“Ophthalmic” or “ocular” migraines are quite common, but they are not always easy to diagnose. Migraine headaches are unusually severe headaches that are generally one-sided but that can occur on either side of the head. The “aura” (including light sensitivity, flashes of light, zig-zag lines of light and blind spots in the visual field) is the ocular symptom preceding a migraine headache. The classic migraine headache starts with the aura followed later by the severe headache. The visual aura can occur by itself without a headache; when this occurs it is an “ocular migraine.” Ocular migraines without headache usually last about 15 to 30 minutes and then slowly disappear on their own. If they are infrequent, it is possible no treatment is needed. However, if they are very frequent, they should first be investigated by an ophthalmologist, neurologist or both to be sure there is not another cause. If nothing is found and if the frequency of the migraines is bothersome, your ophthalmologist and/or neurologist will begin preventative therapy.
Ocular migraines are more common in women than men by a ratio of about 3-to-1. Triggers for migraines and ocular migraines can include certain foods — such as chocolates, cheeses and the flavor-enhancer MSG (monosodium glutamate) — as well as certain wines. Missing meals, lack of sleep, birth control pills, smoking and stress can also contribute to migraines. You can help prevent ocular migraines by avoiding these triggers.