What is a Retinal Migraine?

Retinal migraine is a rare condition characterized by recurrent episodes of visual disturbances associated with migraine headaches. The visual disturbances may include monocular blindness which is the loss of vision in one eye, or scintillation which is the sensation of seeing twinkling lights. It commonly occurs in women ages 20 to 30 years old who have experienced migraine with aura in the past. An aura is a visual experience, like seeing a flashing of lights several minutes before a migraine headache occurs. The monocular blindness in retinal migraine usually comes before the migraine attack and is often temporary.

During or within an hour after the visual disturbances, a one-sided and pulsating headache usually starts. The headache may last between four and 72 hours. It is frequently associated with increased sensitivity to sound and light. In severe attacks, nausea and vomiting may also be noted.

An ophthalmologist, a doctor who specializes in disorders of the eyes, would evaluate for the loss of vision in one eye by asking the patient to compare views on each eye by alternately covering them and focusing on an image or object. If monocular blindness is confirmed, the physician then checks the patient for other diseases that may have caused the symptom. Other possible causes of temporary blindness in one eye include nerve problems, heart disorders, and use of some medications.

Diagnostic tests are often helpful in determining if the retinal migraine is due to other chronic diseases. A computerized axial tomography (CAT) scan may be ordered to visualize the anatomy and status of the nerves in the affected eye. This is also indicated to check whether the optic nerves are in good condition and that no obstructions are present that can impede blood flow in the eye. Tumors and growths that may cause the symptoms are also seen in this test. Only after all other diseases that may cause the symptoms are ruled out can a physician give a diagnosis of retinal migraine.

Treatment for retinal migraine frequently uses the same medications given to treat other forms of migraines. These include non-steroidal anti-inflammatory drugs (NSAIDs) for the pain and other medications that can help relieve nausea. Doctors often restrict patients from taking drugs that can cause narrowing of the blood vessels, such as contraceptives drugs, as this may aggravate the symptoms. Other medications prescribed to patients with retinal migraine are antidepressant and antiepileptic drugs.


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