Link Between Ocular Migraine And Covid

After getting COVID-19, some people have complained about ocular migraine. Is there a valid link between the two, and is ocular migraine a dangerous enough condition? Is there a link between COVID-19 and ocular migraines, and can the vaccine trigger them?  Will treatment for the migraine interfere with the vaccine, or vice-versa? Thankfully, ocular migraines are annoying but temporary. 

This article will discuss everything you need to know about the ailment and its connection to the COVID-19 vaccines.

What is ocular migraine?

According to the American Migraine Foundation,¹ ocular migraine is characterized by vision impairment and a headache. The effects usually last for an hour or less. The foundation distinguishes between two types: migraine with aura and retinal migraine. The difference between the two is largely the form in which the vision disturbances manifest. 

Retinal migraine generally occurs in only one eye. In migraine with aura, a person may see stars, flashes of light, or experience blind spots. In addition to seeing stars, people experiencing a retinal migraine may notice decreased vision, temporary blindness, or even irreversible visual loss as a complication. 

Retinal migraine is a rare subtype of ocular migraine, while migraine with aura is the more common version.

Causes

The aura of migraine with aura and the visual disturbances of retinal migraine are both caused¹ by abnormal electrical activity. For migraine with aura, this abnormal activity is located in the visual cortex area of the brain. The patterns caused by the ocular migraine result from these electrical abnormalities spreading across different parts of the visual cortex. 

In the case of retinal migraine, electrical abnormalities occur in the retina's back. Retinal migraines may also be caused by a temporary lack of blood flow to the retina.

In terms of what can trigger these conditions, the American Optometric Association² says that triggers for ocular migraine are similar to those for migraine in general. The NHS lists³ some of these potential causes as:

• bending over

• contraceptive pills

• dehydration

• excessive heat

• exercise

• high altitude

• high blood pressure

• high stress

• low blood sugar

• smoking

Symptoms

Symptoms differ slightly depending on the type of ocular migraine you're experiencing. For a migraine with aura, the symptoms include the visual impairments listed above, a feeling of numbness or tingling in the face or extremities, and slurred or mumbled words. Because the source of the visual disturbances is in the visual cortex, the visual symptoms may occur in both eyes but might be stronger in one eye or the other.

For retinal migraine, the loss of vision or perception of stars/flashing lights will occur in only one eye before the headache phase of the ocular migraine kicks in. 

Unlike migraine with aura, retinal migraines are caused by disturbances in a single eye itself. Because of this, the visual effects should disappear when you close the affected eye.

Complications

The symptoms of ocular migraine are annoying but temporary. In most cases, the condition is nothing to worry about. However, in the case of retinal migraine caused by decreased blood flow, there is a small chance that the lack of blood can damage the vessels in the eye. It's rare for this damage to result in permanent vision loss, however. 

For some people, migraine with aura can increase the risk of stroke. Because of this, your doctor may recommend some medications and suggest treatment for other stroke risk factors.

The link between COVID-19 and ocular migraine

Many people who experience migraines never experience an ocular migraine. Their headaches simply don't present in conjunction with any visual abnormalities. However, many people who have regularly had migraines throughout their life find themselves experiencing migraine with aura for the first time after contracting COVID-19.

In some cases,⁴ people who contract COVID-19 have experienced headaches without aura long after recovering from the virus. 

Can migraine occur after the COVID-19 vaccine?

There has been a report of a person who, after receiving the COVID-19 vaccine, has experienced an oppressive headache. In addition to the headache, the person experienced a loss of visual acuity, albeit subjectively. However, no tests were performed on the individual to confirm the causes of these vision problems.

Causes

Although the exact link hasn't been found, researchers believe that COVID-19 affects the bioelectrical system of the brain by increasing electrical activity. If this increase in electrical activity happens in the visual cortex area, the exact type of electrical disturbances that result in a visual aura can occur. 

To confirm that this is what's going on, researchers will need to conduct additional tests on those who contract the virus and begin to experience ocular migraines. Furthermore, there is also evidence of direct viral invasion of the nervous system by SARS-CoV-2, and thus the systemic inflammatory response may explain the association.

Will migraine medication interfere with the COVID-19 vaccine?

Two primary concerns have been raised concerning the COVID-19 vaccine and those currently undergoing migraine treatment. Will the migraine treatment impact the vaccine's effectiveness, and will the vaccine impact the effectiveness of the treatment? 

Researchers examined several prescriptions and over-the-counter treatments for migraine and how they may interact with the COVID-19 vaccines. They concluded that there was no reason to suspect that either would negatively impact the other.

What you should know about ocular migraines

If you begin noticing visual abnormalities and migraine after getting the COVID-19 vaccine, you may be worried about experiencing serious side effects. While such visual disturbances can result from something more serious, ocular migraines themselves are not a particularly threatening condition. For most people, they clear up quickly, even though they may be painful while they are happening. 

The information below will help you better understand the condition.

Diagnosing ocular migraine

When diagnosing ocular migraine, your doctor will perform a comprehensive eye exam. They'll also ask you about your history of headaches and other pertinent medical questions. If the doctor thinks that something more serious may be causing your symptoms, they may order blood work or other tests to give them a better glimpse at your health and rule out other causes.

Management of ocular migraine

When you develop an ocular migraine, the two major points of managing the condition are treating the current discomfort and taking steps to prevent the condition from recurring. 

After a doctor has confirmed that your condition isn't something more serious, the treatment for ocular migraine is simple. While you might find that you can't fully prevent migraines from recurring, steps can be taken to minimize the chance.

Treatment

Because they are temporary and not usually dangerous, treatment for an ocular migraine mainly focuses on alleviating the pain that they cause. 

The first step is to avoid anything that might trigger the migraine and worsen it. If you experience these migraines frequently, you'll learn what your triggers are. To help with the pain, your doctor may suggest that you take medication.

For mild symptoms, over-the-counter painkillers are effective against ocular migraine. If your pain is more intense, your doctor may prescribe you a painkiller. 

In the case of retinal migraine, other medications, such as a beta-blocker, antiepileptic or tricyclic medications, may help prevent these migraines.

Prevention

Preventing ocular migraines from occurring in the first place mostly involves avoiding the triggers that cause them. As stated previously, you'll learn over time what these triggers are. 

To help you track what causes your migraines more effectively, you can keep a journal of what you were doing right before the migraine started. Your entries can include actions, foods, medications, and anything else you think might have brought on the migraine.

When to see a doctor

Vision problems with headaches may be ocular migraine, or they may signify a deeper underlying issue. Anytime you experience a loss of vision, consulting with a medical professional as soon as possible helps rule out any more serious issues. 

Your doctor will be able to confirm that there are no serious risks to your vision or health and offer you treatment that will help alleviate the symptoms of your ocular migraines should they recur. Seeing a doctor is also important if your symptoms don't improve after an hour, never fully go away, or are accompanied by other symptoms that can't be explained by ocular migraine alone.

The lowdown

Ocular migraine, be it in the form of migraine with aura or retinal migraine, can be a painful and distracting experience. If you've experienced migraines before and are just starting to notice visual disturbances, it might even be a scary experience. This is especially true if you've just taken a SARS-CoV-2 vaccine and are worried about potential side effects. 

Your doctor can help set your mind at ease by ruling out more serious issues. Once they do, ocular migraines, while annoying, do not usually pose a threat for serious complications and are often over in less than an hour.