A retinal migraine is a type of migraine with aura that is rare and includes repeated bouts of short-lasting, diminished vision or blindness in one eye.
These bouts of diminished vision or blindness may precede or accompany a headache and nausea.
The exact cause of retinal migraine is unknown and controversial. There are several mechanisms that have been considered including retinal vasospasm (narrowing of arteries), inflammation around the nerves, and changes within areas of the brain.
More research is needed to fully understand potential causes.
Some eye experts believe that retinal migraine results from changes in nerve cells spreading across the retina. Typically, long-term damage to the eye is rare.
Retinal migraine is not a sign of serious problems within the eye. There’s a small chance that reduced blood flow can damage the retina. If this happens, it can lead to long-term vision impairment.
The following activities and conditions can trigger retinal migraine attacks:
- intense exercise
- tobacco use
- low blood sugar
- birth control pills that modify hormonal levels
- high altitude
- hot temperatures
- caffeine withdrawal
Additionally, certain foods and liquids can trigger retinal migraine, including:
- foods that contain nitrates, such as sausage, hot dogs, and other processed meats
- foods with tyramine, such as smoked fish, cured meats, and certain soy products
- products that contain monosodium glutamate, including snack chips, broths, soups, and seasonings
- alcoholic beverages including certain beers and red wine
- beverages and foods with caffeine
Retinal migraine is triggered by different things in different people.
The symptoms of a retinal migraine are similar to regular migraine, but they include a temporary change in one eye’s vision.
People experiencing retinal migraine attacks will often lose vision in one eye only. This is usually brief, lasting about 10 to 20 minutes. In some cases, this can last up to an hour.
Some people will also see a pattern of black spots called “scotomas.” These black spots gradually get bigger and cause complete loss of vision.
Partial vision loss
Other people will partially lose vision in one eye. This is usually characterized by blurry, dim vision or twinkling lights called “scintillations.” This can last up to 60 minutes.
Sometimes, people who experience retinal migraine will experience a headache after or during the attack on their vision. These headaches can last for a few hours to a few days.
Physical sickness, nausea, and painful throbbing of the head often accompany the headaches. These typically affect one side of the head. This pain may feel worse when you’re physically active.
If retinal migraine isn’t experienced frequently, doctors or optometrists may prescribe medications typically used to treat other forms of migraine.
These rescue medications include triptans, nonsteroidal anti-inflammatory drugs such as aspirin and ibuprofen, and antinausea medications.
Additionally, doctors may look at your individual triggers and try to deal with them actively to prevent future episodes.
An eye specialist may sometimes prescribe specific medications for a retinal migraine including a beta-blocker such as propranolol, an antidepressant such as amitriptyline, or an anticonvulsant such as valproate or topiramate.
More research needs to be done in this area to come up with a more definitive treatment.
The terms “ocular migraine” and “retinal migraine” are often used to mean the same thing. But to be precise, a retinal migraine is a rare type of ocular migraine.
It’s also worth differentiating the term “visual migraine,” in which the migraine affects an area of the brain that involves vision. This may result in aura affecting sight in both eyes, not just one.
Most often, a retinal migraine attacks will subside after a short time with no lasting harm, though it can affect your ability to drive safely.
Still, it’s worth discussing with your doctor and potentially getting an eye examination to look into potential causes and rule out more serious concerns, such as a stroke in the eye.
If it’s never happened before, losing vision in both eyes at the same time may also be a sign of a more serious problem.
Your head may start to hurt at the same time a retinal migraine affects your vision or up to 1 hour later, or you may not experience a headache at all.
The same is true for the more common migraine with aura.
Retinal migraine is considered relatively rare. It’s more common for a different type of migraine to affect vision in both eyes, not just one.
Older research from 2005 puts the frequency at about
The visual effects of a retinal migraine usually last no more than an hour.
Not all retinal migraine attacks come with a headache or nausea, but such symptoms may last longer — potentially for more than a day.
Both children and adults of any age can experience retinal migraine. These tend to be more common in the following groups:
- people under 40 years old
- people with a family history of retinal migraine or headaches
- people with a personal history of migraine or headaches
People with certain illnesses that impact the blood vessels and eyes may also be at risk. These illnesses include:
There aren’t any specific tests to diagnose a retinal migraine.
If you see a doctor or optometrist during a retinal migraine attack, they may use a tool called an “ophthalmoscope” to check for decreased blood flow to your eye, but this generally isn’t feasible because attacks are usually brief.
Doctors typically diagnose a retinal migraine by investigating the symptoms, conducting a general examination, and reviewing a personal and family medical history.
Retinal migraine is usually diagnosed by a process of exclusion, meaning that symptoms such as transient blindness can’t be explained by other serious eye diseases or conditions.
Retinal migraine typically begins with total or partial vision loss, or visual impairment such as twinkling lights. This typically lasts no more than an hour.
The headache phase starts during or after the visual symptoms appear. This headache can last a few hours to several days.
Typically, this type of migraine occurs once every few months. Episodes can occur more or less frequently than this. Either way, you should consult with an eye specialist if you’ve experienced the associated vision impairment.