Ocular Migraines: What They Are and What to Do
You're going about your day when something strange happens to your field of vision.
A flickering arc of light creeps into your vision, or part of your visual field simply disappears. No headache, no warning. Just a sudden, unsettling change in what you see. This is often an ocular migraine, and while it can be alarming the first time it happens, understanding what's going on can make it much less frightening.
What Is an Ocular Migraine?
The term "ocular migraine" gets used in a few different ways, so it helps to be precise. Most people use it to describe a visual migraine aura, a temporary disturbance in vision that occurs without (or before) a headache. These episodes typically affect both eyes and last anywhere from a few minutes to about half an hour. The visuals can vary widely from person to person. Common experiences include:
- A shimmering or flickering arc (called a scintillating scotoma)
- Zigzag lines or geometric patterns at the edge of your vision
- A blind spot that slowly expands
- Blurring or kaleidoscope-like distortions
The root cause is a wave of electrical activity moving across the visual cortex at the back of the brain, temporarily disrupting how your brain processes visual information.
Who Gets Them, and Why?
Ocular migraines are surprisingly common. They tend to run in families and are more frequent in women than men. Known triggers include stress, lack of sleep, caffeine, alcohol, dehydration, bright lights, and hormonal shifts. Some people experience them regularly; others have one episode and never have another.
When to Be Concerned
In most cases, an ocular migraine is harmless and resolves on its own. But certain situations warrant prompt attention. See your eye doctor or go to an emergency room if:
- You experience sudden vision loss in one eye only (not both), which can signal a more serious vascular event
- Symptoms last longer than an hour
- Vision changes accompany sudden severe headache, weakness, or difficulty speaking You have never had this happen before and are over 50
It's always worth mentioning any new visual disturbance to your eye care provider, even if it passed quickly and felt minor.
What to Do During an Episode
There is no treatment needed to stop an ocular migraine aura in progress. The best approach is to:
- Stop driving or any activity that requires sharp vision
- Sit down in a calm, low-light environment
- Wait it out. It will pass.
If headaches follow the aura regularly, your physician may discuss preventive options. Keeping a simple log of when episodes occur, and what preceded them, can help identify your personal triggers.
The Bottom Line
Ocular migraines are startling but usually benign. The most important thing you can do is know the difference between a typical aura and a warning sign that needs immediate care. If you have questions about your vision or have experienced a recent episode, schedule an appointment with your optometrist.