For many centuries people have suffered from migraines, a special form of which is ocular migraines. This predominantly chronic disease is an ailment that is extremely uncomfortable and immensely reduces the quality of life of those affected.
What is eye migraine?
In medical terminology, the synonym ophthalmic migraine or migraine ophtalmique hides the eye migraine. This disease, also known as ophthalmic migraine, can occur in two different forms.
According to DigoPaul, the ocular migraines are often so severe that patients have to withdraw from everyday life. Eye migraines, which are usually perceived as “threatening”, can also be very painful and are characterized by various accompanying symptoms.
The stress on the eye migraines arises from the temporary lack of vision. Unfortunately, eye migraines do not only occur in adults. More and more children are already affected by eye migraines, a neurological disease.
When the causes are found, not all processes have yet been fully researched, which is still a limitation, especially in terms of prevention and treatment. Finding the cause of ocular migraines has so far yielded findings that relate to fluctuations in the hormonal balance, different stressors, strong glare of light and the increased consumption of alcohol and nicotine.
Various ingredients in food and changes in the climate can also trigger eye migraines. Some drugs are also suspected of being able to trigger ocular migraines. In the context of hormonal irregularities, puberty, the birth control pill, the time immediately before menstruation and the menopause can be decisive.
These factors influence the nervous system and are centralized on the visual cortex, in the area of which the posterior cerebral artery is located. The resulting conditions in these areas contribute to the visual disturbances and loss of vision as well as persistent massive pain in the case of an ocular migraine.
Symptoms, ailments & signs
A typical sign of eye migraines is the appearance of visual disturbances, which are, however, only of a temporary nature. They show up in both eyes. Ciliated scotoma is one of the most common symptoms of ophthalmic migraines. This leads to a flicker in front of the eye, which can be accompanied by flashes of light.
The ciliated scotoma is associated with the loss of the visual field. It is characteristic that the outer scope narrows from the outside to the inside or that the failures appear in the middle of the field of view. The extent of the loss of visual field varies from patient to patient.
Some of those affected perceive their surroundings as if they were under blinkers. If there is a flickering scotoma, a part of the field of vision appears flickering or blurred. Similar to the migraine aura, the scotomas sometimes change or move from one direction to the other.
It is not uncommon for flashes of light to occur. They are similar to the bright spots of light that appear when you look into a lamp and do not immediately disappear again. In some cases, symptoms change after a few years and switch to other forms of migraine.
If the eye migraines are pronounced, the visual disturbances sometimes even turn into optical hallucinations. Above all, this includes the appearance of double images or the perception of objects that do not even exist in reality. Furthermore, all symptoms of classic migraines can also occur with eye migraines.
Diagnosis & course
In classic ocular migraines, symptoms occur in both eyes, which impair vision. In these cases, so-called visual disturbances occur, which are described as ciliated scotomas.
In eye migraine, bilateral deficits of the visual field and the scotomas in the form of moving flashes of light are typical. These symptoms occur either in combination or individually. The subsequent course of eye migraines is characterized by massive throbbing headaches, pain in the face and / or neck.
People with ocular migraines experience nausea and vomiting, sensitivity to light and dizziness. Since changes in blood pressure can occur, the patients usually feel extremely uncomfortable and may sweat heavily.
In many cases, eye migraines can severely limit the patient’s everyday life. As a result, everyday things and activities are no longer possible, as the eye migraines lead to severe pain and dizziness. Often it is also no longer possible for the patient to go to his workplace.
Usually, the eyesight is also severely impaired, so that the affected person has to wear visual aids in order to see objects clearly. Eye migraine is not treated directly, but there are many remedies that can alleviate the symptom so that normal everyday life is possible again. Above all, this includes pain relievers.
However, it is not advisable to take these in the long term, as they can attack the stomach. Eye migraines can also arise due to an intolerance to a certain drug. In this case, the respective drug must be discontinued and the disease progresses positively.
If the eye migraine is treated, there are usually no further complications. Without treatment, eye migraines can greatly reduce the quality of life and pull the patient out of everyday life. This can also create social problems and difficulties.
When should you go to the doctor?
An eye migraine does not necessarily require medical treatment. The symptoms usually disappear after a few hours or can be relieved independently by simple measures. A doctor visit is recommended if symptoms persist longer than usual (maximum 24 hours) or if health complications occur. Visual disturbances such as a flickering scotoma or persistent flashes of light should be examined by a doctor. A migraine with aura, i.e. neurological failures, requires immediate treatment.
If the ocular migraines are left untreated, a migrainous infarction and, as a result, a stroke can occur. Patients suffering from chronic eye migraines should generally consult a doctor. In the event of severe attacks, a hospital should be visited for further treatment. Children who complain of eye pain and typical migraine symptoms should be taken to a family doctor or pediatrician.
In the event of prolonged attacks, dizziness and neurological failures, an emergency doctor must be called. Chronic migraine attacks should be discussed with a specialist. Expert advice is particularly recommended if the complaints are associated with severe symptoms such as speech or impairment of consciousness or double vision.
