Causes, Symptoms, Treatments… Ocular Migraine Update

Ocular migraine is both a neurological and an ophthalmic condition. What are the symptoms ? What are the causes and how to treat them? We take stock with Dr. Pierre Quéromès, ophthalmologist at OPH78.

What is an ocular migraine? What Are the Symptoms of a Migraine Aura?

Ocular migraine is a well-known phenomenon, as presented by Pierre Quéromès: “Ocular migraine is a fairly common counseling issue. These are in fact a spread of migraines. Classic migraine is a condition characterized by a severe headache (headache). Ocular migraine, also known as migraine aura, is actually the visual symptom that precedes migraine. These Migraine Aura Symptoms, What Are They? “They are very different depending on the patient. In general, there is the appearance Points of light, spots of color or blurred vision. Another typical feature of ocular migraines is the appearance of sparkling scotomas. It is a cloudy or luminous veil that appears at the periphery of the eye. A Impairment of the visual field can also be observed by the patient. Furthermore, these symptoms are not of ophthalmological origin, but neurological, because the activation of specific neurons generates these visual disturbances.

How long does ophthalmic migraine last?

As with the appearance of the symptoms, the duration of this visual disturbance varies from person to person, as Pierre Quéromès explains: “An ocular migraine can last a few minutes, but it can also last for half an hour or even an hour. Once these symptoms pass, the headache will definitely set in soon.”

Causes: What triggers an ocular migraine?

As we have seen, ocular migraine is a specific symptom of migraine, as Dr. Quéromès reminds us: “Headaches can obviously be caused by a whole range of diseases, some of which are serious, such as the presence of a tumour. But when we talk about migraine aura, it means the person has migraine. It’s a specific diagnosis.” So what are the causes of migraines? “That are many. This may be related genetic predisposition, but also caused by the patient’s environment and lifestyle. Lack of sleep, stress, emotional shock or fatigue can trigger migraines. Excessive consumption of foods such as alcohol, chocolate, coffee or tobacco can also be held responsible. Too frequent exposure to bright lights or loud noises, such as at concerts, has also been linked to the development of migraines. In women, the menstrual cycle can also play a role. In fact, some women develop cases of migraines in the week before the rules go into effect, for example. On the other hand, it should be noted that children are not very exposed to migraines and that pregnancy is not a risk factor.”

Diagnosis: Which doctor should be consulted for an ocular migraine? Neurologist or Ophthalmologist?

What to do if you suffer from a so-called ocular migraine? Pierre Quéromès replies: “It is important to make an appointment with a first ophthalmologist, especially if you have never had this phenomenon of impaired vision. In fact, the doctor will perform a number of tests, in particular a visual field check, to see if the vision problem is not being masked eye pathology. If he finds nothing, the ophthalmologist explains that it is a migraine aura. Then the patient has to visit their family doctor or even a neurologist to do other basic tests such as an MRI. In addition, if it is a migraine, it is necessary to establish with the doctor what could be the origin of the migraine and what environmental factors it could be (excessive noise, intolerance to bright light, etc.). The diagnosis of an ocular migraine therefore requires cooperation between the ophthalmologist, neurologist and general practitioner.

Once an ocular migraine has been diagnosed, is there any treatment to relieve the headache? “As for ocular migraines, there is no specific treatment for vision problems. Treatment addresses headaches, especially when they are frequent and intense. In this case, painkillers may be prescribed if the headache occurs and medication to prevent the headache from occurring. At the same time, once we have identified the trigger for the migraine, we do everything we can to ensure that the headache does not come back.”

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