Ocular migraine refers to a migraine episode with visual symptoms. If it occurs in one eye, it’s called retinal migraine. But if it occurs in both eyes, doctors call it migraine with aura. It’s unclear what causes this, but it may be due to the excited neurons in your brain’s cortex.

Migraine is a neurological condition that can cause severe headaches and other symptoms such as:

  • nausea and vomiting
  • trouble speaking
  • sensitivity to light and sound

Migraine episodes affect about 12% of the general population. About 30% of people who experience migraine episodes develop migraine with aura. A migraine with aura is when sensory, motor, or speech symptoms occur at the same time or before a migraine.

An aura often causes visual changes such as:

  • partial vision loss or blind spots
  • zigzagging lines or geometric shapes in your vision
  • flashes of lights, stars, or spots

Medical professionals no longer use the term ocular migraine. Still, many people use it to refer to any migraine that causes visual symptoms. They may also use the term ophthalmic migraine. It can include migraine with aura, which usually causes symptoms in both eyes, or retinal migraine, which causes symptoms in one eye.

Keep reading to learn more about these two types of migraine.

A migraine with aura can cause changes in your vision in both eyes. Visual changes occur in about 98% to 99% of people who experience migraine auras.

In a 2019 review of studies, researchers found that the most frequently reported visual symptoms of a migraine with aura were:

  • flashes of bright light: 16% to 38%
  • foggy or blurred vision: 25% to 54%
  • zigzag or jagged lines: 24% to 81%
  • flickering blind spots (scotoma): 23% to 77%
  • blind spots: 32%
  • black dots: 3% to 17%
  • small bright dots (phosphenes): 19% to 70%
  • flickering light: 12% to 91%

Researchers don’t know exactly why migraine auras occur. Some think it could be due to a phenomenon called cortical spreading depression. That’s when a slow wave of altered electrical activity spreads throughout your cerebral cortex. This altered activity is reversible and does not cause brain damage.

Can you have ocular migraine without headache pain?

It’s possible to develop a migraine with a visual aura without having a headache. Researchers estimate that aura without headaches occurs in about 4% of people with migraine and 38% of people with migraine with aura.

A migraine with a visual aura can cause debilitating symptoms that affect your quality of life. Some people may have symptoms that impair their everyday activities.

Although migraine can cause severe symptoms, it’s not usually life threatening and does not cause brain damage. According to the National Health Service (NHS), migraine episodes tend to improve over many years in most people.

Still, migraine with aura can have some serious complications. In rare cases, it can trigger a seizure. People who have migraine with aura are at an increased risk of heart attack and stroke.

When to contact a doctor

It’s important to visit your doctor if you have frequent or severe migraine symptoms. The NHS defines frequent as having migraine episodes more than 5 days a month, even if you control them with medication.

Medical emergency

It’s critical to call 911 for immediate medical attention if you or somebody you’re with experiences symptoms such as:

These symptoms can be caused by serious conditions like stroke or meningitis.

Many people find it helpful to move to a dark and quiet room when an aura starts. A cold compress on your forehead or the back of your head may help manage pain.

Some medications might help ease your symptoms if you take them when you develop symptoms of an aura. Doctors sometimes recommend:

  • pain relievers such as ibuprofen
  • triptans
  • anti-nausea medications (to reduce nausea or vomiting)
  • ergotamines

Learn more about migraine medications.

Migraine prevention

Some medications may help reduce your number of headache days. It might take several tries to find a combination of medications that work for you. They might include:

Avoiding triggers

It’s not well-known what causes a visual aura, but studies have linked them to different triggers. Starting a migraine diary can help you identify your triggers. In your diary, you can track factors like:

  • what you eat and drink
  • your daily exercise
  • weather patterns
  • your emotional state
  • new medications
  • your overall health

Over time, you may be able to see patterns between certain lifestyle factors and when your migraine episodes occur. Some apps can also help keep track of your migraine episodes.

Learn about the best migraine apps here.

Lifestyle changes

Practicing some of these lifestyle habits may help reduce your migraine episodes if they’re triggers for you:

There’s also a link between migraine episodes and hormonal changes like menstruation. Migraine episodes are most likely to develop in the 2 days before menstruation starts or during the first 3 days of menstruation.

Women experience migraine three times more than men.

Certain weather patterns, like changes in humidity or drops in barometric pressure, are also triggers for some people.

What causes ocular migraine in 1 eye (retinal migraine)?

Retinal migraine causes brief vision loss or other visual problems in one eye. It usually causes partial or total vision loss for 10 to 20 minutes. A headache may occur before, during, or after the episode.

Experts think retinal migraines may be due to cortical spreading depression and the release of certain chemicals. Factors that may trigger a retinal migraine include:

  • stress
  • low blood sugar
  • dehydration

Treatment usually involves taking pain relievers to manage discomfort and reducing exposure to potential triggers. Permanent vision loss is rare, but there’s a small chance that disrupted blood flow can damage your retina.

It’s important to seek urgent medical attention if you experience your first retinal migraine or any other time you suddenly lose your vision.

Some people still use the term “ocular migraine” to refer to any migraine that causes visual changes. Retinal migraine episodes can cause temporary vision loss in one eye. Visual changes in both eyes are most likely to be caused by migraine with aura.

About one-third of people who have migraine episodes have auras. Almost all these people experience temporary vision changes during their episodes.

There’s no cure for migraine with aura, but your doctor can help you create a plan to help prevent episodes.