Ocular Migraines & Migraine Aura

June 10, 2021

A middle-aged man has his hands on his temples, pressing in agony.

Nearly every person has experienced a headache at some point. For those who suffer from migraines, severe headaches can be a regular part of life. Visual symptoms can be present before or during a migraine attack. It is also possible to have visual symptoms, but no headache. This blog will dive deeper into the connection between headaches, ocular migraines, and migraine auras.


Ocular Migraine

An ocular migraine is temporary vision loss in one eye. Similar to a typical migraine, there is decrease blood flow or spasms of the blood vessels supplying the retina. Vision loss associated with an ocular migraine is painless, however, a severe headache or migraine may occur after the visual symptoms are noticed. The vision should fully return to normal within an hour. Ocular migraines as less common than migraine aura, however, many people use the term “ocular migraine” to actually describe migraine aura.


Migraine AuraA young girl is playing on a jungle gym net. She is very blurry appearing and there are blue and green zigzag shapes around her face.

The visual symptoms associated with migraine aura are bilateral, or in both eyes. Rather than having vision loss, like an ocular migraine, the visual changes are more of a hallucination. There are many different descriptions of what people see with an aura. It can start in one spot and migrate across vision or completely move to another location altogether.

The most commonly described auras include:

– Zigzag lines
– Flashing or moving lights
– Shapes and colors (like looking through a kaleidoscope)
– Shimmering or pixelated shapes
– Tunnel vision

Some people experience migraine aura as a warning sign of an impending headache. Vision starts changing and there might be a couple minutes to hours until a migraine headache occurs. Other people have all the vision symptoms, but never get the associated headache. All of the vision changes are temporary and should dissipate in 20 to 30 minutes; However, the headache can last much longer.


Causes of Ocular Migraine & Migraine Aura

Spasming blood vessels alter the blood flow to particular areas of the brain and retina. This can contribute to vision loss associated with ocular migraines and trigger pain in the head, leading to the actual migraine headache aspect. The specific cause of ocular migraine and migraine aura usually varies on an individual basis.

Large wheel of cheese with a wedge cut out. There is a glass of red wine with the bottle. Scattered nuts and chocolate cover the wooden cheese board. The following list includes the most common triggers of ocular migraine and migraine aura:

– Bright or flashing lights, fluorescent lighting
– Stress and/or lack of sleep
– Foods: chocolate, aged cheeses, artificial sweeteners
– Drinks: red wine, caffeinated beverages
– Strong smells: smoke, perfume, chemicals
– Hormones
– Changes in the weather


Treatment & Prevention of Ocular Migraine & Migraine Aura

The first time a person experiences an ocular migraine or migraine aura, it can be alarming. Call your eye doctor immediately with loss of vision, new floaters or flashing lights. Vision loss can be related to something more dangerous, such as a retinal detachment or retinal stroke. Once those conditions are ruled out, the primary care physician (PCP) might recommend medication to help with associated headaches. While over-the-counter pain medicine helps for some people, others need prescription medicine to prevent the onset of migraines. The PCP might also refer to a neurologist, who specializes in the brain and migraines, for brain imaging.

It is very helpful to determine the trigger of the vision changes and/or headaches. Start a migraine journal to keep track of daily activities and diet to figure out if a particular food, activity, weather condition, etc. is causing the symptoms. Once a trigger is determined, it is best to avoid it to prevent future migraine occurrences. Stay healthy overall by maintaining a balanced diet, hydration, sleep schedule, and exercise.