Ocular Migraine

Ocular migraine is quite common. Typically, these episodes begin with a visual disturbance that begins in the peripheral vision. It often consists of a semi-circular, jagged, zig-zag, shimmering light, which enlarges and becomes more central. This disturbance usually obscures the vision within the jagged area. The light is often described as a pale pastel in color.  There are many variations of symptoms. These symptoms usually resolve spontaneously after several minutes but usually less than one hour. Often, rest in a darkened room can be helpful during a migraine attack. Medical treatment is usually not necessary.

In the typical episode, the visual disturbance lasts 15 – 20 minutes and then disappears. A mild headache may or may not follow the disturbance. Many ocular migraine sufferers complain only of fatigue after the visual disturbance.

If a headache follows the episode, it is called a migraine headache with visual prodrome. Some people get migraine headaches without the visual symptoms. Some people get the visual symptoms without the headache. This is called Ocular Migraine. The cause is due to a temporary spasm in the blood vessels behind the eye or in the brain called "vasospasm" similar to a spasm or cramp that you may have once experienced in one of your leg muscles (Charlie-Horse). Usually, this resolves without treatment and many people never have another episode. Some people may continue to have them. An examination of the eye is important to rule out any other causes for these symptoms.

In the rare instance that these symptoms continue to recur on a regular basis and interfere with one's quality of life, then treatment is available with pills that both decrease the frequency of attacks as well the severity of the attacks. Treatment is usually started in consultation with an internist, family physician, or neurologist. We usually reserve treatment for those patients who have symptoms regularly and it interferes with daily living because the medications used to treat migraine can have side effects, just like any medication.