Michael Chua, MD
Ocular Migraine (Retinal Migraine) vs. Migraine Aura EXPLAINED | How to treat and prevent
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In this video, Dr. Michael Chua discusses ocular or retinal migraines and migraine with aura. He talks about the best ways to treat and prevent these conditions.
Timestamps
0:00 Introduction
0:56 What are ocular migraines and migraine with aura?
2:16 Ocular Migraine (Retinal Migraine)
3:04 Ocular Migraine Triggers
3:40 Ocular Migraine Treatment and Prevention
5:33 Migraine Aura
6:24 Migraine Treatment and Prevention
7:13 Other Important Causes of Vision Loss
8:09 Summary
Connect with Dr Michael Chua on social media
https://www.instagram.com/michaelchuamd/
Website:
https://www.puentehillseyecare.com/
Hashtags
#MichaelChuaMD #ocularmigraine #migraineaura #migraine
MEDICAL ADVICE DISCLAIMER: All content in this video and description were created for informational purposes only. The content is not a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health provider with questions you have regarding health conditions. Accessing, viewing or reading this content does not create a physician-patient relationship between you and the author.
are you noticing flashing lights shimmering shapes or kaleidoscopes in your vision maybe it's associated with a headache or maybe it's not I'll explain the most common causes for these visual changes including ocular migraines and migraine with aura and how to best treat and prevent these problems from occurring at the end of the video I'll also discuss some signs and symptoms that you don't want to miss because they might suggest something more serious like a stroke or a retinal detachment by the way I'm Dr Michael Chu I'm a board certified opthalmologist with P Hills ey care and I make videos to help you see better look better and feel better so when a patient comes to me mentioning that they're seeing shimmering shapes or what seems like light shows in their Vision or maybe it's a large blind spot that usually lasts several minutes the top two things I'm concerning are that it's either an ocular migraine or a migraine with aura sometimes people get mixed up between ocular migraines and something called a migraine Aura because they both affect your vision even doctors especially the ones who don't focus on headaches or Vision can mix up these terms but it's essential to know that a migraine Aura and an ocular migraine are not the same thing so let's go through these conditions and figure out how we can differentiate them ocular migraines can also be referred to as retinal migraines and are different than Migraine with or now the key differentiating factor with these two conditions is that ocular or retinal migraines cause visual symptoms in one eye whereas migraine auras cause symptoms in both eyes the reason for this difference comes from the underlying pathophysiology the exact mechanism of both ocular migraines and migraine ORS is not totally understood some Studies have suggested that ocular migraines and migraine ORS may be caused by spasming and constricting of our blood vessels but others have suggested that it actually might be a regular dilation or widening of these blood vessels and studies suggest that spasming and constricting of the blood vessels might not be the cause of the migraines but just the downstream effect of increased inflammation and sensitivity of the blood vessels in our eyes and our brain during the time of an ocular migraine or migraine Aura whatever the exact cause is research suggest that there's some sort of dysfunction of the blood vessels either in our brain or our eye that are causing these problems the key difference between an ocular migraine and a migraine Aura is where the disfunction is occurring in ocular or retinal migraines the dysfunction is thought to occur in the retina of one eye which is why you'll only see the visual symptoms from that one eye whereas in a migraine Aura the vascular dysfunction occurs in the brain since the visual information in the brain has already taken the inputs from both eyes this is why in a migraine Aura You'll See Vision symptoms like shimmering lights BL Vision or even blocking out of vision in both eyes okay now that we understand the difference between ocular and retinal migraines and migraine auras let's go into each condition separately let's discuss ocular migraines first this study reviewed the most common symptoms associated with ocular migraines and they are complete vision loss and one in 50% of patients blurring of vision in 20% a scotoma or enlarged blind spot in 133% partial loss of vision in 12% and dimming in 7% in the study more than 75% of patients mentioned that they had a headache on the same side as the vision symptoms within an hour after the visual changes most of the time these visual symptoms last in the range of 5 to 40 minutes there also seems to be a genetic component to ocular migraines as 50% of patients report a family history of migraines and there also seems to be an association between ocular migraines and migraine headaches as 29% of patients with ocular migraines report a history of migraine headache okay now that we understand the symptoms associated with ocular migraines let's discuss some of the most common triggers some common triggers reported in the medical literature include dehydration stress increased screen time low blood sugar birth control pills excess heat exercise high altitude smoking and high blood pressure other risk factors that increase your chances of