Retinal migraine is a retinal disease often accompanied by migraine

Migraine

Migraine is a chronic neurological disorder characterized by moderate to severe headaches, and nausea...

 headache

Headache

A headache or cephalalgia is pain anywhere in the region of the head or neck. It can be a symptom of a number of different conditions of the head and neck. The brain tissue itself is not sensitive to pain because it lacks pain receptors. Rather, the pain is caused by disturbance of the...

 and typically affects only one eye. It is caused by an infarct or vascular spasm in or behind the affected eye.

The terms "retinal migraine" and "ocular migraine" are often confused with an abnormal condition in the brain (cortical spreading depression

Cortical spreading depression

Cortical spreading depression is a wave of electrophysiological hyperactivity followed by a wave of inhibition, usually in the visual cortex.The term is used by neuroscientists to represent at least one of the following cortical processes:...

) that may cause similar symptoms such as scintillating scotoma

Scintillating scotoma

Scintillating scotoma is the most common visual aura preceding migraine and was first described by 19th century physician Hubert Airy . It is often confused with ocular migraine which originates in the eyeball or socket.-Presentation:...

 affecting vision in both eyes, also associated with migraine headaches.

Symptoms

Retinal migraine is associated with transient monocular visual loss (scotoma

Scotoma

A scotoma is an area of partial alteration in one's field of vision consisting of a partially diminished or entirely degenerated visual acuity which is surrounded by a field of normal - or relatively well-preserved - vision.Every normal mammalian eye has a scotoma in its field of vision, usually...

) in one eye lasting less than one hour. During some episodes, the visual loss may occur with no headache and at other times throbbing headache on the same side of the head as the visual loss may occur, accompanied by severe light sensitivity and/or nausea. Visual loss tends to affect the entire monocular visual field of one eye, not both eyes. After each episode, normal vision returns.

It may be difficult to read and dangerous to drive a vehicle while retinal migraine symptoms are present.

Retinal migraine is a different disease than scintillating scotoma

Scintillating scotoma

Scintillating scotoma is the most common visual aura preceding migraine and was first described by 19th century physician Hubert Airy . It is often confused with ocular migraine which originates in the eyeball or socket.-Presentation:...

, which is a visual anomaly caused by spreading depression in the occipital cortex, at the back of the brain, not in the eyes nor any component thereof. Unlike retinal migraine, such a scintillating aura affects vision from both eyes, and sufferers may see flashes of light; zigzagging patterns; blind spots; and shimmering spots or stars. In contrast, retinal migraine involves repeated bouts of temporary diminished vision or blindness in one eye.

Diagnosis

The medical exam should rule out any underlying causes, such as blood clot, stroke, pituitary tumor, or detached retina. A normal retina exam is consistent with retinal migraine.

Treatment

Treatment depends on identifying behavior that triggers migraine such as stress, sleep deprivation, skipped meals, food sensitivities, or specific activities. Medicines used to treat retinal migraines include aspirin, other NSAIDS, and medicines that reduce high blood pressure.

Prognosis

In general, the prognosis for retinal migraine is similar to that of migraine headache with typical aura. As the true incidence of retinal migraine is unknown, it is uncertain whether there is a higher incidence of permanent neuroretinal injury. The visual field data suggests that there is a higher incidence of end arteriolar distribution infarction and a higher incidence of permanent visual field defects in retinal migraine than in clinically manifest cerebral infarctions in migraine with aura. One study suggests that more than half of reported recurrent cases of retinal migraine subsequently experienced permanent visual loss in that eye from infarcts. An infarction in the retina, however, is usually apparent to the patient.