Ophthalmic migraine is quite common. Patients usually experience visual symptoms of seeing bright zig-zag type lines in their central or peripheral (side) vision. These bright lines may have associated flashing light sensations and sometimes can interfere with vision. There are many variations of symptoms. These symptoms usually resolve spontaneously after several minutes but usually less than one hour. Often, rest in a darkened room can be helpful during a migraine attack. Medical treatment is usually not necessary.
Sometimes, there can be a headache after the visual symptoms resolve. This is called migraine headache with visual prodrome. Some people get migraine headaches without the visual symptoms. Some people get the visual symptoms without the headache. This is called Ophthalmic Migraine. The cause is due to a temporary spasm in the blood vessels behind the eye called “vasospasm” similar to a spasm or cramp that you may have once experienced in one of your leg muscles (Charlie-Horse). Usually, this resolves without treatment and many people never have another episode. Some people may continue to have them. An examination of the eye is important to rule out any other causes for these symptoms.
In the rare instance that these symptoms continue to recur on a regular basis and interfere with one’s quality of life, then treatment is available with pills that both decrease the frequency of attacks as well the severity of the attacks. Treatment is usually started in consultation with an internist, family physician, or neurologist. We usually reserve treatment for those patients who have symptoms regularly and it interferes with daily living because the medications used to treat migraine can have side effects, just like any medication.