In short
“Ocular migraine” is used for two different things. Usually it means visual aura, zigzag lines or a shimmering blind spot affecting both eyes, which is common and harmless. Rarely it means retinal migraine, temporary vision loss in one eye, which needs prompt assessment to rule out other causes.
On this page
Two meanings of “ocular migraine”
1. Visual migraine (migraine aura)
This is what most people mean. It’s a migraine aura that affects vision: zigzag lines, flashing or shimmering lights, or a blind spot that spreads over several minutes and lasts up to an hour. It comes from the brain, not the eye, so it affects the same side of vision in both eyes. It may or may not be followed by a headache. See migraine with aura.
2. Retinal migraine
This is a rare condition causing temporary visual disturbance or loss of vision in one eye only, linked with migraine. A review in Cephalalgia found that it is uncommon and that many cases labelled as retinal migraine turn out to be something else, so it should only be diagnosed after other causes have been ruled out.
How to tell the difference
During an episode, cover one eye, then the other:
- If the visual change is there with either eye covered, it’s coming from the brain, which is typical of migraine aura.
- If it’s only in one eye, the cause may be in that eye or its blood supply.
Headaches taking whole days away?
Talk it through with an Australian doctor online. No referral needed.
When to get urgent help
Seek urgent medical care, by calling 000 or going to an emergency department, for:
- sudden loss of vision, especially in one eye
- vision changes with weakness, numbness, facial drooping or trouble speaking
- a first episode of visual disturbance, especially over the age of 50
- new flashes and floaters with a shadow or curtain across your vision, which can mean a retinal detachment
- a painful, red eye with blurred vision
Managing visual migraine
- Stop driving or operating machinery until the aura has passed
- Rest in a quiet, dim place
- Track episodes and possible triggers
- If episodes are frequent, talk to a GP about prevention
When to see a GP
See a GP if you have visual disturbances, even if they pass quickly, so the cause can be confirmed. Your GP may refer you to an optometrist, ophthalmologist or neurologist.
Next step: talk to a doctor
Answer a few quick questions and you’ll get an email about your eligibility. A consultation doesn’t guarantee any particular treatment.
References
- Grosberg BM, Solomon S, Friedman DI, et al. Retinal migraine reappraised. Cephalalgia. 2006;26(11):1275-86.
- Viana M, Tronvik EA, Do TP, et al. Clinical features of visual migraine aura: a systematic review. J Headache Pain. 2019;20(1):64.
- . Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018;38(1):1-211.
- healthdirect. Migraine.
This guide is general information, not medical advice. It doesn’t replace a consultation with a doctor who knows your history. In an emergency, call 000.