Migraines

Monday, Jul 1, 2024 by Nisha Gupta, MD

This month we will talk about migraines and the effects on the eyes.

What are migraines?

Migraines are a common condition that usually involves a throbbing headache. The pain may get worse with movement, bright lights, and loud sounds. Nausea and vomiting may occur. Many people experience visual symptoms before getting the headache. These symptoms can last up to thirty minutes. Shimmering lights, flashes of light, and peripheral vision loss can occur.

An ocular migraine is a migraine variant that only involves eye symptoms without the headache. These can last up to sixty minutes. Usually these affect the central vision as a blind spot, colored lines, or geometric shapes.

What are the causes?

It is not clear what the exact causes of migraines are. Doctors think they are related to chemical changes in the brain or irritation of the blood vessels. Ocular migraines may be related to spasms of the blood vessels that affect blood flow to the eyes. Certain things can trigger a migraine including:

  • Food and drink including cheese, chocolate, and alcohol
  • Food additives such as artificial sweeteners and nitrates
  • Environmental factors such as perfumes and bright lights
  • Irregular sleep patterns
  • Hormone changes in women
  • Medications including oral contraceptives and opioids
  • Stress or anxiety
  • Dehydration

How are they detected?

A physical exam with a primary medical doctor will determine if the headaches are migraines. A neurology exam may also be necessary. For eye symptoms, a comprehensive exam including checking the vision and dilating the eyes are important to ensure no other findings are present.

What are the treatments?

The best way to prevent migraines is to identify and avoid the triggers. Non-prescription and prescription medications can help with the pain. Medication may be necessary on a daily basis if one is experiencing frequent migraines. Ocular migraines usually resolve on their own. There are no specific treatments for the eye.

Return next month for a discussion on a new topic!

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