getting ocular migraines are female sex and the theory is that the hormonal changes related to the menstrual cycle may increase the likely Ood of developing these ocular migraines if you're in your 20s or 30s if you have a personal history of migraines or if you have a family history of migraines and if you have a history of autoimmune disease like lupus okay now that we know some common triggers and risk factors let's discuss how to treat and prevent these ocular migraines from occurring the primary focus of managing retinal migraines is to avoid those triggers it helps to keep a headache diary so you can organize all your information for your own reference and for your doctor as well you'll want to set up columns across the top of the page of your diary information that's helpful to include is the date of the rental migraine start time end time symptoms such as shimmering lights blacking out of vision headache and the most important column is triggers here you can try to identify what you were doing prior to the onset of the retinal migraines so when you review multiple episodes you can look for patterns into what may be causing your retinal migraines pay attention to things like what foods you ate prior to the retinal migraine how did you sleep the night before what was your stress level were you exercising or recently finished exercising were you feeling dehydrated did you have a big cup of coffee or maybe missed your moaning cup try to be detailed here so that you can analyze the information later once you have enough episodes and entries we can identify the triggers that may be responsible for bringing on your symptoms for example we may recognize a pattern that these ocular migraines are more common after a few nights of poor sleep in that case we may want to talk about sleep hygiene and improving Sleep Quality or maybe you're noticing that these retinal migraines are occurring after drinking lots of coffee or alcohol then you may want to cut down on those during the ocular migraine episode itself I usually recommend resting your eyes getting away from harsh LED lights or sunlight and to take breaks from looking at screens ideally you would lie down and close your eyes in a dark quiet room are there some prescription medications that can possibly help yeah medications like calcium channel blockers including barabam or nifedipine can be prescribed for these ocular migraines but it's very rare that doctors write prescription medications for this condition okay so we covered ocular migraines now let's cover migraine auras before we get into migraine auras if you're enjoying this video I think you'd like my optimized newsletter I compile evidence-based ways to help maintain your vision and health and send that information directly to your email you can visit my website at Michael md.com and sign up for the newsletter today okay back to migraine Aura so migraine auras are visual or sensory disturbances that can happen as a migraine begins or just before it starts about onethird of people who have migraines will have auras there are several types of migraine oras the most common symptoms associated with aura are visual symptoms up to 99% of patients who have migraine with aura report visual symptoms these include black spots flashes of light blind spots zigzagging lines or shimmering shapes like we mentioned before since the origin of migraine with aura is is in the brain we expect to see these visual symptoms in both eyes other types of symptoms you can have with auras are numbness or tingling perhaps in the hands fingers or face some people can have difficulty with speech temporarily and have difficulty articulating words in some cases Aura can manifest as weakness of the limbs oras typically last anywhere from 5 minutes to an hour and then after the aura there are the classic symptoms of migraine which include throbbing or pulsing headaches nausea vomiting dizziness and sensitivity to lights and sounds now let's discuss prevention and treatment of migraines with Ora just like retinal migraines one of the first steps for managing migraine with aura is to keep track of your triggers in a migraine diary and to avoid these triggers some common triggers reported in the medical literature include alcohol caffeine processed foods changes in the weather excessive noise flashing lights poor sleep and stress and just like Ral migraines if you feel a migraine with aura coming on it helps to try to seclude yourself and lie down in a dark and quiet room in terms of treatments some over-the-counter options include nids or nonsteroidal anti-inflammatories like Advil Motrin or Tylenol another common over-the-counter option that can provide relief is Excedrin which includes acetominophen or Tylenol aspirin and caffeine if over-the-counter options aren't providing enough relief and migraines are still bothering you your doctor may try to prescribe medications like sumatriptan for more severe migraines okay now that we cover the specifics of ocular migraines and migraines with aura let's go through other conditions that we need to make sure we rule out if you're having new vision changes generally if you're experiencing new visual changes you should be evaluated by a doctor as soon as possible so they can get down to the bottom of what's causing your symptoms if you're experiencing those vision changes in one eye it could be a sign of a retinal problem like a retinal detachment a vitous Detachment or a retinal artery occlusion so it's important to receive a full eye examination