and other craniofacial pain. In: Adams & Victor's Principles of Neurology. 10th ed. McGraw-Hill; 2018. https://accessmedicine.mhmedical.com. Accessed July 19, 2022.
- Jogi V, et al. More clinical observations on migraine associated with monocular visual symptoms in an Indian population. Annals of Indian Academy of Neurology. 2016; doi:10.4103/0972-2327.168628.
- Kissoon NR, et al. Aura and other neurologic dysfunction in or with migraine. Headache. 2017; doi:10.1111/head.13101.