Migraine Aura: Causes, Symptoms, Treatments

Written By: Susannah Lockett

Migraine headaches occur when specific changes in the brain cause blood vessels in the head to expand. Migraines almost always affect only one side of the head, typically the temple area, and may be accompanied by nausea and sensitivity to light, sound, and smells.

Excruciating, throbbing pain generally in the temple area can be severe enough to hinder the sufferer for a few hours to several days. Female migraine sufferers outnumber males by three to one.

Migraine with Aura

Migraine with aura is a subtype of the same condition. About a third of people with migraines experience an aura within 20 minutes of an impending migraine.

Aura is a painless prodrome that may involve flashing lights, blind spots, blurry vision, and black zigzag lines in the visual field.

Aura may also include numbness and difficulty with speech. Migraines tend to peak in the teen years and early adulthood. It’s not uncommon for women to see significantly reduced migraine attacks as they approach age 35 or so. Migraine attacks may even cease altogether at this time.

Migraines in children are possible but not common. The condition tends to run in families, with about 90 percent of sufferers reporting that their condition also affects other family members.

Migraine with aura may signal a deficiency of blood flow to brain cells. It can also mimic the symptoms of a transient ischemic attack or TIA. Sometimes, TIA is called a mini-stroke.

Ocular Migraines and Visual Migraines

A visual migraine is another term for migraines with aura. However, another type of this condition is called ocular migraines or retinal migraines. These attacks occur when reduced blood flow temporarily deprives the retina’s blood vessels of oxygen.

Ocular migraines typically last less than one hour and involve temporary vision loss, including blind spots and even total blindness in one eye. Ocular migraines usually affect only one eye, but migraine with aura (visual migraines) usually affects both eyes.

If you cover one eye with migraine with aura, you will still see the visual disturbances coming from both eyes. Ocular migraine typically affects only one eye. If you cover the affected one, the visual disturbances are no longer there.

Any eye symptoms involving blind spots and flashing lights requires immediate evaluation by an eye care professional. Never assume your problem is a migraine or migraine with aura unless you have been previously diagnosed with this condition by a doctor.

The visual symptoms produced by migraine with aura are generally harmless.

Symptoms of Visual Migraines (Migraine with Aura)

These may include:

1. A flickering blind spot drifting slowly across your visual field

2. A wavy or zigzag ring of color surrounding the blind spot

Ocular Migraine

There may be a blind spot called a scotoma in the central vision of one eye. This spot grows larger and interferes with activities like driving and reading. Sometimes, the entire visual field may be affected to the point of blindness in that eye.

Ocular migraine attacks tend to last around an hour or less. The aura of a visual migraine is usually shorter, around less than 20 minutes.

Causes of Migraine with Aura

There are several causes linked to migraine attacks, with and without aura. These are called triggers and may include:

  • Skipping meals or going too long without food
  • Lack of sleep
  • Not staying hydrated
  • Poorly managed stress
  • Environmental factors like pollution, bright or flashing lights, changes in air pressure and altitude, strong odors, and motion sickness
  • Weather changes
  • Hormonal changes related to pregnancy, menstruation, and menopause may trigger migraine attacks


Migraine Food Triggers

Although it’s commonly believed that certain foods and additives, especially MSG or monosodium glutamate, a flavor enhancer, can trigger migraines, Cathy Glaser, executive director of the Migraine Research Foundation, disagrees.

Glaser states that food triggers for a migraine remains unproven and are never universal. However, she does recommend limiting alcohol and caffeine.

Treatment of Migraines

Some sufferers find relief with relaxation and visualization techniques like biofeedback, yoga, and meditation. Regular aerobic exercise may also help to reduce stress and limit migraine attacks.

There are several medications available to eliminate or reduce the frequency and severity of migraines. These medications fall into two basic categories:

1. Preventive

2. Abortive

Preventive Migraine Medications

Preventive medications are taken daily, regardless of whether there is a migraine attack. These include anti-seizure drugs, beta-blockers, calcium channel blockers, antidepressants, and Botox.

Botox, a purified preparation of a muscle-paralyzing toxin, may help prevent or limit migraines by stopping certain brain chemicals from reaching target nerve endings in the head and neck.

Beta-blockers and calcium channel blockers are drugs used mainly to treat high blood pressure and certain heart conditions. However, they may help prevent migraines by reducing the dilation of blood vessels in the head.

Abortive Migraine Drugs

These medications are taken either after the migraine begins or as soon as a warning aura occurs. Some migraine sufferers without aura still notice symptoms warning them of an imminent attack.

A group of drugs called triptans works to relieve migraines by dampening the brain’s overactive pain nerves. They may help to reverse the cascade of events leading up to a migraine attack.

Ergotamine is a derivative of a specific type of fungus that grows on grain. It works to abort a migraine attack by narrowing the dilated blood vessels in the head that are causing pain. Ergotamine is highly effective but does have some serious potential side effects, such as kidney damage.

In more recent times, the use of ergotamine has somewhat diminished in favor of triptans. Other migraine remedies include aspirin, ibuprofen, and acetaminophen, all available over the counter.

Opioids and anti-nausea drugs may also be prescribed for migraines. Some sufferers need both preventive and abortive therapy for best results.

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Published on: May 1, 2022
Last Updated: August 3, 2022