Many of my patients experience frequent migraines. Some of them also experience a so-called “visual aura” that occurs about 20-30 minutes before the onset of a migraine. These auras can be anything from flashing lights zig-zagging across your vision to the feeling of a veil over your vision. I have never experienced this until today. I thought it would be interesting to document the symptoms from an eye doctor’s perspective.
Visual Aura: My Experience
During my lunch break, I picked up a book to read. I began reading the first line and immediately had to re-read it several times. I realized that I was unable to see well out of my left eye. Suddenly, I noticed a band of light just beneath and to the left of my point of fixation. The band had every color of the rainbow in it and was spinning, flashing, and fluttering. The bar remained in the same location regardless of where I looked. Unlike vitreous floaters, the bar did not accelerate and decelerate with my eye movements. I knew it was either a retinal issue or an ocular migraine. Needless to say, I was freaking out a little!
Thinking it was likely a migraine, I immediately went to the nearest store and bought OTC Excedrin Migraine and took two, then returned to the office. By the time I made it to the office (10 minutes after onset) the colored band was gone and replaced by a veiling glare in my lower left visual field. I had a staff member perform Confrontation Visual Fields (a gross measurement of your peripheral vision) and found that my entire inferior temporal quadrant was missing. If I was freaking out before, I was really upset now! Within 2-3 minutes, my peripheral vision had improved and was almost back to normal. I had a staff member perform a threshold visual field test on me, but by the time the machine was ready to go, my symptoms were almost gone. The visual field came out normal.
Then the headache hit. It started as a dull throb in the back of my head and quickly escalated to an intense pain deep in my head. As the headache worsened, my visual symptoms returned to normal. Needless to say, I have a new-found empathy for those experiencing this condition for the first time. It can be quite frightening.
So what causes visual auras?
Although our understanding is incomplete, we do know that visual auras are caused by the same pathophysiological processes as migraines themselves. It all has to do with reduced blood flow to different parts of the brain and nervous system. Some patients can have visual auras followed by no headache, while it serves as a warning for impending migraines to others. If and when you get one, immediately taking an OTC medication like Excedrin Migraine may reduce the severity of the impending headache. If you suffer from chronic migraines, talk to your primary care doctor about treatment options.
Dr. Canaan Montgomery is an optometrist in Paducah, KY. As an eye doctor in Paducah, he treats eye diseases, fits contact lenses, and sees pediatric patients.
Note: This is not medical advice. If you have a concerning headache, you should see your doctor to come up with a treatment plan under their guidance.