_{This content has been medically reviewed by Dr. Jennifer Chima.}

"Ocular migraine" is a term that often causes confusion. It's used to describe two distinct conditions: retinal migraine and migraine with visual aura. Understanding the difference is crucial for getting the right diagnosis and treatment.

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What is retinal migraine?

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Retinal migraine directly involves the eye itself, potentially due to temporary disruptions in blood flow to the retina. This can cause a range of visual disturbances in one eye, including:

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• Temporary vision loss: Partial or complete loss of sight in the affected eye.
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• Flashing lights or shimmering: Seeing sparks, flickers, or shimmering patterns.
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• Blind spots (scotomas): Areas where you can't see.

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While the exact cause of retinal migraine is still being investigated, it may be related to blood vessel problems or a wave of electrical activity in the retina.

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What is migraine with visual aura?

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Migraine with visual aura is much more common than retinal migraine. It involves visual disturbances that originate in the brain's visual processing areas, not the eyes themselves. These disturbances typically affect both eyes and include:

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• Flashing lights: Often in a zig-zag pattern, sometimes called a "fortification spectrum."
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• Shimmering or wavy vision: Objects may appear to shimmer or distort.
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• Blind spots (scotomas): Areas of vision loss, often with shimmering edges.

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These visual symptoms are usually followed by a headache, but not always.

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Why knowing the difference matters

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Distinguishing between retinal migraine and migraine with visual aura is crucial for several reasons:

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• Accurate diagnosis: A correct diagnosis ensures you receive the appropriate treatment and management strategies.
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• Underlying causes: Retinal migraine may indicate underlying vascular issues that require further investigation.
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• Treatment approach: While both conditions may involve similar preventive measures, the acute treatment for retinal migraine may differ, focusing on addressing the vascular component.
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• Prognosis: Retinal migraine may have a higher risk of permanent vision loss if left untreated.

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How to tell the difference

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During a visual disturbance, try this simple test:

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Close one eye. Do you still see the visual changes?
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Switch eyes. Do the symptoms move with the eye that's open?

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Symptoms in both eyes? Likely migraine with visual aura.

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‍Symptoms only in one eye? Possibly retinal migraine.

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When to seek medical attention

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If you experience any sudden or unusual visual disturbances, especially if they affect only one eye, it's essential to seek medical attention immediately. Your doctor can perform a thorough eye exam and neurological evaluation to determine the cause and recommend appropriate treatment.

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Is your migraine well-managed?

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Neura Health's headache specialists can diagnose and create a personalized treatment plan for your specific type of migraine. Book a video visit with a Neura headache specialist and get care within days.

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