Retinal Migraines: Symptoms, Causes, and Treatment

Retinal migraine is a rare type of migraine that causes visual disturbances in only one eye before the headache comes on.

Not all migraines with visual symptoms, such as auras, are covered by the term. It differs somewhat from ocular migraine and migraine with aura, despite the fact that the names are occasionally used interchangeably.

Ocular migraine is the broad term for any headache that impairs vision momentarily. Vision alterations are brought on by migraine with aura in both eyes. The term “retinal migraine” refers to a more specific ailment that is monocular, or affecting just one eye.

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Retinal migraine causes

There is debate about and no consensus on the precise etiology of retinal migraine. Numerous processes have been proposed, including retinal vasospasm (artery constriction), inflammation surrounding the nerves, and alterations in certain brain regions.

The following activities and conditions can trigger retinal migraine attacks:

  • intense exercise
  • smoking
  • tobacco use
  • dehydration
  • low blood sugar
  • birth control pills that modify hormonal levels
  • hypertension
  • high altitude
  • hot temperatures
  • caffeine withdrawal

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Retinal migraine symptoms

A brief change in vision in one eye is one of the symptoms of a retinal migraine, which are otherwise identical to ordinary migraine symptoms.

Vision loss

Those who suffer from retinal migraine headaches frequently only lose vision in one eye. This often lasts 10 to 20 minutes and is short. This can sometimes go on for an hour. Scotomas, a pattern of black specks, are sometimes also seen. These dark dots progressively enlarge until they completely block eyesight.

Partial vision loss

Others will experience partial visual loss in one eye. This is typically characterized by hazy, dull vision or “scintillating” lights. This may go on for up to an hour.

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Retinal migraine sufferers can get a headache before, during, or after the attack on their vision. From a few hours to a few days, these headaches may linger.

The headaches are frequently accompanied by physical illness, nausea, and excruciating head throbbing. Usually, just one side of the head is affected. When you exercise, this ache could feel worse.

Are retinal and ocular migraines the same thing?

It helps to first grasp some of the fundamental terms associated with migraines. Migraine, in its simplest form, is a headache condition that comes in two basic varieties: migraine without aura and migraine with aura. A migraine with aura is a migraine that also has other symptoms, such as altered vision, hearing, touch, or even speech. These signs are transient.

Visual symptoms occur in over 90% of people who have migraine with aura and usually affect both eyes. They can include:

  • Small blind spots with bright colors or jagged lines around the edges
  • Flashing lights
  • Blurry or foggy vision 
  • Feeling like you’re seeing distorted shapes and sizes
  • Black, white, or gray areas of blindness
  • Partial (small area) or complete loss of vision 
  • Symptoms in only one eye
  • Sudden or gradual appearance of symptoms
  • Flashing lights or similar visual symptoms 

Treating retinal migraine

Doctors or optometrists may provide drugs commonly used to treat other types of migraine if retinal migraine is not frequently encountered. Triptans, nonsteroidal anti-inflammatory treatments like aspirin and ibuprofen, and antiemetic drugs are some of these rescue drugs.

In order to stop more episodes, doctors may also examine your specific triggers and make an active effort to address them. A retinal migraine may occasionally require the prescription of a particular drug, such as a beta-blocker like propranolol, an antidepressant like amitriptyline, or an anticonvulsant like valproate or topiramate.

Ocular migraine vs. retinal migraine

Both “ocular migraine” and “retinal migraine” are frequently used interchangeably. A retinal migraine, however, is a specific kind of ocular migraine.

It’s also important to distinguish between “visual migraine” and other types of headaches that damage the brain’s visual cortex. This might cause aura to impact not only one eye’s vision but possibly both.

How long does retinal migraine last?

A retinal migraine’s visual symptoms typically last no more than an hour. Although headaches and nausea are not always present during retinal migraine attacks, they may linger longer—possibly for more than a day.

Retinal migraine risk factors

Retinal migraines can affect people of any age, even kids. These are more typical in the subsequent groups:

  • people under 40 years old
  • women
  • people with a family history of retinal migraine or headaches
  • people with a personal history of migraine or headaches
  • sickle cell anemia
  • epilepsy
  • lupus
  • hardening of the arteries
  • giant cell arteritis, or inflammation of blood vessels in the scalp

When should I seek help for a retinal migraine?

Go get aid if you’re losing your vision. It’s crucial to have the condition examined because there are several different conditions that might lead to blindness. These can include stroke or other conditions that affect the eyes or brain specifically.

Because of this, there is no established test for retinal migraine. Before a diagnosis can be determined, the other conditions must be ruled out. Imaging, blood testing, and cardiac monitoring may all be used in the “ruling out” approach.

Can you prevent retinal or ocular migraines?

There are no particular preventative recommendations for migraines that affect the eyes or the retina. Generally speaking, if at all feasible, avoid triggers to help prevent migraines. Several instances include:

  • Stress
  • Smoking 
  • High blood pressure
  • Birth control pills
  • High altitude
  • Dehydration
  • Low blood sugar
  • Excessive heat