to rule out those causes retinal detachments can present as Shadows over the vision and retinal artery occlusions can cause severe blurring or blocking out of the vision as well if you're experiencing vision changes in both eyes your doctor will need to rule out other causes like a stroke or other brain issues if you're experiencing any paralysis or weakness either on one side of your face or on one side of your body slurred speech or sudden headache with severe pain unlike anything you've had before or a headache with a stiff neck fever confusion or double vision those are signs to look for emergency medical attention right away okay I hope this review of ocular migraines and migraine with aura was helpful to you to summarize with ocular or retinal migraines you'll notice vision changes in one eye while with migraine auras you'll see visual changes in both eyes common symptoms associated with these conditions are shimmering shapes flashing lights or block or blurry spots in your vision it helps to seclude yourself in a dark and quiet room if you have these symptoms and if these problems continue to bother you try to keep a migraine diary so you can identify triggers that may be worsening the condition and to be safe if you're noticing new visual symptoms get checked out by an eye doctor to rule out other more serious conditions if you find this information helpful please subscribe to the channel for more updates and if you live in the Los Angeles Orange County or Inland Empire area and will like an eye exam feel free to visit our website or give our phone number a call to make an appointment today I'm Dr Michael Chua with P Hills I care see you next time
#Ocular #Migraine #Retinal #Migraine #Migraine #Aura #EXPLAINED #treat #prevent
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I'm probably self diagnosing, but after your description, I think I get Migraine Auras. Ophthalmologists have explained it to me as Retinal Migraines. There's definitely a multicolored ring encircling a blind spot. I'll have to pay attention next time if it is in both eyes or just one. After your description, I 'm apt to side with Migraine auras, but I don't often get headaches. . If I was to pick a trigger, I would say. it's computer monitors and fluorescent lights. I'm now retired and spend less time on computer monitors or rooms brightly lit with fluorescent lights and the frequency of occurrence has decreased accordingly. But, yes, the method for alleviating Auras was to close my eyes for 10 to 15 minutes. Thanks for the video. I think it helped.
For several decades I got terrible, debilitating migraine headaches from late teens to late 30's. After going through an early menopause in my early 40's my migraine headaches STOPPED and I started getting Migraine Auras and continue to get them today – I am 72 years old!!! They are always black and white spinning pinwheels on the outer edges of both eyes. No pain at all before or after – nothing, just the Auras lasting under 30 seconds. No triggers that I can put my finger on!!! Pretty much a daily occurrence.🙃 Much preferred over the migraine headaches!!!!
you're giving me a migraine just listening to you talk so fast!
My Migrantes stopped when began taking blood pressure medicine
Never again. 12 years now. Do it people it's the solution. You get spikes of high blood pressure that kicks off the mig anes. NEVER AGAIN. Truth
My experiences are very sudden blurring in one eye, pain, nausea, dizziness. Then headache for a few days. CT shows normal function.
Sometimes I get the sparkling auras in both eyes with blind spots and then a headache. My doctor and optometrist offer nothing to treat these sudden happenings. Do you have any suggestions for me?
I used to get these all the time. No pain but sparkling lights and a colorful, circle. The.eye doctor said "ocular migraine. I told my father, he said "I get those!".
Thank you for the graphic of the aura. I could never really describe it other than it made a blurry spot in my vision that gradually moved across my field of vision over about 20 – 25 minutes. By the time it was gone my headache was booming.
I think Kratom use was causing me to experience occasional migraine auras. Stopped the kratom and over time they finally stopped happening.
Have had ocular migraines for 40 days..nothing helps.
I had these in perimenopause. It affected both eyes, but didn't come with headache. It was like someone drew a thick outline around the Hawaiian Island chain, patterned it with cross-hatches of bright lines, and then animated the pattern. The outline got bigger and bigger (with an increasing patch of clear vision in the middle) until it got so big it was out of my field of vision. Weird stuff. I didn't talk to my doctor, but I did talk to my optometrist about it and she sent my in the right direction.
Thank you so much for this video. It helps so much. I have had migraine with aura for years but last few ive been having one sided/ one eye zigzags and blurry vision and excruciating pain in the same side of head/ behind same eye. I had a feeling they were ocular and this confirms the difference none of my doctors took note of.
Migraine aura it is. Thanks, doc!
Hmmm, i have always thought i was having an occular migraine. I never have an actual headache. Symptoms start as a dot of light that gradually spreads across my vision as a moving silver zig zag line. I am unable to see properly and i have to close my eyes til its over, usually 30 minutes or so. Then im back in service. Like i said, never any pain.
