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What is a Retinal Migraine?

Though they fall under the same general umbrella, there are several different kinds of migraines. One of those is called a retinal migraine (also known as an ocular migraine) that causes temporary vision loss. It is sometimes accompanied by the pulsating headache that migraines are known for and typically only lasts for a short period of time. While this medical problem affects both men and women, it occurs more often in young women with a history of migraine headaches.

This condition is often confused with another visual disorder called cortical spreading depression which affects the visual cortex. The primary difference between this disease and a retinal migraine is cortical spreading depression is the result of hyperactivity in the brain, while an ocular migraine occurs because of a vascular spasm or infarct inside or behind the eye.

Symptoms of a Retinal Migraine

In the medical community, retinal migraines are considered rare, affecting only 1 out of every 200 people who suffer from migraines. However, this may be because many people attribute the cause of vision loss to other medical disorders. Since the condition is transient, the person may not seek treatment unless it severely impacts his or her quality of life. Unfortunately, failure to treat the condition properly can result in permanent vision loss in the affected eye.

The primary symptom of retinal migraines is vision loss in one eye for less than an hour. This may be accompanied by a throbbing headache on the same side of the head as the affected eye. The person may also experience severe sensitivity to light and feel nauseous. Other symptoms include:

  • Dark spots or patterns in visual field
  • Seeing flashing lights, bright-colored streaks, diagonal lines, or zigzag lightening patterns
  • Vomiting
  • Sensitivity to light and sound
  • Headache that lasts from 4 to 72 hours

To be considered a retinal migraine, the condition must have occurred at least 2 times. While the intense headache can start during or up to an hour after the vision loss, it is important to note that retinal migraines can occur without head pain. The absence of a migraine headache does not automatically rule out an ocular migraine diagnosis.

Treatment Options

Treatment for retinal migraines begins with ruling out other possible causes of the vision loss such as detached retina, tumor, or stroke. Once a positive diagnosis is made, the doctor will work on identifying the trigger for them. Like most migraines, this condition can be triggered by a number of internal and environmental factors including stress, food sensitivities, exercise, hormonal imbalances, and other issues.

The doctor will usually address the underlying cause of the ocular migraine first (e.g. prescribe high blood pressure medication). If headaches accompany the episodes, patients may be prescribed pain medication that is strong enough to alleviate the discomfort. If the condition doesn’t respond to the first line of treatment, the doctor may recommend other medications such as calcium-channel blockers like verapamil, beta blockers, or anticonvulsants. It is important to work closely with your family physician to create an effective treatment plan that saves your vision.

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