Treatment & Therapy
A possible therapy for ocular migraines has been sought for a long time. Eye migraine patients use the offers that are available today as part of current therapy options.
In principle, the treatment of ocular migraines is primarily based on high-quality medication. In this context, those affected rely on drugs such as pain relievers and substances such as caffeine, ergotamine and pharmaceutical substances prescribed as beta blockers for heart disease. In addition, drugs such as amitriptyline and riza- or sumatriptan are relevant in the treatment of ocular migraines.
These interrupt the transmission of the pain by influencing the responsible messenger substances and are very reliable. However, sumatriptan and rizatriptan do not have an effect in all patients. Various homeopathic active ingredients on a natural basis can also be helpful against the symptoms of ocular migraines.
When the ocular migraines occur acute, tried and tested pharmaceutical products such as pain relievers and medication against nausea are taken. The best “medicine” for an ocular migraine, however, are the preventive measures that go with it
The ocular migraine is a phenomenon that usually resolves quickly without medical treatment and does not develop any complications. However, follow-up care for a short period after the attack is a good practice. For patients, the migraine attack is often an event that not only affects the physical symptoms, but can also cause fear in some people.
It is therefore good if the eye migraines are followed by a rest phase. This is particularly useful if the actual migraine attack is followed by a headache phase. The contact person for the treatment and follow-up care of eye migraines is your family doctor or neurologist.
Follow-up care means that the patient gives himself some time after the attack to process the visual disturbances physically and psychologically and not immediately go back to everyday stress. Driving, sunlight, going to discos. The ocular migraine is a phenomenon that usually resolves quickly without medical treatment and does not develop any complications.
However, follow-up care for a short period after the attack is a good practice. For patients, the migraine attack is often an event that not only affects the physical symptoms, but can also cause fear in some people. It is therefore good if the eye migraines are followed by a rest phase.
This is particularly useful if the actual migraine attack is followed by a headache phase. The contact person for the treatment and follow-up care of eye migraines is your family doctor or neurologist. Follow-up care means that the patient gives himself some time after the attack to process the visual disturbances physically and mentally and not immediately go back to everyday stress.
Driving, sunlight, going to the discotheque, watching TV or reading are all strained on the eyes and should ideally be avoided for an hour or two. It makes sense to wear sunglasses in appropriate weather. Distraction from the flickering event, which those affected often perceive as psychological stress, is ideal in aftercare. Drinking enough water can also be helpful with regard to a classic attack of migraines. In consultation with a neurologist or family doctor, a tablet can also be taken for prophylaxis.
Outlook & forecast
The ocular migraine is a classic seizure disorder that often always shows the same appearance. A negative prognosis in the sense of a worsening of physical findings is not to be expected, since there are usually no organic findings behind the ocular migraines. This applies to patients who simply wait for the attack or who seek treatment from a doctor or alternative practitioner because of subsequent headache attacks.
The prognosis for the acute condition of the eye migraines is also very good. The ciliated scotoma, which leads to a more or less severe visual impairment in the affected person, disappears spontaneously. In many cases the phenomenon will be over within 15 to 20 minutes. It does not matter whether the affected person lies down during this time or, as far as possible, goes about their normal daily routine.
The only conceivable course that could be a little less favorable has less to do with the flickering of the eyes than with the psychological condition of the person concerned. Again and again there are patients who, despite the fact that the doctor has made a harmless diagnosis, are very frightened with every attack. The fear can prolong an attack or a possibly subsequent pain problem and in some cases also increase the disposition for the next attack. If necessary, further education or brief psychotherapeutic treatment can be helpful.
All causes that are causally related to the development of an ocular migraine should initially be avoided as sensible prophylaxis. Avoiding special foods and alcohol shouldn’t pose too much of a problem. It becomes a little more difficult with the stress factors, which can lead to eye migraines, but cannot always be ruled out.
Doctors therefore recommend regular relaxation exercises and learning relaxation techniques in order to be able to successfully counter eye migraines. There are no prophylactic drugs against ocular migraines.
You can do that yourself
There is no special form of therapy for ocular migraines; the guidelines for treatment are based on classic migraines.
The eye symptoms are reliably announced so that patients can take countermeasures in advance with medication. Doctors prescribe triptans – these are pain relievers that are specifically approved for the treatment of migraines. The products are now freely available in pharmacies.
For the patient, it means security to always have a dose of his medication on hand. If pain pills are not enough, the doctor can also prescribe preparations against nausea and dizziness.
If eye migraines appear, patients should act directly. While a glass of water is often sufficient for normal headaches, the pain of a migraine attack does not go away untreated. Even small signs can be counteracted with the drug dose.
An additional anti-stress program can be helpful for many patients. Behavioral therapies, hypnosis sessions or yoga can lower the personal stress level and thus reduce the frequency of eye migraines.
The causal treatment of the disease makes the most sense. Occasionally, eye migraines can be triggered by stress, high blood pressure or hormone fluctuations. The regular intake of any antihypertensive drugs and the reduction of stress are therefore often part of the therapy components.