You might be suffering from an ophthalmic migraine. Find out what it is and how to get help.
We all think of a migraine as a piercing, just-want-go-back-to-bed pain that makes the sufferer miserable. While that is the case for many patients who are living with migraines, there is a type of migraine that could be painless.
While a painless migraine may seem like a better option, an ophthalmic migraine can be just as disruptive. This type of migraine is a disturbance in the visual part of the brain.
“Your brain has different sections that do different things,” said Scott & White ophthalmologist Kyle H. Smith, MD. “There’s a part of the brain—the occipital cortex—that processes your vision. When you get a migraine in that part of the brain, then you experience visual symptoms.”
What are the symptoms of an ophthalmic migraine?
The symptoms vary from person to person, but Dr. Smith said that typically patients will see a flashing or flickering light in the center of their vision. The term for these symptoms is called a scintillating scotoma, and it usually lasts about 15 minutes.
“It is generally a spot of light that appears and grows,” he said. “It flickers and shimmers and usually has zigzag edges. A lot of people describe it as a kaleidoscope.”
The light will be bright and often form in an arc or C-shaped pattern. Some have also described it as heat waves in front of their vision. You can see through it, but it blocks your vision enough that it may impair your ability to read something on a page.
“Over that 15-minute time period, the spot will move off to the side and disappear,” the doctor said.
Are these migraines painful?
Ophthalmic migraines—sometimes called visual or ocular migraines—can be associated with some pain. But the pain is usually not the typical excruciating pain that is associated with a migraine.
And although this type of migraine is associated with the patient’s vision, they do not cause any pain in the eyes.
“We get patients who come in panicky because they think they’re going blind, or they think they’ve had a stroke,” Dr. Smith said. “It’s hard to explain that they’ve had a migraine because they haven’t had any pain. Everybody believes that migraines cause horrible headaches.”
What causes ophthalmic migraines?
While the causes of migraines are largely unknown, the ophthalmologist said that migraines tend to be genetic.
“Most commonly when someone has migraines, I’ll ask, does your mom have migraines? And their answer is usually yes,” he said.
While genetics may play a big part in who will suffer from migraines, the doctor said that environmental factors like stress, activity, exercise, smells and foods you eat can trigger the symptoms of a migraine.
What are the treatment options available?
If migraine symptoms—ophthalmic or otherwise—are disrupting or hindering daily activities, like driving a car or being productive at work, then patients need to seek help from a doctor.
“There are medications that can help. It’s what we call migraine prophylactics,” Dr. Smith said. “The medication helps to prevent a migraine from occurring.”
Patients who haven’t had a lot of success with standard migraine treatments have opted for Botox injections in the scalp or taking vitamins like coenzyme Q or magnesium.
“You can also treat migraines with migraine abortive therapy, which is medication used to abort a migraine that’s already started,” he said. “Imitrex is the one most commonly used. It comes in pill form or injections.”
Are there ways to prevent an ophthalmic migraine?
Other than choosing your parents, the only way to prevent getting migraines is to identify and avoid the triggers that can cause the symptoms.
It’s also a good idea to see your primary care physician if your migraines are getting worse or are hindering your work performance. Your doctor can put you on a regimen of migraine prophylactics or put you under the supervision of a migraine specialist.
The good news is that ophthalmic migraines aren’t usually debilitating. And they are very common.
“One out of every four women will have an ophthalmic migraine at some point in her life,” Dr. Smith said. “I see them virtually every day in my clinic.”