What is a migraine with aura or retinal migraine?
Migraine is the most common and disabling neurological disorder in the UK. It affects 1 in 7 people and is more prevalent than diabetes, epilepsy and asthma combined.1 In fact, tension type headaches and migraine rank as the second and third most common disease in the world, behind dental caries2
Migraines almost certainly have a genetic basis. They tend to peak around the age of 35 to 45. They also affect three-times as many women as men, this higher rate being most likely hormonally-driven.3
As this September is Migraine awareness month we thought we would shine a spotlight on migraine conditions that affect the eyes.
Types of Migraine
There are two main types of migraine:
- Migraine without aura, often referred to as a common migraine
- Migraine with aura, often referred to as a classic migraine or visual migraine
Most migraines are common migraines, or migraine without aura. Typical symptoms include a pulsing and throbbing pain usually on one side of the head. This is different from tension headaches, where pain is felt all around the head.
Unlike non-migraine headaches, the pain with common migraines can be made worse by movement. They can also be accompanied by nausea and/or vomiting. In addition, there is often heightened sensitivity to light (photophobia) and to sound (phonophobia).
Migraine with aura
Aura is a sensory phenomenon that may occur before or during a migraine. It’s caused by unusual activity in the brain and can be:
- Visual e.g. flashing lights, geometric patterns
- Auditory e.g. hearing buzzing or other sounds not present in the actual environment
- Olfactory e.g. smelling odours that aren’t there
- Tactile e.g. numbness or a tingling sensation
A migraine aura can be followed by a mild headache or no headache at all. This is known as a silent or acephalgic migraine.
Migraines where vision is significantly affected during an aura are sometimes referred to as ocular migraines. Migraine with aura or ocular migraines should not be confused with retinal migraine, which is a separate condition. You can find out more about migraines with aura here
Around 1 in every 200 people who get migraines will have a retinal migraine 4.
Unlike most migraines with aura, a retinal migraine affects vision in one eye only.
The visual symptoms during a retinal migraine usually do not last as long as with a visual aura of migraine. Typically symptoms
- Spread gradually over 5 minutes or longer
- Last 5 to 60 minutes
- Accompany a headache within an hour of visual symptoms
Unlike the visual disturbances experienced in migraine auras which are caused by unusual activity in the brain, retinal migraine occur when the blood vessels to the eye suddenly narrow and reduce blood flow to the eye.
This vessel narrowing can be seen by optician using an instrument called an ophthalmoscope, but only during an attack. It is therefore more likely that the condition would be diagnosed based on an account of your symptoms.
Retinal migraines, similar to common migraines, can start due to a single or combination of triggers:
- Emotional triggers : Eg. Stress, anger, anxiety, shock
- Physical triggers :Eg. Tiredness, strenuous exercise, eye strain
- Dietary triggers : Eg. Lack of food, dehydration, caffeine, alcohol
- Environmental triggers : Eg. Bright lights, louse noise, strong smells
Please call us urgently if you experience any loss of vision. There are many other causes of vision loss that need to be ruled out before a firm diagnosis can be made.
There is currently a lack of research about the best way to treat or prevent retinal migraines. However there are some treatments which may be able to help including aspirin, beta-blockers, calcium channel blockers, tricyclic antidepressants and anti-epileptics.
Useful sites about migraines
0203 9510 150 Mon – Fri 10am – 4pm
National Migraine Centre
020 7251 3322