How Do I Know even though I Have an Ocular Migraine?

To many people, a migraine headache is a migraine headache. They assume, falsely, that all migraines are pretty much the same.

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So when one of the 15% of our population that suffers from migraine says they have an ocular migraine, non-sufferers may raise a skeptical eyebrow. The truth is, however, that there are many different kinds of migraine.

Define Ocular Migraine

An ocular migraine is a type of migraine that focuses on that part of the aura in which visual symptoms predominate. There may never be an actual headache.

Symptoms of Ocular Migraine

If you are familiar with regular migraine pain, and now hear of ocular migraine, you may very well ask, “How do I know if I have an ocular migraine? I have no headache.”

An ocular migraine is sometimes called a migraine without headache. It is a migraine that distorts images when you look at them. The distortion usually begins in the image’s center, and then moves to one side. Ocular migraine is likely to affect only one eye at a time. As an ocular migraine progresses, images may turn grey or wavy. You may even lose your sight temporarily.

Doctors differ in their understanding of ocular migraine. Some say that ocular migraine is more likely to occur as you get older. Others say it is typically seen in young adults. It can be quite frightening, as you may think you are losing your sight forever.

Physicians differ, too, in their understanding of ocular migraine symptoms. Some use the term to explain visual disturbances of aura without headache. Other use it to refer to one-sided blind spots in the field of vision, or blindness, that lasts less than an hour and is associated with a headache.

Do you have ocular migraine? With or without a headache, if you have the visual disturbances of an aura in only one eye, yours may be an ocular migraine.

Specific Symptoms of Ocular Migraine:

How do I know if I have an ocular migraine? I will have one or more of the following specific symptoms. See if any of these is true of you.

1. Holes in your field of vision – places where there is nothing. Perhaps you are looking at a flower, and the center of the flower is missing. Or you are watching television, and you can see the outside of the screen, but cannot see the center of the picture. When you close the unaffected eye, you can see that portion of the screen. The affected eye, however, has a blind spot.

2. When looking through the affected eye, you see everything as though hidden behind a shade of gray. It is as though you were watching television and someone slipped a piece of thin gray cloth over the screen.

3. Another test for ocular migraine is to see if the affected eye sees things as though looking through a window with rain streaming down over it. The watery glass effect will be limited to one eye.

Ocular Migraine Symptoms Are Temporary

Although you may feel, during an optical migraine episode, that you will never see clearly again, the symptoms are temporary and will not cause lasting damage to your eye.

While they are present, however, ocular migraine symptoms will interfere with daily activities such as reading and driving.

Why Ocular Migraine Is Not Just Another Migraine Aura

Ocular migraine and migraine with aura are very similar, and some people have difficulty distinguishing between the two. The source of the visual disturbances is the key. even though it is migraine with aura, the source of visual trouble is the brain’s occipital cortex. even though it is ocular migraine, the source is the eye’s retinal blood vessels.

How are migraines treated?

Migraine headaches are chronic. They can’t be cured, but they can be managed and possibly improved. There are two main treatment approaches that use medications: abortive and preventive.

  • Abortive medications are most effective when you use them at the first sign of a migraine. Take them while the pain is mild. By possibly stopping the headache process, abortive medications help stop or decrease your migraine symptoms, including pain, nausea, light sensitivity, etc. Some abortive medications work by constricting your blood vessels, bringing them back to normal and relieving the throbbing pain.
  • Preventive (prophylactic) medications may be prescribed when your headaches are severe, occur more than four times a month and are significantly interfering with your normal activities. Preventive medications reduce the frequency and severity of the headaches. Medications are generally taken on a regular, daily basis to help prevent migraines.

What medications are used to relieve migraine pain?

Over-the-counter medications are effective for some people with mild to moderate migraines. The main ingredients in pain relieving medications are ibuprofen, aspirin, acetaminophen, naproxen and caffeine.

Three over-the-counter products approved by the Food and Drug Administration for migraine headaches are:

  • Excedrin® Migraine.
  • Advil® Migraine.
  • Motrin® Migraine Pain.

Be cautious when taking over-the-counter pain relieving medications. Sometimes overusing them can cause analgesic-rebound headaches or a dependency problem. If you’re taking any over-the-counter pain medications more than two to three times a week, report that to your healthcare provider. They may suggest prescription medications that may be more effective.

Prescription drugs for migraine headaches include:

Triptan class of drugs (these are abortives):

  • Sumatriptan.
  • Zolmitriptan.
  • Naratriptan.

Calcium channel blockers:

  • Verapamil.

Calcitonin gene-related (CGRP) monoclonal antibodies:

  • Erenumab.
  • Fremanezumab.
  • Galcanezumab.
  • Eptinezumab.

Beta blockers:

  • Atenolol.
  • Propranolol.
  • Nadolol.

Antidepressants:

Antiseizure drugs:

Other:

  • Steroids.
  • Phenothiazines.
  • Corticosteroids.

Your healthcare provider might recommend vitamins, minerals, or herbs, including:

Drugs to relieve migraine pain come in a variety of formulations including pills, tablets, injections, suppositories and nasal sprays. You and your healthcare provider will discuss the specific medication, combination of medications and formulations to best meet your unique headache pain.

Drugs to relieve nausea are also prescribed, if needed.

All medications should be used under the direction of a headache specialist or healthcare provider familiar with migraine therapy. As with any medication, it’s important to carefully follow the label instructions and your healthcare provider’s advice.

Alternative migraine management methods, also known as home remedies, include:

  • Resting in a dark, quiet, cool room.
  • Applying a cold compress or washcloth to your forehead or behind your neck. (Some people prefer heat.)
  • Massaging your scalp.
  • Yoga.
  • Applying pressure to your temples in a circular motion.
  • Keeping yourself in a calm state. Meditating.
  • Biofeedback.

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