Thursday, 21 March 2019

Blind spots, zig-zag lines, or seeing stars? It could be ‘The Ocular Migraine'

15 February 2019 | Views | By Dr Arindam Dey

The exact cause of ocular migraine is unknown. Leading theories attribute them to spasms in retinal blood vessels, and changes to nerve cells in the retina.

Flashes of light, shimmering stars and a fade to black. While this may sound like the climactic end to a sci fi movie, don’t be fooled. These are the symptoms people may experience when they suffer from an ocular migraine.

Ocular migraine also called as Retinal migraine, is a different condition and shouldn’t be confused with headache type migraine which is known as migraine aura that usually affects the vision of both eyes. Ocular migraine may cause partial or total loss of vision in one eye and this usually lasts approximately 15-30 minutes before vision gradually returns.

Since ocular migraines are a type of migraine that are in maximum cases painless and silent, the experts use only these words while referring them to people. However, one cannot interchange these two terms. Ocular migraines cannot be used interchangeably with name tag of ‘silent migraine’. These are the migraine where people experience auras in vision, accompanied with or without headache and temporary loss of vision.

Thankfully, ocular migraine symptoms usually go away on their own within 30 minutes. Let us check what differentiates ocular migraine from migraine aura.

What differentiates ocular migraine from migraine aura?

The symptoms of the two conditions are nearly the same except for a few prominent signs. Regular migraine
attacks can also cause vision problems, called as aura, which can involve flashing lights and blind spots. But
these symptoms usually appear in both eyes along with splitting headache. The main difference is a migraine
with aura will affect both eyes, while an ocular migraine affects only one and can be painless. Both may have
visual disturbances such as:

  • Flashes of light
  • Zigzagging patterns
  • Blind spots
  • Shimmering, coloured, or flickering lights
  • Floating lines

What causes ocular migraine?

Ocular migraine can be triggered by high blood pressure, stress, excessive heat, smoking, disturbed sleep cycle,
high altitude and usually tend to be more common among women, people aged < 40 years, or people with family
history.

The exact cause of ocular migraine is unknown. Leading theories attribute them to spasms in retinal blood vessels, and changes to nerve cells in the retina. Theories have also stated that it is caused by electrical activity in brain usually when an electrical impulse causes abnormal activity. It then spreads over the surface of the brain and hence triggers ‘ocular migraine’. Some theories have also linked that there are certain factors
triggering regular migraines which might trigger ocular migraines. Some of these factors include disturbed sleep
cycle, caffeine, hormonal changes, dehydration and stress.

How to treat ocular migraine?

Taking care of oneself is the key treatment to people suffering from ocular migraines. You can even keep a detailed dairy to maintain a record of the elements that trigger ocular migraines for you. The elements can be food, medications, weather conditions or lights that might trigger them. Acupuncture & acupressure and even ice bags are some of the remedies apart from prescriptive medications that can be beneficial for such patients.

Ocular migraine symptoms usually go away on their own within 30 minutes. In the interim, resting the eyes, avoiding bright light, avoiding stress factors and minimizing screen time (time spent looking at a television, computer monitor, tablet or phone) can also bring relief.

Non-steroidal anti-inflammatory (NSAID) pain medications and anti-nausea medications can be beneficial for alleviating the symptoms, your doctor may prescribe Beta-blocker, Calcium-channel blocker etc, and however it’s always recommended to visit your ophthalmologist, if the symptoms persist.

- Dr Arindam Dey, Head- CDMA, Alcon India

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