optic migraine
Ocular, Optical, and Ophthalmic Migraines
Does this sound like you?
Do you see twinkling lights or black spots? Do you have blurred vision? Are you experiencing vision loss or blindness? Does light seem to bother you more than usual? Are these symptoms followed by a headache? Always or only sometimes? Does the pain come on slowly or very suddenly? When the headache comes on, do your visual problems go away? Is your headache single sided, located around your eye area? Is the pain throbbing?
If so, then someone may have suggested that you have ocular or optic migraines. The first thing you need to know, is that “optic” or “ocular” migraine is not an actual type of migraine or diagnosis. Why is this? Well, it is a common symptom of migraine in general to have pain in the ocular area as well as visual disturbances – there isn’t an actual need for a specific migraine classification in every case (two exceptions – retinal and basilar-type migraine will be discussed below.)
The symptoms above are all characteristic of migraine, either with aura in the event you experience visual disturbances and other symptoms before the headache comes on (or doesn’t – that’s okay, that’s possible too) – and if there are no aura symptoms but you feel your pain primarily in the eye area, then you are likely experiencing migraine without aura. In the case where visual disturbances are NOT followed by headache, that very well may be a case of migraine with aura without headache. It is entirely possible to have a migraine attack that is not followed by a headache.
The Four Stages of Migraine
Migraines have four stages. The first stage is the pre-migraine stage which can be characterized by feelings of exhaustion, food cravings, trouble concentrating, mood swings, etc. The second stage is the aura stage. Not everyone will experience a migraine aura and not necessarily every time. The aura stage of a migraine is a period time where a variety of neurologically driven symptoms will occur. Each symptom will develop over five to 20 minutes and last for no more than sixty. Aura symptoms will then disappear when the migraine moves on to the third stage – the headache stage. Aura symptoms can include visual disturbances (blurred vision, double vision, distorted vision, seeing twinkling lights, spots, zig zags, or even partial or full blindness,) auditory disturbances, nausea and vomiting, numbness, tingling, and sometimes more severe symptoms like blindness, loss of consciousness, paralysis, or seizures. The third stage of a migraine – the headache stage – also does not necessarily develop every time. When it does the pain can last from hours to days, is typically severe, has a throbbing pain sensation, and is commonly located on one side of the head. There are of course exceptions, this is just a general description. The last stage of a migraine is the post-migraine phase. At this point the headache has passed and the sufferer is left feeling exhausted and drained.
Retinal Migraine
Retinal migraine suffers frequently experience repeated attacks of pain or visual disturbances in a single eye in addition to the migraine headache.
If this sounds like you ask yourself:
- Have I had at least two attacks?
- Have the visual disturbances you have experienced during an attack (twinkling lights, blindness, etc) been confirmed by a qualified doctor? Do these symptoms always go away after an attack?
- Does a migraine without aura follow either while experiencing the visual disturbances or within sixty minutes of them ending?
- Have you ruled out all other reasons for blindness?
Retinal migraines are different from regular migraine in that only a single eye is affected. If both eyes are affected, then you are probably experiencing a migraine with aura.
“Aura” is simply the term used to refer to a whole set of neurological symptoms that precede the onset of a migraine headache and disappear once it develops. To be defined strictly as “aura” each symptom must develop over five to twenty minutes and last for no more than sixty minutes. The aura stage is not experienced by every person or even every time.
Common visual symptoms of aura include:
Seeing flickering lights, spots, lines, zigzags, or loss of vision. Other people report seeing “chicken-wire,” “bugs,” or “clouds.” Descriptions and perception will vary from person to person.
Other types of migraines that can cause vision problems:
Basilar-Type Migraine (Intense Migraines with temporary blindness)
This is a condition could be referred to as a migraine with extreme symptoms including – intense vertigo and temporary blindness. Basilar-type migraines are frequently seen in young adults. It is believed to originate in the brain stem and/or both hemispheres of the brain. Diagnosing basilar-type migraine is dependent on ruling out anxiety disorders and well as hemiplegic migraines (if motor weakness is experienced, then the diagnosis is usually FHM or sporadic hemiplegic migraine.)
People who are diagnosed as having basilar –type migraines must meet the following criteria:
- Have experienced at least two attacks.
- Auras with at least two of the following symptoms (but no motor weakness): difficulty in articulating words, dizziness, ringing in the ears, double vision, lack of coordination, sensations of numbness or pins and needles on both sides of the body.
- At least one aura symptom must develop over more than five minutes and/or different symptoms occur in succession over five minutes or more AND/OR each aura symptom lasts between five to sixty minutes.
- Headache without aura develops during the aura or within 60 minutes of the aura ending.
- None of the symptoms of this condition must be attributed to another disorder.
