A large percentage of migraine sufferers experience a wide variety of visual disturbances, which usually last less than an hour. However, some of these may be related to other eye problems. So what are these disturbances, and how do we treat them?;
Migraine is a chronic disorder that occurs more frequently in women and is characterized by episodes of headache combined with symptoms of the autonomic nervous system. The headache is often accompanied by nausea, vomiting, and photophobia, while approximately 30% of sufferers experience visual disturbances (known as the aura phase).
The exact cause of migraines is unknown. Possible causes include increased brain excitability in response to external biochemical stimuli and vasoconstriction in the brain and surrounding tissues. The aura phase usually precedes the headache, but it can occur independently or simultaneously with it. The main characteristic of the aura is visual disturbances, which generally last less than an hour, usually 10–30 minutes.
Visual disturbances associated with migraine with aura affect both eyes. This may not be easily noticeable, especially when they occupy part of the visual field. By temporarily covering one eye and then the other, we can determine whether the problem affects one eye or both. When visual disturbances are confined to one eye, we’re talking about a rarer type of migraine called ocular migraine. Ocular migraine affects approximately 1 in 200 people with migraine. Possible causes include blood vessel spasms and disorders of the retinal nerve cells. People who experience ocular migraines may have a higher risk of permanent vision loss in one eye.
The most common visual impairment What a patient with an aura perceives is the scintillating scotoma. It is an area of blurred vision surrounded by zigzagging, sparkling lines, which gradually enlarges and eventually dissipates.
Other optical phenomena is:
- flashes,
- little flies,
- a flickering light,
- blind spots in the field of vision,
- impaired vision,
- temporary loss of vision,
- the feeling that we're looking through water,
- image fragmentation and
- disturbances in the perception of the size of objects and their colors.
Less commonly, in addition to the disorders mentioned above, the patient may have diploma, drooping eyelid and changes in pupil size of the eyes.
Over time, headache episodes may become less frequent, milder, or even stop, while the aura phase—that is, the visual disturbances—persists and may be the only symptom of migraine, usually in people over the age of 50. Therefore, it is often difficult to determine whether the visual phenomena are related to the migraine or are symptoms of another eye condition.
Serious ophthalmic and systemic diseases that affect our visual system, such as vascular occlusions in the retina and brain, increased intracranial pressure, ischemic optic neuropathy, glaucoma, retinal detachment, orbital tumors, etc., present with similar visual disturbances, and some of these may be accompanied by headache. An immediate and thorough ophthalmological examination not only aids in the diagnosis of migraine by ruling out other causes of headache, is essential before a newly onset visual disturbance is attributed to migraine and to rule out other serious ophthalmic conditions that carry a high risk of eye damage.
