Retinal (Ocular) Migraine

Retinal migraine is a rare subtype of migraine with aura. With retinal migraine, a person has vision changes in just 1 eye just before the head pain phase of an attack.

Vision changes with retinal migraine

The type of vision changes a person might have include:1

  • Seeing twinkling, flashing, wavy, or zigzagging lights or halos
  • Blind spots or dark spots in vision
  • Temporary blindness
  • Tunnel vision

These symptoms spread slowly over 5 minutes to 1 hour and last up to 1 hour, followed by head pain. Sometimes the vision changes overlap the head pain. Retinal migraine is one of the least understood forms of migraine.2

Some people call this type of migraines by the older term “ocular migraine.”

What is the retina?

The retina is found in the eye. It is made up of nerves that line the back wall inside the eye. These nerves sense light and send signals to the brain that get translated into what you see. A retinal migraine affects the retinal nerves.3

What causes retinal migraines?

Doctors do not know what causes retinal migraines. One theory is that a spasm in blood vessels that supply the retinal nerve aggravates the nerve. Because it is a rare condition, doctors do not have many patients to study to learn more about this type of migraine.4

Diagnosing retinal migraines

Doctors diagnose retinal migraine by looking at a person’s medical history, family health history, a physical exam, and by studying the symptoms reported by the person. A migraine diary can help record when symptoms stop and start and how often these happen. A full eye exam done by an eye doctor (ophthalmologist) may be needed.1

It is important to rule out stroke of the eye (amaurosis fugax) and other health problems that cause temporary blindness.

Treating retinal migraines

Retinal migraines can be treated with a combination of medicine and lifestyle changes. The most common treatments include:1

  • Preventive drugs that help reduce how often you have migraines and how severe the attacks are
  • Acute drugs taken at the beginning of an attack to try and reduce its severity
  • If you are taking a triptan as an abortive drug, you should talk with your doctor. Triptans can lead to decreased blood flow and worse vision.
  • Complementary treatments to reduce stress, such as biofeedback and cognitive behavioral therapy
  • Learning your triggers and avoiding the ones you can, such as certain foods and drinks, not eating, or not getting enough sleep

Taking a daily aspirin, stopping smoking, and stopping birth control pills may also help control retinal migraine attacks.1

Complications of retinal migraine

Some people with retinal migraine find that the blindness does not go away. One small study found that almost half of people with retinal migraine had permanent vision loss. However other doctors believe this study may overestimate this complication.4

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Written by: Jessica Johns Pool | Last reviewed: October 2020