Visual Migraine

Understanding Retinal Migraine

Retinal migraine (sometimes referred to as ocular migraine) is a rare type of migraine involving repeated attacks of temporary visual disturbance or vision loss in one eye, typically lasting less than an hour. These episodes may or may not be followed by a headache.

Retinal migraines are thought to be caused by a temporary reduction in blood flow to the retina, often due to vasospasm (a sudden narrowing of the blood vessels).

Recognising the Symptoms

Typical symptoms include:

• Temporary vision loss or dimming in one eye

• Flickering lights, zigzag lines, or a small blind spot that gradually expands

• Headache (often one-sided and pulsating)

• Sensitivity to light and sound

• Nausea

If you experience vision loss in both eyes, or permanent visual changes, you should seek urgent medical advice as this could indicate a different and more serious condition.

Common Triggers of Retinal Migraine

Retinal migraines may be triggered by a number of factors, including:

• Emotional stress or anxiety

• Fatigue or poor sleep

• Dehydration or skipping meals

• Hormonal changes (e.g. during menstruation or when using hormonal contraceptives)

• Bright lights or screen exposure

• Intense physical exertion

• Certain foods (e.g. aged cheese, chocolate, red wine)

• High blood pressure

• Smoking

Identifying and avoiding your personal triggers can significantly reduce the frequency of retinal migraine episodes.

Medical Assessments You May Need

Because retinal migraines can resemble other more serious conditions, your GP or healthcare provider may recommend several tests to help confirm a diagnosis and assess your overall vascular and eye health.

1. Blood Pressure Check

• High blood pressure can affect the small arteries that supply the retina and brain.

2. Blood Tests

• These may include cholesterol levels, blood glucose, and inflammatory markers. High cholesterol can narrow arteries and affect blood flow to the eye.

3. Eye Examination

• An optician or ophthalmologist will examine the back of your eye (retina), optic nerve, and retinal vessels using specialist tools. This helps rule out other eye conditions such as retinal detachment, retinal artery occlusion, or optic neuritis.

Managing Retinal Migraine

There is no single treatment for retinal migraine, but management often includes a combination of:

Lifestyle changes:

• Avoiding known triggers

• Maintaining a consistent sleep schedule

• Staying hydrated and eating regular meals

• Stress reduction techniques such as mindfulness, yoga, or cognitive behavioural therapy (CBT)

Medications (prescribed where appropriate):

• Pain relief: Paracetamol or ibuprofen during an attack

• Migraine prevention: May include beta-blockers, calcium channel blockers (e.g. verapamil), anti-seizure medications, or tricyclic antidepressants

• Aspirin or other antiplatelet medications may be advised in some cases

Always consult your GP before starting or stopping any medications.

When to Seek Urgent Medical Attention

Seek immediate help by calling 999 or going to A&E if you experience:

• Sudden or permanent loss of vision

• Vision loss in both eyes

• Weakness or numbness on one side of the body

• Difficulty speaking or understanding speech

• A sudden, severe headache unlike any you’ve had before

These could be signs of a stroke or another serious neurological or vascular issue.

Summary

Although retinal migraines are usually temporary and not harmful to the eye in the long term, they can be alarming and sometimes mimic more serious conditions. A thorough assessment by your GP, and possibly an optician or specialist, is important.

To manage your condition effectively:

• Attend all recommended medical checks

• Monitor your blood pressure and cholesterol

• Keep a migraine diary to track symptoms and potential triggers

• Follow medical advice regarding treatment and lifestyle changes

If you’re concerned about your symptoms or they are changing in nature or frequency, contact your GP for a review.