Ocular and Visual Migraines

Although ocular and visual migraines are used interchangeably, they are different entities. If the symptoms occurs in both eyes it is more likely a visual migraine; whereas if it occurs in one eye it is more likely an ocular migraine; however, if there is sudden new onset of vision loss, you should seek medical care. 

Ocular or Retinal Migraine
An ocular migraine is a rare condition and is also called a retinal migraine.  It is thought to be due to reduced blood flow or spasms of the blood vessels of the retina (back of the eye).  This leads to temporary vision loss or blindness of one of the eyes.  The person experiences a blind spot which can become enlarged during the episode.  Typically, the symptoms resolve within an hour from onset.  This can be pain-less or can occur with or be followed by a migraine.  Complications may include irreversible vision loss and the exact incidence of irreversible vision loss is unknown.

Visual Migraine or Migraine Aura
This is a much more common and is considered a more harmless condition.  It is more commonly called a migraine aura and is characterized by temporary visual loss that lasts less than 30 minutes.  It is thought to occur due to abnormal electrical activity in the cortex of the brain.  This typically affects both eyes unlike the ocular migraine.  Symptoms vary much more and may include flickering blind spot, flashing lights, wavy or zigzagged ring of colored light, or a blind spot that moves across the vision.  A migraine headache may occur shortly there after or no migraine can occur.  

Treatment
Treatment is highly individualized depending on frequency of migraines; however, those with either ocular or visual migraines are recommended to receive medications to reduce incidence of migraines (migraine prophylactic medications).  These medications may include anti-seizure medications or antidepressants.  Additionally, they are recommended to avoid potential triggers of migraines, which may inclue bright light, stress, hormonal changes, nitrates, fasting, and wine among many others.  

Image from:  ​https://www.medicalnewstoday.com/articles/314917

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