About Retinal Migraine
The pathophysiologic causes of retinal migraine are not fully understood, and more research is needed to determine the exact mechanisms. However, several potential causes have been proposed, including retinal vasospasm (narrowing of arteries), inflammation around the nerves, and changes within areas of the brain. Some eye experts believe that retinal migraine may result from changes in nerve cells spreading across the retina. It's important to note that retinal migraine is not usually considered to be a sign of serious problems within the eye and long-term damage to the eye is rare.
Risk Factors for retinal migraine include:
- Female sex: Women tend to have a greater risk for developing retinal migraine compared to men.
Triggers of retinal migraine episodes include:
- Stress
- High blood pressure
- Smoking
- Hormonal birth control pill use
- Dehydration (not drinking enough water)
- Low blood sugar.
Common symptoms of retinal migraine include:
- Flashes or sparkles of light
- Temporary loss of vision in one eye
- Flickering lights in the affected eye
- Blind spots or partial loss of vision
Migraine headache signs and symptoms start within 60 minutes of visual changes. Symptoms include:
- Aura spreading gradually over 5 minutes or more
- Pulsing or throbbing headache
- Moderate to severe pain intensity
- Worsening of headache with activities like walking or climbing stairs
- Nausea and vomiting
- Increased sensitivity to light and sound
Visual changes may be due to other conditions. If you suspect you may have retinal migraine, it is recommended to consult with a doctor for proper evaluation and management.
To diagnose retinal migraine, doctors typically rely on a process of exclusion and consider the following:
- Investigation of symptoms: Doctors review your symptoms, such as transient blindness or visual disturbances occurring in one eye, along with a headache that starts within 60 minutes. The doctor may a description of all your symptoms to determine if you are having an aura with the migraine.
- General examination: A physical and neurological examination is usually performed, which may be entirely normal in most cases. This helps rule out other causes of symptoms.
- Personal and family medical history: Doctors inquire about your personal and family history of migraines to help with the diagnosis.
Additional examinations or tests may include:
- Ophthalmoscope evaluation: During an attack, an ophthalmoscope may be used to check for decreased blood flow to the eye, although this is not always feasible due to the brief duration of attacks.
- Specialist consultation: In some cases, a specialist doctor, such as a neurologist or ophthalmologist, might be consulted to rule out other serious eye diseases or stroke.
It's important to consult with your healthcare professional for accurate diagnosis to enable appropriate management of retinal migraine.
The goals of treatment for retinal migraine are to preserve and restore vision and reduce the frequency of episodes. Although damage to the retina from retinal migraine is very rare, it is important to reduce the risk of long-term disrupted blood flow in the eye.
Here are the recommended treatments and how they work to achieve these goals:
- Medications:
- Nonsteroidal anti-inflammatory drugs (NSAIDs): Over-the-counter medications like aspirin or ibuprofen can help relieve pain and inflammation associated with retinal migraine. People with chronic (long-term) medical conditions or taking prescription medications should check with their healthcare provider before starting new medications.
- Antinausea medications: These medications can help prevent nausea and vomiting during episodes.
- Preventive medications: Calcium channel blockers, anti-seizure drugs, antidepressant medications, and daily low dose aspirin may be prescribed to reduce the frequency of retinal migraine episodes.
- Lifestyle and Health Behavior Changes: Changes to daily habits to reduce triggers of retinal migraine
- Dietary adjustments: Removing trigger foods from your diet may help prevent retinal migraine episodes.
- Quitting smoking: If you smoke, quitting can be beneficial as it may be a trigger for retinal migraine.
- Drink fluids: Getting enough fluid intake may help reduce the risk of retinal migraine triggered by dehydration.
- Managing blood pressure: Taking steps to control hypertension, if it is a trigger for your retinal migraine, can help prevent episodes.
It's important to note that treatment recommendations may vary depending on individual factors. Consult with your healthcare professional for personalized advice. Medication dosing may be affected by many factors. Check with your health care professional about dosing for your individual situation. Side effects can occur. Check with your health care professional or read the information provided with your medication for side effect information.