What you should know about ocular migraines

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When you tell your physician you have a headache, it typically involves follow-up questions. Can you pointing to where the pain is, what type of pain is it and what other symptoms do you experience are all important questions to ask in order to determine what type of headache you’re experiencing and how it can be treated. This additional information is essential to determine if you experience ocular migraines.

What is an ocular migraine?

An ocular migraine is really a migraine with visual aura. Typically, these are visual symptoms that occur just prior to a migraine, although they can occur during a migraine, as well. Typically, they last 5-60 minutes. There are some patients who have persistent auras, or auras without headaches.

What are the symptoms of an ocular migraine?

Symptoms can include an area of greyness or loss of vision, surrounded by sparkling floaters. Other patients see kaleidoscope vision, or random colors, or flashing lights. There’s a wide spectrum of visual auras.

What causes ocular migraines?

Migraine with aura is thought to be caused by cortical spreading depression, which is an electrochemical wave that travels across the cerebral cortex.

How can ocular migraines be treated? Is the treatment different than other migraines?

Some migraine treatments, such as certain anti-epilepsy medications, certain anti-hypertensives, the anti-NMDA (n-methyl-d-aspartate) medication memantine and transcranial magnetic stimulation are particularly effective for migraine with aura.

What are the dangers associated with ocular migraines?

Migraine with aura does confer a slightly increased risk of stroke early in life, but even that risk remains low. There is controversy as to whether women with migraine with aura should take estrogen-containing oral contraceptives due to additive stroke risk, although this is still under study.

Kevin Weber is a neurologist at The Ohio State University Wexner Medical Center.