By Dr S.S. Gill

Ipoh Echo’s EYE HEALTH series continues with Consultant Eye Surgeon Dr S.S. GILL talking to us about OPHTHALMIC MIGRAINE.

OCULAR MIGRAINE is sometimes referred to as Retinal Migraine or Ophthalmic Migraine. Symptoms are variable. In most individuals it starts as a small, enlarging dark area (scotoma) in the central vision (simulated photos below). This dark central area of vision usually is accompanied by a surrounding bright light that flashes or flickers (scintillations). Quite often, it assumes a wavy pattern of light or zig-zag lines surrounding a dark central area of vision. The dark central area then usually enlarges to move across the entire field of vision. It may be quite frightening to the person concerned.

Some people have described it as a “fireworks display” in the eye. The whole migraine episode usually ends in a few minutes, but may last up to 30 minutes. The headache that may or may not follow this “firework display” may last from hours to days.

Trigger factors

The trigger factors may range anything from exposure to stress, fatigue, bright lights, hormonal changes, medication or certain foods containing tyramine or phenylalanine (e.g., cheese, chocolate) and alcohol intake.

Are Ocular Migraines dangerous?

Generally, ocular migraines are considered harmless and cause no permanent visual or brain damage and does not require treatment. It happens because blood vessels in the brain go into spasm altering blood flow to cause all the symptoms. Initially there is decrease flow in the vessels, and then later an increase in blood flow in the vessels when the vessels dilate. The vessels therefore get over-filled and this causes the throbbing or “pounding” headache.

What should you do?

Vision temporarily gets affected during the ocular migraine attack and so it is important to take certain precautions when driving or operating machinery. If you are driving, pull to the side of the road until the attack passes and your vision becomes normal again. Do not move or drive until the ocular migraine resolves.

Take note

Before you presume that you have ocular migraine, always consult a Physician should you have such symptoms to make sure that you are not suffering from hypertension or some stroke. If this is negative, you will be referred to an eye care professional to rule out an ocular problems related to the retina.

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