Retinal migraine is a less common type of migraine. Retinal migraine attacks can cause a very brief loss of vision or other vision problems, such as flashes of light or dimming vision. What sets retinal migraine apart is that visual disturbances occur in one eye only.

Visual symptoms may appear slightly before or at the same time as a migraine headache begins. Having these migraine auras — sensations that happen immediately before the headache itself — along with temporary blindness can be frightening.

Here, we break down what retinal migraine is, including its symptoms, how it’s diagnosed, and available treatments.

What Is Retinal Migraine?

Retinal migraine is a type of migraine with aura. About 1 in 5 people with migraine have auras. Typical symptoms of migraine attacks include:

• Pounding headaches that are limited to one side of the head
• Nausea with or without vomiting
• Hypersensitivity to sounds or lights

Auras of classic migraine headaches usually involve seeing halos or bright spots, hearing certain noises, feeling numbness or tingling, or having a “rising sensation” in your belly. People with retinal migraine have auras that relate to a part of the eye called the retina.

The retina is where the light that enters the eye gets turned into images before being sent to the brain. Each eye has its own retina that transmits input to the visual cortex of the brain. Retinal migraine affects one retina, not the brain. Retinal migraine symptoms happen in one eye, unlike visual auras from other types of migraine, which affect both eyes.

Causes and Risk Factors for Retinal Migraine

It’s thought that the cause of a retinal migraine attack is a vasospasm — a sudden, temporary narrowing of the blood vessels that provide oxygen to the retina. This brief decrease in blood flow causes temporary vision loss or disturbances in one eye, often right before the migraine headache begins.

Like other types of migraine, retinal migraine is caused by a mix of genetic (inherited) and environmental factors. A family history of migraine can increase your risk of developing migraine, including retinal migraine. This type of migraine typically occurs between the ages of 30 and 39 and is more common in women than in men, according to the American Optometric Association.

Environmental factors can also trigger or worsen retinal migraine in some people. Specific triggers that can cause or worsen retinal migraine attacks include:

• Having high blood pressure
• Not drinking enough water
• Having low blood sugar levels
• Leaning forward

Retinal migraine can also be caused by other common migraine triggers, such as:

• Strong smells
• Loud noises
• Weather changes
• Lack of sleep
• Stress
• Oral contraceptive use or hormonal changes
• Certain foods or drinks, especially those including caffeine or alcohol

Symptoms of Retinal Migraine

Retinal migraine attacks can include visual symptoms such as:

• Sudden, painless, temporary vision loss in one eye
• Blind spots or spots with unclear vision (known as scotomas)
• Seeing twinkling lights (called scintillations)

These visual auras are usually limited to one eye and often happen soon before the migraine headache starts. Retinal migraine vision loss usually lasts for five to 60 minutes.

Loss of vision and other vision changes that continue after a retinal migraine headache ends have been reported. However, this is rare as retinal migraine symptoms are typically short-lived, so you will need further investigations to exclude other conditions. Health experts don’t yet understand why some people experience permanent vision loss and other visual changes.

Diagnosing Retinal Migraine

According to the American Migraine Foundation, there’s no single test for diagnosing retinal migraine. Instead, a diagnosis is made by ruling out other medical conditions that could be the cause of your symptoms. This may require seeing a range of specialists, including neurologists (doctors who specialize in brain disorders) and ophthalmologists (doctors who specialize in eye conditions).

Your eye doctor may perform visual field testing to gauge how far you can see to either side and up and down while looking directly ahead. The doctor will also likely take a look into your affected eye using an ophthalmoscope — just like during regular eye exams — to check for vasospasm. You may also be asked to draw on a sheet of paper what you see in each eye to confirm an aura.

Your healthcare provider will also talk to you about your symptoms and family history to help make a diagnosis of retinal migraine.

Ruling Out More Serious Conditions

Sudden loss of vision can also result from serious conditions such as a stroke or a blockage of the ophthalmic artery — the source of blood flow to the eye. Strokes and blood vessel disease are often due to clots coming from the heart or the carotid arteries (the two big arteries in your neck).

To rule out these causes, your doctor may do other scans and tests, such as:

• Echocardiogram (a scan of your heart using sound waves)
• Electrocardiogram (a test that monitors your heart rhythm)
• Ultrasound of your neck arteries
• CT or MRI of your brain

Treatmenting Retinal Migraine

Many of the treatments for retinal migraine are similar to general migraine treatments. There are two ways medications can help manage migraines. Acute treatments help to curb a migraine attack as it’s happening. Preventive medications are taken regularly to help prevent future migraine attacks.

During a Migraine Attack

Medications that relieve pain, like over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), can help during a migraine attack.

Triptans — one of the main drugs used for treating migraines — aren’t recommended for people with retinal migraine. This is because one side effect of triptans is an even greater narrowing of blood vessels.

On the other hand, oral calcitonin gene-related peptides antagonists — called gepants or gepant drugs — don’t constrict blood vessels. Your doctor may recommend gepants to help manage your retinal migraine symptoms.

Preventing a Migraine Attack

According to the American Headache Society, calcitonin gene-related peptides (CGRPs) and gepants should be considered as first-line treatments to prevent migraine.

Other preventative medications for retinal migraine include:

• Anti-seizure (antiepileptic) drugs
• Certain blood pressure drugs, such as calcium channel blockers
• Other gepants
• Tricyclic antidepressants

These drugs can have side effects, so it’s important to talk to your doctor about all of your options and get their medical advice. Let them know about any other medical conditions you may have or if you’ve had previous drug reactions.

Simple lifestyle changes may help as well. Try maintaining good sleep hygiene, eating smaller meals, and exercising regularly. Consider keeping a migraine diary where you record when you get migraine attacks and what might have triggered them. Then, try your best to avoid those triggers.

Talk With Others Who Understand

On MyMigraineTeam, people share their experiences with migraines, get advice, and find support from others who understand.

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