Questions answered by Charles Slonim, MD

[Editor's note: All About Vision's ocular migraine article has inspired commentary and questions from readers who have searched far and wide for explanations about these peculiar vision symptoms. In this Q&A, All About Vision board member Charles Slonim, MD, provides answers and additional insights about visual symptoms that many describe as seeing a "zigzag effect." Note that the proper term for an ocular migraine is "ophthalmic migraine," though we refer to both terms because of common usage.]

How common are ocular migraines?

Q: Thank you for the information you have published about ocular migraines. I've had numerous episodes over the past five years, but most recently was last week when I was two and a half hours away from my home. It took over an hour for it to totally go away. I appreciate your explanation of the usual symptoms, because it described what I experienced to a "T."

I had one question, though. Other sources on the Internet say this phenomenon is rare. But you say it is quite common. Is it? — B.M.

A: Ophthalmic migraines are not rare, especially if you are a woman under age 40 with a history of migraines. — Dr. Slonim

Symptoms of ocular migraines

Q: I have had ocular migraines for many years. I have the classic jagged strobe effect. No big deal usually.

But last year I had a weird and different thing happen that still worries me. All of a sudden my eyes crossed and stuck that way. My fingertips went sort of numb, and the side of my tongue and bottom lip went numb. When I tried to explain this to the nurse, I sounded like a stroke victim.

I saw a neurologist, and he felt it was just a more intense type of ocular migraine. Have you ever heard of this? The MRI showed nothing significant. — S.

A: By definition, this would not be a classic ophthalmic migraine, because the symptoms are outside of what is seen. Therefore, I personally would not classify it as a "more intense type of ophthalmic migraine." These symptoms could be associated with some of the more common non-ophthalmic migraine phenomena. — Dr. Slonim

Q: My husband began having symptoms of something very strange. We looked online and found your site. It turns out he was having an ocular migraine.

Your explanation and — even better — the visual little flash movie explained exactly what he was having and put our minds at ease. We were both thinking brain tumor or aneurysm (too much "Grey's Anatomy"). So thank you for putting together such an amazingly informative website.

And even better, thank you for putting together something as simple as that flash movie describing what it looks like. I never would have believed him otherwise. I know a lot of work went into it, and today you saved us a trip to the ER. Thanks so much! — L.S.

A: Thank you for your kind words. The brain is our central command center for all body functions, so tumors, aneurysms, strokes and degenerative diseases can have myriad signs and symptoms (too many to list on our website). A person should seek immediate medical attention in cases such as:

• A noticeable disruption of any of the five basic senses (seeing, hearing, smelling, tasting, touching).

• A sudden change in mental status, such as unusual memory loss or inability to recognize a familiar face.

• Difficulty in ambulating, which includes walking in a straight line or standing in place without falling.

• Difficulty in communicating, such as slurred speech.

By the way, even though your husband's experience may indeed have been an ocular migraine, it would be wise for him to visit his doctor and make sure that his symptoms weren't caused by something else that was possibly more serious. — Dr. Slonim

Q: Thank you so much for your article on ophthalmic migraines. I thought I was a goner. :) I'll be sure to make a note of this should I get another one anytime soon. But for now, I am gratefully reassured. Thanks again for the information. — J.

A: Thank you for visiting our website. An informed patient is always a better patient for both the patient and the doctor. Our goal is to keep you informed about your eyes and the conditions that are sometimes related to the eyes, such as ophthalmic migraines.

See the above note about seeing a doctor. Plus, you really might consider keeping a log of your ophthalmic migraine episodes. This could be of great value to a doctor who may consider treatment if your symptoms ever worsen or the frequency of occurrences starts to increase.

Get a calendar or date book, and jot down the day and time of occurrence, length of the episode and all of the symptoms you experienced. Check your vision in each eye individually — in other words, cover one eye at a time with your hand and note any symptoms in your uncovered eye. Try to remember what you experienced during the hour before the episode. Some examples would be an argument with someone, heavy exercise or a stressful moment at work.

In reviewing your log, you or your doctor may find a consistent pattern of triggers related to your episodes. Avoiding these triggers might help reduce the frequency of your episodes. — Dr. Slonim

What causes ocular migraines?

Q: I'm very concerned. This is my third attack of ocular migraine. The first time it ever happened was when the microwave oven at someone's home was on with nothing in it for over 20 minutes. Not knowing this, I used the microwave oven and heated some items. Thirty minutes later, I had symptoms.

I actually thought I got radiation in my eyes. Could that be possible? And can things like this trigger an ocular migraine? — M.L.

A: As long as the door on the microwave was closed during those 20 minutes, the outside environment (that is, the kitchen) should have been protected from any microwaves trying to leave the oven. The microwaves do not build up in the oven. So when you opened the oven door, there would be little chance, if any, that you were bombarded by a high dose of microwaves that were stored up before you opened the door.

Remember that ophthalmic migraines do not originate in the eyes. They originate in the brain, but the symptoms are visual because they affect the visual cortex (the part of the brain responsible for sight). — Dr. Slonim

Q: I would like to commend you for the fine article on ocular migraine. Especially helpful were the photos, which I recognized from my own attack. I have been doing some heavy dieting and I think that might have triggered the attack. — D.B.

A: I am not aware of any research that directly links heavy dieting with ophthalmic migraines. However, stress and fatigue have been known to trigger episodes in susceptible persons. Certainly, heavy dieting can be stressful and can be fatiguing depending on the lack of nourishment that one might experience during the diet. — Dr. Slonim

A cure for ocular migraines?

Q: I read your article on ocular migraines and I have some questions. I've been taking medication for GERD (gastroesophageal reflux disease) for seven years and have been a long-distance runner for seven years. After about five years of this, I started getting ocular migraines. Eventually, they started occurring several times per week.

I read some information that suggested taking B vitamins, especially B12, might help. I tried that. Within two weeks, the ocular migraines were gone. Could this really be the root of the problem? If so, maybe it would help others if you considered adding this to the article. — S.S.

A: I am aware of a few research studies that have demonstrated a relationship between B vitamins and folic acid intake and a reduction in the frequency of migraine headaches. However, I'm not aware that any of these studies were specific to ophthalmic migraines. Nonetheless, thank you very much for this information. — Dr. Slonim

Please note: If you have an urgent question about your eye health, contact your eye care practitioner immediately. This page is designed to provide general information about vision, vision care and vision correction. It is not intended to provide medical advice. If you suspect that you have a vision problem or a condition that requires attention, consult with an eye care professional for advice on the treatment of your own specific condition and for your own particular needs. For more information, read our Terms of Use.

Page published on Wednesday, April 3, 2019