The exact cause of ocular migraine is not entirely understood. However, certain triggers have been identified, including bright lights, stress, and more.

“Ocular migraine” is a term used to cover several migraine subtypes that cause visual disturbances, including migraine with aura, retinal migraine, and ophthalmic migraine, among others.

During an ocular migraine episode, you may see flashing or shimmering lights, zigzagging lines, or stars. It may also cause blind spots in your field of vision.

An ocular migraine attack can interfere with your ability to perform tasks like reading, writing, or driving. Symptoms are temporary, and ocular migraine is typically not considered a serious condition.

The exact causes of ocular migraine are unknown. One theory is that a narrowing of arteries causes a temporary lack of blood flow to the eye and induces symptoms.

However, other factors may contribute to ocular migraine.

In this article, we discuss what causes ocular migraine and ways to cope with it.

There’s a genetic link to migraine.

According to a 2023 review, genetics may account for 30% to 60% of the chance of having the condition. The authors also note that studies have identified over 180 genes that are associated with migraine.

Some research also suggests that a family history of migraine or ocular migraine may double your likelihood of having them, too.

However, studies have not assessed a clear pattern of inheritance for ocular migraine.

There may be a link between estrogen levels and migraine. However, the exact nature of this relationship isn’t clear.

Studies have suggested that a drop in estrogen concentration is the most likely hormonal cause of migraine.

Estrogen is a hormone that controls chemicals in the brain associated with pain. In people assigned female at birth, hormones fluctuate due to the menstrual cycle, pregnancy, and menopause. Oral contraceptives and hormone replacement therapies can also affect estrogen levels.

These fluctuations may play a role in migraine symptoms developing.

Many people are able to identify individual migraine triggers or trigger combinations. Knowing these can be particularly helpful in migraine prevention.

Triggers of ocular migraine vary from person to person and may include:

  • bright lights
  • loud sounds
  • powerful odors
  • stress, anxiety, or relaxation after a period of stress
  • changing weather
  • smoking
  • some alcoholic beverages, especially red wine
  • poor sleep quality
  • too much caffeine or withdrawal from caffeine
  • foods containing nitrates, such as hot dogs and luncheon meats
  • foods containing monosodium glutamate (MSG), such as fast foods, seasonings, spices, and broths
  • foods containing tyramine, such as aged cheeses, hard sausages, smoked fish, soy products, and fava beans
  • artificial sweeteners

You can try to identify your migraine triggers by keeping a headache diary. The diary should include notes on diet, exercise, sleep habits, and menstruation.

The terms “ocular” and “retinal” can be used interchangeably to describe a type of migraine that includes visual symptoms in one eye.

A retinal migraine is an episode of transient visual symptoms that lasts more than 5 minutes but less than 60 minutes. This can be followed by a migraine headache (migraine with aura) or no headache (migraine aura without headache).

Aura typically involves visual impairments, such as:

  • visual changes, including seeing blind spots, shimmering spots, flashing lights, or zigzag lines
  • numbness or tingling in the hands or face
  • weakness
  • speech changes

Not all people who experience migraine symptoms will experience auras in a typical way.

For example, ophthalmic migraine comes with visual disturbances, but without headache pain. Meanwhile, retinal migraine only occurs in a single eye.

Some people use the terms migraine and headache interchangeably, but this is incorrect. Migraine is a neurological disorder, whereas headache describes the symptom of head pain.

For example, the pain from a tension headache — the most common form of headache — will be mild to moderate. Tension headaches tend to be distracting but not debilitating.

Cluster headaches, which can occur in cycles, usually cause very severe and debilitating pain. They can result in visual disturbances, similar to migraine. However, cluster attacks tend to be short, while migraine attacks tend to be longer.

Sometimes, headaches with aura are a symptom of an underlying health condition. These can include:

How can I cope with an ocular migraine headache?

When experiencing migraine, you may find some of the following at-home coping tips helpful:

  • lying down or sitting in a dark, quiet room
  • massaging your scalp with a lot of pressure
  • putting pressure on your temples
  • putting a damp towel over your forehead

An ocular migraine attack typically goes away with time.

If you experience migraine headaches from time to time, a doctor may recommend avoiding triggers, such as caffeine, smoking, stress, and bright lights.

Over-the-counter (OTC) medications, like simple analgesics and nonsteroidal anti-inflammatory drugs (NSAIDs) or combination medications like Excedrin Migraine, may also help relieve pain.

If you experience ocular migraine more frequently, a doctor may recommend prescription medications to help manage and prevent headaches. The best type of medication will depend on the type of ocular migraine you have.

Prescription medications may include:

Some of these prescription medications will be taken on a regular basis instead of an as-needed basis when you get migraine symptom flares.

You may be experiencing ocular migraine due to certain triggers, such as stress, hormone fluctuations, bright or flickering lights, loud sounds, and certain foods.

Red flags of an ocular migraine include symptoms of vision loss like dark, shaded, and white areas. These may be a sign of stroke or permanent vision loss.

It’s important to get immediate medical attention if you experience any of these symptoms and they don’t improve within 1 hour, or visual symptoms accompanied by other symptoms.

In many cases, an ocular migraine will get better. However, you should seek medical advice if the auras interfere with daily activities, if you experience them frequently, or if vision changes don’t go away after 1 hour. Also speak with a doctor if you have never had ocular migraine and suddenly develop them.

Consider connecting with a general practitioner first. They could assess your symptoms and, if needed, refer you to a neurologist or opthalmologist for further assessment and treatments.

Ocular migraine refers to several types of migraine headaches, including retinal, aura, and ophthalmic migraine.

The exact cause is unknown, but researchers believe it has to do with the constriction of blood vessels and impaired blood flow.

Several triggers have also been identified, including bright lights, stress, dehydration, exercise, and loud noise, among others.

Consider speaking with a healthcare professional if you experience ocular migraine frequently or if they’re increasing in severity. They could develop a treatment plan for you.