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Ocular Migraines and Scotomata

An ocular migraine (OM) is characterized by visual aberration presenting them in a field of view. On its own, an OM is harmless and disappears in less than an hour.  Normally only one eye is affected. People who experience OM get them frequently and can be triggered by things such as stress, food, temperature, light, sounds or smells.

The visual loss experienced is called a scotoma. A scotoma is a region in one’s field of view where visual acuity is lowered. Objects in this are may appear blurry, may come in and out of focus, or may disappear entirely.

The visual discrepancies occurring from an OM is difficult to describe to someone who has not experienced it. The scotoma is not equivalent to vision loss that comes from a disease such as macular degeneration. The regions are not blackened area but just general regions of fuzziness. Those having an OM may not consciously acknowledge their blind spot.

Scotomata vary widely from person to person. Individuals tend to experience the same visual disturbances every time an OM occurs. A scotoma can be a small circular region, or a ring like shape. The boundaries can be smooth or jagged, described by some as “shattered glass.” Sometimes they carve a wormlike structure through your field of view. These shapes may move throughout the migraine.

While an OM may be caused by cancer, stroke, or detached retina, they can also be caused by less serious symptoms. Stress, hunger, allergies, sleep deprivation, or excessive light exposure can all cause an OM. An overdose of aspirin can cause an episode, along with some prescription medication.

Recurrent migraines may be more of a problem. Having many OM’s may be a sign of infarcts, tissue death in the retina. There may also be a genetic predisposition to having harmless OM episodes.

OM headaches are different to visual defects that occur on, before, or during a migraine (these are called auras). The aura’s presence is because of chemical and neurological symptoms originating in the brain. Scotomata that occur during an OM are due to defects in the eye.

If pain is not present during an OM and they resolve themselves in less than 45 minutes, they generally require no treatment. However, when they first occur it is better to visit a doctor to make sure serious conditions are not the cause (cancer, stroke, etc.). If the episodes are frequent enough, your doctor may recommend migraine medication.