Ophthalmic Migraine: Causes, Possible Treatment and Prevention

An ophthalmic migraine is an uncommon condition that can cause temporary vision disturbances or even temporary blindness in one of your eyes. This problem is the result of decreased blood flow or blood vessel spasms behind the eye or in the retina. Typically, the vision returns to normal within an hour. Ophthalmic migraines may be painless, or they may occur at the same time as or after a regular migraine headache. Your Miami eye doctor can help you determine whether you have an ophthalmic migraine by ruling out other conditions.

Causes

The exact cause of ophthalmic migraine isn’t known, although some experts believe the problem could be related to spasms in the retinal blood vessels or changes in the nerve cells in the retina. People with ophthalmic migraine have a higher risk of permanent vision loss in one eye. It’s possible that certain medications used to prevent migraines such as anti-seizure medications or tricyclic antidepressants may help prevent vision loss. However, if you experience an ophthalmic migraine, even if your symptoms always go away on their own, you should talk to your doctor about possible treatments.

Possible treatments

Getting treatment for ophthalmic migraines begins with a correct diagnosis. Your eye doctor will first rule out other problems that can cause similar symptoms such as spasms in the artery that delivers blood to the retina, other blood vessel problems associated with autoimmune disease, inflammation in the blood vessels, conditions that prevent proper blood clotting such as sickle cell disease, and drug abuse.

Many people do not require treatment for ophthalmic migraine, especially if their symptoms abate untreated within half an hour or so. You should stop what you’re doing and rest until your vision returns to normal; if a headache accompanies your symptoms, ask your doctor what pain relievers are right for you. Other possible treatments include:

• Beta-blockers, special medications that help regular blood pressure
• Tricyclic antidepressants
• Drugs that treat epilepsy

Prevention

The most important thing you can do to avoid ophthalmic migraine is to refrain from engaging in possible triggers.

• Manage your stress levels
• Avoid smoking
• Maintain healthy blood pressure
• Avoid hormonal birth control pills
• Exercise only moderately if exercise is a trigger for you
• Avoid high altitudes
• Stay hydrated
• Avoid low blood sugar with small, regular, healthy snacks
• Keep cool during the summer

Some people notice that they have dietary triggers such as caffeine or artificial sweeteners, although these are more likely to cause regular migraines.

Certain medications can help prevent ophthalmic migraines. Calcium-channel blockers open the blood vessels. It’s possible also to use nonsteroidal anti-inflammatory drugs sometimes. Less often, doctors may prescribe medication used to treat depression, epilepsy, and blood clotting. Preventive medicine is usually recommended for patients who experience ophthalmic migraines more than four days per month that do not respond to other treatments.

One other possible treatment option is a device known as Cefaly. This portable headband-like device delivers electrical impulses at the forehead to stimulate a specific nerve. Patients wear the device for 20 minutes once a day. SpringTM and gammaCore are two similar devices that have shown success in some cases of ophthalmic migraine.