Retinal migraine

Retinal migraine (ocular migraine) is an eye condition that causes brief attacks of blindness or visual problems like flashing lights in one eye.

These episodes can be frightening, but in most cases they're harmless and shortlived, and eyesight goes back to normal afterwards.

Some people get retinal migraine every few months, although the frequency can vary.

Retinal migraine is a separate condition and shouldn't be confused with headache-type migraine or migraine with aura, which usually affects the vision of both eyes.

Symptoms of retinal migraine

The symptoms of retinal migraine may include:

• partial or total loss of vision in one eye – this usually lasts 10 to 20 minutes before vision gradually returns
• headache – this may happen before, during or after the vision attack

It's unusual for an episode of vision loss to last longer than an hour. The same eye is affected every time in almost all cases.

Vision may slowly become blurred or dimmed, or there may be flashes of light. Some people see a mosaic-like pattern of blank spots (scotomas), which enlarge to cause total loss of vision.

When to seek medical advice

If your eyesight suddenly deteriorates, make an emergency appointment to see an optician trained to recognise eye abnormalities and signs of eye disease (optometrist), your GP, or call NHS 111.

Use our directory to find opticians or find GP services.

It's important to see an optometrist or medical doctor urgently if you suddenly lose your eyesight, particularly if it occurs for the first time. There are other more serious causes of sight loss that doctors will want to rule out.

Diagnosing retinal migraine

If you manage to see a GP or optometrist during an attack, they may be able to see the decreased bloodflow to your eye using an instrument called an ophthalmoscope.

In this case the GP or optometrist may be able to make a confident diagnosis of retinal migraine.

However, as attacks are usually brief it's more likely you'll be diagnosed based on an account of your symptoms.

You may be referred to an eye specialist for tests to rule out other more serious eye diseases or stroke.

Causes of retinal migraine

Retinal migraine is caused by the blood vessels to the eye suddenly narrowing (constricting), reducing the bloodflow to the eye.

It may be triggered by:

• stress
• smoking
• high blood pressure 
• hormonal birth control pills
• exercise
• bending over
• high altitude
• dehydration
• low blood sugar
• excessive heat

Afterwards the blood vessels relax, bloodflow resumes and sight returns. Usually there are no abnormalities within the eye and permanent damage to the eye is rare.

Retinal migraine tends to be more common in:

• women
• people aged under 40
• people with a personal or family history of migraines or other headaches
• people with an underlying disease – such as lupus, hardening of the arteries, sickle cell disease, epilepsy, antiphospholipid syndrome, and giant cell arteritis

Treatment for retinal migraine

Treatment for retinal migraine usually just involves taking pain relief for any headaches and reducing exposure to anything that might be triggering the retinal migraine.

Your doctor may sometimes prescribe medication, such as:

• aspirin – to reduce pain and inflammation
• a beta-blocker – which may help relax blood vessels
• a calcium channel blocker – which may help prevent blood vessels constricting
• a tricyclic antidepressant – which may help prevent migraine
• anti-epileptics – which may help prevent migraine

However, there's still a lack of research about the best way to treat or prevent a retinal migraine.

Possible complications of retinal migraine

There's a small risk that the reduced bloodflow may damage the thin layer at the back of the eye (the retina) and the blood vessels of the eye. This will be monitored in your follow-up appointments. Permanent vision loss is rare.