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Here’s What Ocular Migraine Really Means—and How to Treat Yours

Visual disturbances like twinkling lights and zigzag patterns might originate in your brain, not your eyes.

If you’ve ever seen shimmery spots or flashing lights, or worse, experienced blind spots, you know that random visual disturbances can be mega creepy as far as health symptoms go. When spotty vision resolves fairly quickly, it’s easy to chalk it up to a bad week of sleep, your intense new hot-yoga regimen, or even just good old-fashioned aging. However, if you frequently experience bouts of temporary vision problems—with or without other symptoms like a headache, dizziness, or nausea—ocular migraine could be the reason, especially if you have a family history of migraine. Ocular migraine is a general, catch-all term that’s often used interchangeably with ophthalmic migraine and visual migraine. All refer to recurring attacks of short-lived visual symptoms, like scotoma (blind spots), scintillations (twinkling lights), and zigzag patterns. These visual disturbances often start as a small shimmering spot that gradually expands outward and evolves within your field of vision.

What is ocular migraine, exactly—and why does it spark such strange symptoms?

The term “ocular migraine” actually encompasses two separate clinical diagnoses. The first is migraine aura, which affects about a third of people living with migraine, a chronic neurological condition that causes debilitating headaches along with many other symptoms. Set off by a wave of brain activity—rather than caused by a problem within your eyes, as you might assume—aura typically involves visual disturbances that occur shortly before a throbbing migraine headache begins. That said, it’s also possible to experience migraine aura on its own, without any head pain. (FYI, a migraine without headache has its own name: acephalgic migraine). Less commonly, aura can also involve other sensory symptoms like tingling, dizziness, and difficulty with speech. A few clues that your eye issues are tied to migraine aura: Your visual symptoms affect both of your eyes, they have a distinct start and finish, and they last between five minutes and an hour. If you can still see your visual disturbances when you close your eyes, this is another sign that the cause originates in your brain, not your eyes.

That said, if you’ve experienced some of these visual symptoms but they’ve only affected one of your eyes, retinal migraine is more likely at play. This condition, which can also involve partial or complete temporary blindness in one eye, also begins in the brain, possibly the result of blood flow to the retina suddenly being restricted due to narrowing of blood vessels, known as a retinal vasospasm. Retinal migraine is rare, and it’s important to get an eye exam to confirm this diagnosis, since vision problems limited to just one eye—as well as complete vision loss, however fleeting—can also be a symptom of more serious conditions, like a mini-stroke. Whatever your ocular migraine symptoms, an eye doctor or other healthcare provider can do neurologic testing, imaging, and blood work to help pinpoint the root cause of your visual disturbances.

What’s the treatment for ocular migraine? 

While migraine aura and retinal migraine can be inconvenient (it’s hard to read when you’re seeing zigzag lines) and sometimes scary (pull over if you start experiencing symptoms while driving) they’re not usually serious on their own. One of the most challenging parts is the anxiety ocular migraine can cause. While it helps to remind yourself that ocular migraine symptoms usually pass quickly, and to recognize the familiar phases of your own attacks once you’ve gotten through a few, there’s no pill that will make flashing lights go away or alleviate blind spots. Once an ocular migraine attack starts, you just have to ride out the symptoms—preferably in a dark, quiet room, as you would with a migraine headache. Avoiding bright sunlight or removing yourself from harsh office lighting and screens and placing a cool, damp cloth on your forehead can help provide some relief. Over-the-counter NSAIDs like ibuprofen can be effective if you experience mild to moderate headache pain along with your visual symptoms.

The good news is that long-term routines can go a long way toward helping you keep ocular migraine in check, including taking preventative migraine medication, which can range from daily low-dose aspirin to prescription medications commonly used for migraine treatment. Discuss the best preventative options for you with your healthcare provider. It’s also crucial to get plenty of sleep, manage your stress levels, stay hydrated, maintain healthy blood pressure and eat regularly to avoid low blood sugar, as crashes are known to bring on ocular migraine symptoms. And, of course, it helps if you can figure out which other specific factors seem to bring on your visual symptoms; classic migraine triggers can also set off ocular migraines, too. Think red wine, caffeine, aged cheeses, high altitude, smoking, artificial sweeteners, and certain hormonal contraceptives, including birth control pills. Review this list of 10 top migraine triggers from the American Migraine Association and stay focused on the long-term picture—by figuring out which triggers are most important to navigate around in your daily life, you’ll get on the path to fewer scary visual interruptions going forward.