What Are Retinal Migraines? Symptoms, Treatment, and How to Them Tell Apart From Other Migraines

Migraines are a painful neurologic condition. Many people who have migraines also experience auras. Auras are sensory experiences that can include vision changes. 

If you’re having headaches and vision changes in just one eye, you might be having a retinal migraine. Here’s what you should know about them.

What is a retinal migraine?

A retinal migraine is a rare condition that affects your retina. The retina is the back of your eye. Its job is to send light signals to your brain so people can see images. 

People who have retinal migraines experience temporary vision changes. Retinal migraines are different from regular migraines. It’s important to know if you’re having a classic migraine with auras or a retinal migraine because the two need very different treatments. 

What are the symptoms of a retinal migraine?

The main symptoms of a retinal migraine are vision changes in one eye. These vision changes can include:

• Partial or complete loss of vision in one eye

• A large blind spot (called a scotoma) in one eye

• Flashing or twinkling lights in one eye

These vision changes can last anywhere from 5 to 60 minutes. After the migraine ends, vision usually goes back to normal. Permanent vision changes are very rare.

As you might guess from the name, people with retinal migraines also have headaches along with these vision changes. The headache may start at the same time as the vision changes or up to 1 hour later. 

But retinal migraines don’t always include headaches. Some people with retinal migraines only experience vision changes. It’s possible to have a retinal migraine without a headache.

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Are retinal migraines and migraines with aura the same thing?

Retinal migraine and migraine with aura aren’t the same thing. But they’re both types of migraine. 

Classic migraines with auras are much more common than retinal migraines. Only 1 out of every 200 people experience retinal migraines. 

But about 1 out of 3 people with classic migraines experience visual auras. Visual auras cause symptoms like:

• Small blind spots with bright colors or jagged lines around the edges

• Flashing lights

• Blurry or foggy vision 

• Distorted vision that makes things look bigger or smaller than they actually are

In classic migraines with auras, vision changes affect both eyes. People with retinal migraines have vision changes in only one eye. 

How does a retinal migraine differ from ocular migraine?

“Ocular migraine” is an old term for retinal migraine. So, the two terms mean the same thing. “Ophthalmic migraines” and “anterior visual pathway migraines” are two other old names for retinal migraines. 

What causes a retinal migraine?

It’s not clear why people develop retinal migraines. Current evidence suggests that a temporary blockage in the blood supply to your retina causes both the vision changes and the headache. 

Vision goes back to normal once the blood vessels relax and blood flows through again. 

Certain things can trigger retinal migraines. Since only a few people have them, and triggers can vary from person to person, there isn’t a complete list. But some reported triggers include:

• Stress

• Smoking 

• High blood pressure

• Hormonal contraception

• High altitude

• Dehydration

• Low blood sugar

Who gets retinal migraines?

Retinal migraines aren’t common, and it’s not clear what causes them. Because of this, there isn’t much information about who is most at risk for getting them. 

Some evidence shows that people are more likely to develop retinal migraines if they:

• Are younger than 40 years old

• Have family members with a history of classic migraines 

• Have certain medical conditions, like lupus, sickle cell disease, or hardened arteries (atherosclerosis)

How do you treat a retinal migraine?

Finding the right treatment for your retinal migraines can be tricky. Since so few people have retinal migraines, there isn’t enough evidence for experts to develop treatment guidelines. 

Experts recommend avoiding medications that treat classic migraines, like triptans, because they can affect blood vessels. Beta blockers and ergot derivatives aren’t options either, since they can also affect blood vessels and might, in theory, trigger permanent vision loss.

But there are still ways to help reduce your retinal migraine episodes. Here are three options to consider.

1. Avoiding triggers

Staying away from common triggers can help keep your retinal migraine episodes at bay. If you smoke, consider quitting. If you’re taking hormonal contraceptives, think about switching to a nonhormonal form of birth control, like a diaphragm or a nonhormonal IUD. If you’re not sure what your triggers are, keep a headache diary. This can help you pinpoint your own triggers. 

2. Over-the-counter pain relievers

Over-the-counter (OTC) pain medications may help lessen your headache during a retinal migraine. Some evidence shows that aspirin is a great option for treating retinal migraines. But aspirin isn’t the best option if you take certain medications. Your eye doctor can help you choose the best OTC pain reliever.

3. Calcium channel blocker

If you get frequent retinal migraines, you might want to think about taking a daily medication to prevent migraines. Calcium channel blockers, like nifedipine or verapamil, can help. These are prescription medications, so you’ll need to work with your eye doctor to start treatment. 

When should you seek help for a retinal migraine?

If you ever have a sudden vision change in one eye, see an eye doctor or go to the emergency room right away. 

Many medical conditions can cause vision changes in one eye, and all of them are more common than a retinal migraine. Some are life-threatening, like strokes, blood clots, and tumors. Others, like retinal detachment, can lead to permanent vision loss if not treated quickly.

Your eye doctor will make sure your vision changes aren’t caused by one of these serious conditions. Retinal migraines aren’t dangerous. It’s very rare to have any lasting vision loss from a retinal migraine. 

But experiencing retinal migraines can disrupt your daily life. If you’re having more than one retinal migraine per month, it’s time to see your eye doctor. You might need treatment to prevent retinal migraine attacks.

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Written by:

Nishika Reddy, MD

Nishika Reddy, MD, is an attending physician at the University of Utah. She provides comprehensive and cornea medical care at the Moran Eye Center and serves as clinical assistant professor.

Edited by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

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