I have had the 'aura colors' since I was a little kid. It always follows the same pattern. First, my vision gets out of focus. The vision is not blurred; it's out of focus. That lasts for about 5-10 minutes. I know what will happen next. The 'aura colors' will then start and go for about 10 minutes. The 'aura' moves gradually from the center outward and then disappears. My vision is back in focus again. I think it has to do with allergies as it seems seasonal. I have no headache pain. It seems that food helps to move it along faster, especially a bagel or donut (probably sugar related). It's crazy. I have maybe two episodes a year.
I don't get a headache with my ocular migraine. After my brain surgery, they changed. Before I would get a bright long jagged line that moved across my vision. If I am driving then I would have to stop when it hit my middle vision and wait for it to move enough to drive again. But after my brain surgery on the right side of my head (aneurysm) it now is a bit smaller and only partly crosses my vision and doesn't interfere with my vision when driving. I think it only affects my right eye.
Scent triggers my migraines. Cigar and pipe smoke are the worst. I never buy any perfume without testing it for a day anymore.
Recently bright light/ sunlight has been triggering migraines. This is really annoying. I thought my migraines were decreasing as I reached my 60's. Not so lucky.
My first migraine came when I was 12. Since that's when I started my period, I always assumed there was a connection (something hormonal). I had these headaches throughout my teenage years. They always started with silver spots, then I would get what I called tunnel vision. The outer perimeter of my vision would begin to black out and the area would grow until I couldn't see. Then the pain would come. The first one I ever had was at school and I thought I was going blind.
In later life, I began to get the ocular migraine where it was only visual. No pain. It still started with the tiny silver spots, but only affected one eye. I get the shimmering zigzag lights (black and white) and used to get a spot near the center of my vision that would grow until that eye was essentially blocked from seeing anything. Thankfully this usually lasted about 30 minutes. I always worried it would happen while I was traveling long distance in a car.
I can't remember the last time I had one (just turned 68), but I do know when I began to eat a cleaner diet they stopped. (Keto-carnivore)
The only cure I ever found was to cry myself to sleep, but until that happened, a dark room and silence were my best friends.
I'm a senior and have had migraines since high school. My doctor, who gets migraines herself, had me keep a migraine diary. This helped find my triggers. These include: msg, nitrates in food like bacon, lack of sleep, stress, too much screen time, bright lights, pain, big weather changes, and too much as well as too little caffeine. I get migraines with and without aura. Aura with zigzag flashing lights, partial loss of vision, running nose, left side weakness (hand and sometimes leg), speech disturbance (friends say I talk in gibberish) and I can look at a word and not be able to say it, also many words missing from my vocabulary for the duration of the migraine. Left side weakness is accompanied by pain and loss of vision often in right eye only. My migraines last hours to days. Sometimes horrible throbbing head pain. I go into a cool, quiet, dark room. No computer or phone or tv. Take meds. Over the years meds have changed. The best improvement in treatment came when the triptans arrived. I had a 3 day massive migraine and in the doctor's office, 20 minutes after an injection of Imitrex, that migraine was gone. Then we eventually went to Maxalt, which is another triptan and finally now Ubrelvy (I can use either of these, they both are equally effective). I use Fiorinal in combination with Maxalt or Ubrelvy. Fiorinal is made up of aspirin, butalbital, and caffeine. In years prior when I would get in horrible high migraine periods of time, my doctor would put me on an anti-epilepsy drug that helped stop the migraine cycle. Prior to this doctor, multiple doctors prescribed Tylenol with codeine. It was completely ineffective for me, absolutely worthless for my migraines. Although it does help some people. I also wear a Medic Alert bracelet which says, "migraine accompaniment mimics stroke or TIA". I've seen a neurologist and have had multiple MRI's (to rule out stroke).
I can’t one the other day and I felt like it was only in my right eye, but then when I would close my eye, I would still see it so I don’t know if it was in the other eye or if it was that I was still seeing it with my eye closed I don’t know if that makes sense
I had 3 episodes in last 2 weeks, all of them following the same pattern, after a session of crossfit very intense, arrived home and in the moment i look at any screen (phone or computer) the aura starts. So, in my case, intense exercise + screens is the trigger. I really want to find ways to get out of the aura after starts, someone can help me with tips? One time i fix my aura with ice water in my face, but just worked one time.
I watched this a few hours ago or did my best as i just started an attack. ( both eyes).
I then made a strong coffee 2 heap spoons . Guess what happened.
It cleared up fairly quickly. Normally would clear in an hour.
I believe its caused by bright light