What do those flashes mean?
When sudden flashes in your vision occur it can be frightening. If this is the first time this occurred then an urgent visit to the eye doctor is worthwhile. Dr. Dianna Leong, Dr. Anh Bui and Dr. Elizabeth Yan would do an assessment that includes dilating your pupils to get a look at the retina. The worst case scenario is a retinal tear or hole that is becoming larger. This would require immediate referral to an ophthalmologist for treatment. The best case scenario is an ocular migraine.
What is an Ocular Migraine?
The term ocular migraine may refer to any migraine headache that involves a visual disturbance such as flashes of light, seeing stars or zigzags or the appearance of blind spots in the visual field. Ocular migraines can interfere with your ability to go about your daily tasks such as driving, reading or writing, however, the visual symptoms don’t last long and do go away completely once the migraine has passed. Firstly, migraines with auras often have eye-related symptoms that precede the actual headache. An aura is a physical symptom that is experienced usually within 5 minutes to an hour before a migraine comes on, and can include:
- Blind spots (scotomas) or partial vision loss
- Flashes of light, spots or zigzag patterns
- Visual, auditory (hearing) or olfactory (smell) hallucinations or disruptions
- Tingling or numbness
- Mental fog, trouble finding words and speaking
These types of ocular migraines commonly appear by obstructing a small area of vision which spreads gradually over 5 minutes.
A second type of ocular migraine is when you actually experience temporary vision loss or disruptions (flashes, blind spots, zigzag lines etc.) during or immediately following the migraine headache. Ocular migraines can also sometimes appear without any head pain at all. They may also be called eye, ophthalmic, or retinal migraines.
What Causes Ocular Migraines?
Similar to classic migraines, the exact cause of an ocular migraine is unknown. Genetic predisposition seems to be a factor to some extent, and having a family history of migraines does put you at greater risk.
While they don’t know the cause, experts have seen that spasms in the blood vessels and nerve cells in the retinal lining at the back of the eye are associated with ocular migraine symptoms.
For some, there are certain environmental triggers, or a combination of factors, that cause migraines. These differ on an individual basis but can include:
- Bright lights or loud sounds
- Strong smells
- A sudden or drastic change in weather conditions
- Eating, or exposure to, certain food substances such as, alcohol, caffeine, nitrates, MSG (monosodium glutamate), artificial sweeteners and tyramine.
Since triggers are different for everyone it’s advised to try to identify yours by keeping a journal to track your environment, diet and lifestyle habits, when you experience a headache.
Treatment for Ocular Migraines
Treatment for ocular migraines is usually not necessary as the symptoms typically resolve themselves within 30 minutes. It is advised to rest and avoid doing things that require vision and concentration until the headache goes away and the vision symptoms cease. If you are experiencing an ocular headache:
- Lie down in a quiet, dark room when possible
- Massage or apply pressure to the temples and scalp
- Apply a damp towel to the forehead
If you experience auras, taking a migraine medication when the aura occurs, can often reduce the intensity of the headache that follows. In other words, you can use the aura as a warning sign that a headache is coming on and treat it preventatively. Your doctor may prescribe a pain reliever for associated head pain and, if migraines are chronic, a preventative medication may be given.
It’s important to note that if you are experiencing any unusual visual symptoms or an increase in frequency or duration of symptoms, you should see an eye doctor right away to rule out any serious, vision threatening conditions. Just remember, Alberta Health Care will cover for medical eye exams such as this when your optometrist. Dr. Dianna Leong, Dr. Anh Bui and Dr. Elizabeth Yan are here to support your eye health, and are happy to serve as your first point of eye care to reduce trips to the ER.