A Migraine Without Pain? Yes, It Can Happen, and It’s Called an Ocular Migraine

These silent migraines come with aura but no ache

You might be surprised to know that you can have a migraine without pounding head pain and nausea.

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It’s called an ocular or ophthalmic migraine, and it’s a form of silent migraine – silent in the sense that it isn’t accompanied by pain. Rather, it’s characterized by a variety of vision disturbances that can appear in one or both eyes, such as seeing spots, zig-zags, flashes of light or double vision, or even experiencing a temporary loss of vision.

Migraine sufferers might recognize these strange vision symptoms and know them as aura, a phenomena that sometimes serves as a warning sign that pain is on the way.

But in the case of an ocular migraine, there’s no headache that follows, and the vision symptoms usually resolve themselves within 20 to 30 minutes, says headache specialist Emad Estemalik, MD.

What causes ocular migraines?

They’re thought to originate in a similar way as migraine headaches, by irregular electrical activity in the brain. Genetics play a role in who experiences migraines, and they’re also more common in women. Potential triggers include certain MSG-containing foods, harsh light, stress and changes in weather.

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Although the root cause is the same, it is not known why some people experience migraine pain after visual disturbances and others don’t – or why the same person might experience both on different occasions.

“It is quite common that as women get older, they might have fewer headaches and less pain but more of these auras,” Dr. Estemalik says.

What they mean

While ocular migraines themselves aren’t harmful, Dr. Estemalik cautions that other medical conditions can cause vision disturbances, so if anyone experiences this as a new symptom, they should get it checked out by their doctor.

“It can be quite concerning,” he says. “A patient may think something is wrong with their eye, or if it’s an elderly patient, they might worry they are having a stroke.”

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If potential eye and heart problems are ruled out, people can think about ocular migraines as a temporary inconvenience.

“Over-the-counter magnesium tends to help ocular migraines and auras in general,” Dr. Estemalik says. “There are other drugs we can prescribe, but this is one simple strategy that can help.”

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