Eye Health: Visual Migraine

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

Visual Migraines can be frightening. While doing your work, you suddenly begin to see blurred wavy coloured areas as if looking through shattered glass followed by a dull headache over one eye. You pass it off as having been on the computer for too many hours. However, the symptoms continue to worsen making you finally go in for an eye check. After a thorough eye examination, you are eventually told that you have just experienced an ocular (eye) migraine which is more precisely termed as “ophthalmic migraine”.


It can present with a variety of symptoms. Typically it starts as a small, enlarging blurred area (scotoma) in your central vision. This blurred central area of vision usually is accompanied by a surrounding bright light that flashes or flickers (scintillations). In some people, they may assume a wavy pattern of light or zigzag lines surrounding a dark central area of vision. The blurred area then usually enlarges to move outwards 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 may end 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.


These migraine processes are related to changes in blood flow in the brain (visual cortex). The blood vessels in the brain go into spasm and cause all the symptoms. Initially there is reduction in blood flow in the vessels, and then later an increase in blood flow in the vessels due to the blood vessels dilating. The vessels therefore get over-filled and this causes the throbbing or “pounding” headache.


There are certain trigger factors that may be responsible for initiating the ocular migraine. These 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.


Generally, ocular migraines are considered harmless and cause no permanent visual or brain damage and do not require treatment. However, it can be bothersome to an individual especially for patients who suffer from more prolonged problems as a result of ocular migraine.


Since the vision temporarily gets affected significantly during the ocular migraine attack, it is important to take certain precautions if you are doing something like 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.


Before you presume that you have ocular migraine, always consult an eye doctor should you have such vision symptoms to make sure that you are not suffering from something more serious. When in doubt, get your eyes checked by an eye-care professional.

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