As you are researching this migraine condition, you might notice that it’s difficult to find information about an optical migraine. That’s because doctors are increasingly using terminology for headache disorders(1) that comes from “The International Classification of Headache Disorders.” The term optical migraine is not included in this document.
This means that the term can be used differently by different doctors, and two patients with the same diagnosis can actually have a completely different set of optical migraine symptoms depending on which doctor diagnosis them. Likewise, two patients experiencing the same set of symptoms can receive a completely different treatment.
Still, there are general symptoms of optical migraines that are fairly well recognized and accepted among the medical community.
WHAT DOES A “TYPICAL” OPTICAL MIGRAINE LOOK LIKE?
Most doctors recognize the condition based on the optical migraine symptoms that have to do with vision. Optical migraine sufferers experience episodes of visual disturbances, such as seeing spots or lines, partial or total vision loss, or blurred vision. Often, the symptoms will only present in one eye. The symptoms are short-term, and self-resolve within about half an hour after an attack. Unlike other types of migraines, these symptoms never occur with a headache.
If you have this experience, your diagnosis may actually be “migraine aura without headache.” The condition is commonly referred to, unofficially, as “silent migraine.”
Other doctors will use this diagnosis for any type of migraine if ocular symptoms such as visual disturbances or pain around one eye occur. In this case, the official diagnosis would be an optic migraine disorder.
WHAT CAUSES AN OPTICAL MIGRAINE?
Nobody knows for sure what causes optical migraines or any other kind of migraine disorder, but experts believe that the cause is genetic. About 70 percent of those diagnosed with migraines have family members who also have the condition.
Hormones may also be a culprit in the development of migraines, especially estrogen. Women are much more susceptible to headache disorders than men are, especially during times of hormonal fluctuations such as those that occur throughout menstrual cycles, menopause, pregnancy, and the postpartum period.
The mechanism of action behind migraines has yet to be fully established, though current research suggests that biochemical reactions in the brain are responsible for triggering the onset of migraines. These reactions cause inflammatory substances to be released into the neural network surrounding the brain, resulting in headaches and/or visual disturbances.
Medical imaging has recently confirmed that the brain’s blood flow becomes temporarily irregular during migraines that involve visual disturbances. However, experts are not yet able to explain why these attacks self-resolve in twenty to thirty minutes.
WHAT HAPPENS AFTER DIAGNOSIS?
Treatments used for all types of migraine disorders are similar, but certain types of migraines respond better to some treatments than others. Since the treatment of optical migraine depends on which set of symptoms the patient is suffering with, your best bet is to accurately confirm what type of migraine you have. Discuss your symptoms more in depth with your doctor, and if at all possible, get a second opinion. This way, you can ensure that you are receiving the best treatment for your condition that is available.
Since painless visual abnormalities can be a symptom of much more serious health issues, it is very important to request a full medical workup with both your doctor and an ophthalmologist.
HOW IS OPTICAL MIGRAINE TREATED?
After a full checkup is done and other causes of visual disturbances or headaches are ruled out, your doctor will work with you to identify what is triggering your migraines. For those prone to migraines, certain stimuli such as stress, fragrances, bright lights, working on a computer(2) for long periods of time, and even weather changes can bring them on. Certain foods and alcohol, and especially caffeine, can also cause migraines. You may need to make lifestyle adjustments, such as changing your diet or avoiding strong fragrances, to avoid triggering future migraines.
If you are a woman, your doctor may wish to identify when your migraines occur in relation to your menstrual cycle. For women who have menstrual headaches and migraines related to their menstrual cycle or menopausal changes, hormonal medications such as birth control pills may be prescribed.
Other medications used to treat migraines in conjunction with lifestyle changes include NSAID pain relievers, antidepressants, beta blockers, and anticonvulsant medications commonly used in patients with epilepsy.