Ocular Migraines, Common Types of Migraines, and How They’re Diagnosed

For some migraine sufferers, flashes of light that move across their field of vision are clues that a migraine is on its way. For others, the first hints are unusual food cravings.

Around three out of five migraine sufferers experience warning signs before the onset of head pain typically associated with migraines. Once a headache strikes, it can send them to bed for hours.

According to Statistics Canada, eight percent of Canadians have been diagnosed with migraine headaches. But this figure likely underestimates the actual prevalence of this chronic condition.

Research suggests that many of those affected by migraines do not seek medical assistance.

Migraines cause symptoms such as throbbing and pulsing, usually on one side of the head. Additional symptoms can include extreme sensitivity to light and sound, as well as nausea and vomiting. Migraines tend to be more intense than traditional headaches.

But that doesn’t mean all migraines are the same. Your symptoms might be very different from someone else’s.

Migraines With Aura vs. Migraines Without Aura

There are two main categories of migraines: migraines with aura, formerly known as “classical migraines” and migraines without aura, formerly known as “common migraines.”

“Aura” refers to a group of symptoms that often include vision disruptions such as seeing spots, flashes, or wavy lines. Temporary blind spots can also occur.

Non-visual symptoms of aura can affect your sense of taste, touch, or smell, as well as your motor system. For instance, you might experience numbness, or a tingling sensation or weakness in arms and legs. Migraine aura usually starts before you notice any head pain.

Ocular Migraine

Ocular (retinal) migraines are rare and result in bouts of partial or full vision loss. Contrary to aura which occurs in both eyes, ocular migraine occurs in just one eye. Vision loss generally lasts for less than an hour and can happen before or during the period of head pain. Episodes of blindness in one eye can be symptomatic of a serious condition, so speak to your doctor if you experience this symptom.

Common Types of Migraines

There are several other sub-types of migraines. These include:

• Basilar. Basilar migraines, also known as “migraine with brainstem aura,” may cause visual symptoms and vertigo (spinning and dizziness). But they don’t affect movement or eyesight. For example, you won’t see flashes of light or wavy lines with this type of migraine.

• Chronic. In order to be diagnosed as chronic, headaches must occur 15 or more days in a month for more than three months. This includes migraine-related symptoms on at least eight days each month.

• Hemiplegic. A hemiplegic migraine aura can cause temporary weakness or paralysis on one side of the body. They may also be associated with speech problems, seizures, numbness, and fever. It’s important to make sure a hemiplegic migraine is not a stroke, since the symptoms are similar. Symptoms should disappear within 24 hours.

• Menstrual. A menstrual migraine can strike two days prior to a woman’s menstrual period or up to three days after. Women who experience menstrual migraines may experience other types of migraines when they’re not menstruating.

• Vestibular. Vestibular migraines trigger a sensation of vertigo that can last for a few minutes or a few hours.

How Are Migraines Diagnosed?

If you think you might be suffering from migraines, you should make an appointment to discuss your symptoms with a doctor. Getting a diagnosis usually involves several steps.

Your doctor will likely begin by asking you to talk about your headaches. It’s important to describe all your symptoms in as much detail as possible.

1- Your Headache History

If possible, think about the following questions before seeing your doctor.

• When did the headaches start?
• Do you experience a single type of headache, or do symptoms change from headache to headache?
• How often do you experience headaches?
• Do you know of any factors that trigger your headaches? (For instance, foods, drink, fatigue, medication, menstruation, etc.)
• Does anyone else in your family experience headaches?
• Do you experience symptoms between headaches?
• Is your performance at work or school impacted by your headaches?
• What does it feel like when you get a headache? You should try to describe your headaches in as much detail as possible.
• Have you been treated for headaches in the past? If you have, be sure to bring any materials, such as X-rays and imaging tests, to your appointment.
• Are you currently taking or have you taken medication, whether over-the-counter or prescription, for your headaches?

2- Physical and Neurological Exams

After listening to your headache history and symptoms, your physician may perform physical and neurological tests to rule out other causes of headaches and migraines, such as tumors, brain abscesses, and hemorrhaging. The majority of headaches are benign.

3- Psychological Evaluations

In rare cases, your doctor may recommend speaking to a psychologist to identify stress-related triggers that are contributing to your headaches. You may also be asked to complete an electronic questionnaire or discuss stress in further detail with your doctor.

After evaluating both the information you have provided and the results of physical and neurological exams and psychological evaluations, your doctor should be able to identify what type of headaches you have.  

And be able to tell you whether or not they are caused by a serious problem, and if any additional tests are needed. He or she may conduct additional analyses to confirm the diagnosis and/or rule out other potential medical conditions.

Are you sure you suffer from migraines? Or is it possible you have serious headaches instead? Find out the difference between migraines vs headaches and start learning how to manage them.

The information in this article should not be taken as professional medical advice. If you are having issues or have health-related concerns, you should see your personal physician.