What are Retinal Migraines?
Retinal migraine is said to occur when there is temporary loss of vision followed by throbbing headache within an hour of the loss of vision. The headache at times may occur concurrently with the visual symptoms as well. The root cause of Retinal Migraines is not clear but there are certain factors that may lead to onset of symptoms of Retinal Migraines. These factors are quite similar to that which cause normal migraine headaches and include excessive stress, hypertension, and chronic use of contraceptive pills, barometric changes due to high altitudes as well as exercise.
Dehydration, chronic nicotine use and hypoglycemia also contribute to the development of Retinal Migraines. Additionally, lupus, atherosclerosis and sickle cell disease also are some of the risk factors for Retinal Migraines [1].
Retinal Migraines can affect people as young as 7 years of age but in majority of the cases it is the middle aged people or people in their 40s that get affected by this condition. The primary criterion for diagnosing Retinal Migraines is the alteration of vision in one eye. This may range from temporary blindness to flickering of vision. These symptoms are variable and may last from minutes to maximum up to an hour. This will be followed by a throbbing headache even though in some cases the headache may occur concurrently with the visual symptoms [1].
It has been estimated that 1 out of 150 people with migraine suffer from Retinal Migraines at some point or the other. Retinal Migraines at times is also referred to by the name of ophthalmic or ocular migraines even though the symptoms of Retinal Migraines are somewhat different from that of the other type of migraine described above [1].
What Causes Retinal Migraines?
If experts are to be believed, then Retinal Migraines are caused due to spasms of the blood vessels in the eye that leads to an interruption of blood flow. Once the blood vessel relaxes again, the blood flow normalizes and the symptoms fade away. There are certain factors which contribute to the development of Retinal Migraines and include [3]:
- Excessive stress or fatigue
- Food sensitivity
- Caffeine withdrawal
- Too much of bright lights and noise such as in a concert
- Changes in sleep cycle such as going from one time zone to another
- Certain medications that cause swelling of the blood vessels
- Hormonal changes, specifically in females
- Chronic use of pain medications
- Lack of adequate hydration and nutrition [3]
The risk of Retinal Migraines is somewhat increased in the following
- Middle aged people or people in their high 30s
- Having a family history of migraine disorder
- People with a prior history of lupus, seizures, and sickle cell disease [3]
It should be noted that Retinal Migraines affects females more than males. The visual symptoms tend to go away within an hour but the headache lingers on for a much longer time. The visual symptoms that precede a headache are termed as an aura. The aura occurs due to spasms in the blood vessels in the eye and effects on a single eye and include:
- Flashing lights in the field of vision
- Partial loss of vision
- Complete loss of vision for a few moments [3]
The eye symptoms begin about an hour before the actual headache starts. The headache experienced in Retinal Migraines is mostly throbbing which may at times be severe in intensity. The pain will be aggravated by doing any kind of activities. Some people also have nausea or vomiting with a Retinal Migraine. Photosensitivity and Phonosensitivity is also quite common in Retinal Migraines. The headache may last for a couple of hours before fading away [3].
What are the Symptoms of Retinal Migraines?
Alteration of vision in one eye is quite common in people with Retinal Migraines. This lasts for about 15-20 minutes even though in some cases it may go on for about an hour or so. There will also be black spots in the field of vision which gradually get bigger obstructing the vision totally. Some people have only blurriness of vision and not a complete vision loss. There may also see flashing lights in their field of vision for about an hour or so [2].
The visual symptoms are then followed by a pulsating and throbbing headache. The headaches last for about a couple or hours or so, even though in rare cases they may linger on for a few days. Some people complain of nausea and vomiting due to the headache and feel that it is made worse when performing any activity [2].
How to Diagnose Retinal Migraines?
There are no specific tests to diagnose Retinal Migraines. A diagnosis is usually made after taking a detailed history of the patient including personal, family, and social history. Diagnostic tests will be carried out to rule out other more serious conditions for the symptoms like stroke or other ophthalmic conditions. Once all other conditions have been ruled out and assessing the history of the patient and the symptoms experienced, a diagnosis of Retinal Migraines is confirmatively made [3].
How is Retinal Migraine Treated?
The treatment for Retinal Migraines is based on the age and overall health status of the patient. The frequency and intensity of the symptoms also have a role to play in determining the medications that will be prescribed to the patient. If Retinal Migraines are infrequent, then the standard medications given for other types of migraines are good enough to treat the symptoms. In other cases, the physician might prescribe NSAIDs like ibuprofen or Tylenol for relief of pain and inflammation. Medications will also be prescribed to alleviate nausea and vomiting that occur with Retinal Migraines [3].
Triptans which are normally used for migraines are generally avoided in cases of Retinal Migraines even though many people take these for pain relief. As a preventive measure, the treating physician will recommend beta blockers to keep the blood vessels relaxed along with calcium channel blockers. Certain types of antidepressants are also quite effective in preventing Retinal Migraines from occurring [3].
Additionally, lifestyle changes like quitting smoking and avoiding chronic use of contraceptives are some of the ways to prevent Retinal Migraines. Other than this, there is no specific treatment for Retinal Migraines and medications are only prescribed as a preventive or to calm down the symptoms and allow the patient to function as normally as possible during an attack of Retinal Migraines [3].
