It started out as a migraine. Then, for one hour, De Elizabeth lost her vision.
“All of a sudden, I started seeing weird bright lights in the corner of my eyes, and after a few minutes, I couldn’t see anything on the page. Everything was white, and I also had a splitting headache,” said Elizabeth, a 30-year-old from Boston. She recalled closing her eyes, and waiting for it to pass.
Although Elizabeth didn’t realize it at the time, she was experiencing a migraine attack with a visual aura. More than 38 million people in the United States suffer from migraines, with symptoms ranging from nausea to extreme pain, and in some cases, severely impacted vision. And doctors are working hard to determine just how to treat them.
What’s Really Happening Inside Your Head
Medical professionals, including Andrew Charles, professor of neurology and director of the UCLA Goldberg Migraine Program, are quick to point out that this type of a migraine is often misunderstood. Internet research and some in the medical field often refer to the condition as an ocular migraine, but Charles said that term is incorrect.
“The term ocular migraine is bit of a misnomer because it implies that the problem is in the eye,” Charles said. “In fact, what causes this is waves of abnormal activity that travel across the surface of the brain in the part of the brain that controls vision. Even though often interpreted by patients and physicians as something happening it in the eye, it is something that is happening in the brain.”
These waves of activity that disrupt one’s vision can vary in their appearance depending on the person, said Kevin Weber, an assistant professor of neurology in the headache division of the Ohio State University Wexner Medical Center. The auras can appear as a spot in the middle of your vision field, sparking or flashing lights, black or white dots, zigzag or squiggly lines, and in some cases, items may appear disproportionate in size. Those who experience these types of migraines generally notice a change in vision that precedes the onset of a headache.
“I had to pull over until I could see again. It was really frightening.”
Corey Brewer, a 40-year-old from Seattle, suffers from migraines with visual auras. His would begin as a “small, sparkly blob,” then disruption to his sight would grow larger and brighter before it would fade out. Once his vision returned to normal, Brewer would experience a migraine.
“The first time I got a migraine with a visual aura I was driving a car and had no idea what was happening or what to do,” Brewer said. “I had to pull over until I could see again. It was really frightening.”
In some cases, one can also experience an aura and then never get a migraine, Weber said. This condition is far less common, though.
Finding Relief From The Pain
Doctors treat migraines accompanied by visual auras the same way they treat normal migraines. Ricardo Villalobos, a neurologist at Florida Hospital, said he begins patient consultations with a close examination of their lifestyle. He said he advises patients to keep track of things like their sleeping routine and what they’re eating. He added that stress can be a contributing factor.
“Migraines are a well documented genetic condition,” Villalobos said. “Combine the genetic predisposition with environmental factors like a lack of proper sleep, skipping meals, a change in daily routine, and this can predispose one to migraine headaches.”
Some may choose to seek treatment for their migraines, but others decide to just live with them. Charles said that most visual auras last between 20 minutes and 30 minutes, and many of his patients have expressed a desire not to manage them.
“Occasionally they interfere with vision enough that people may need to stop what they are doing, but often people can continue to function while they are having them,” he said.
For those who do seek medical advice, a doctor will try to establish a course of action that’s best for the patient. According to Charles, taking a low-dose daily aspirin works for some. Weber noted improvement in those who changed their lifestyle, and added daily exercise, regular sleep and proper hydration to their routines.
“Something will be able to work for your migraines eventually.”
Doctors have yet to fully understand why some patients experience an aura and others don’t, Weber said, but it’s believed that the condition does run in families.
“Many patients start experiencing migraines in childhood or teen years,” Weber said. “Interestingly, boys usually start at a younger age, but women over all have a much higher cumulative incidence of migraine throughout the lifetime than men do.”
Migraines accompanied by visual auras are typically not of great concern, but if you begin to notice a change in how your vision is disrupted, or the auras occur with more frequency, then you should consider making an appointment with your doctor.
“The options for treatment are endless,” Villalobos said. “Something will be able to work for your migraines eventually.”
CORRECTION: A previous version of this article incorrectly attributed information to Hunaldo Villalobos at Florida Hospital instead of Ricardo Villalobos.