Ocular Migraines: Symptoms, Triggers & When to Worry

Seeing flashing lights, zigzags, or a blurry blind spot can be unsettling.

This calm, practical guide explains what ocular migraines may feel like, common triggers, steps you can take now, and the warning signs that mean you should seek care. It does not diagnose or promise cures; instead, it helps you decide when to monitor and when to call a professional.

Should I Act Now or Monitor?

It’s reasonable to be cautious with any new visual disturbance. If this is your first episode, symptoms are worsening, or the pattern is different from what you’ve had before, consider contacting a clinician soon—same day if you’re concerned.

Monitor at home if the symptoms are familiar to you, short-lived (often 5–60 minutes), and you’ve previously been evaluated for similar events. Keep notes on duration, possible triggers, whether one or both eyes are involved, and whether a headache follows.

Talk to a doctor soon if you notice: new or sudden visual symptoms, increasing frequency, symptoms lasting longer than usual, or any new weakness, confusion, or speech changes. Think of this as a health and safety decision rather than a quick fix.

Who this guide helps most: people with a migraine history, adults experiencing new visual symptoms, and caregivers supporting older adults who suddenly report visual changes.

Ocular Migraine, Migraine With Aura, and Retinal Migraine

Terminology can be confusing. In everyday language, “ocular migraine” is used loosely to describe visual disturbances that may or may not come with a headache. Medically, there are a few distinct possibilities:

Migraine with aura: Common. Visual aura often affects both eyes and can look like shimmering lights, zigzags, or blind spots. A headache may follow, but not always. Learn more from the Mayo Clinic and the American Migraine Foundation.
Retinal migraine: Rare. Visual loss or disturbance in one eye only, usually short-lived, sometimes followed by headache. Because one-eye symptoms can also signal eye emergencies, evaluation is important.
“Ocular migraine” as a catch-all: Many people and even some clinicians use this term to mean either of the above. If you’re not sure which you’re experiencing, ask your provider to clarify.

Conditions that can mimic ocular migraine include eye floaters, eye strain or dry eye, retinal detachment warnings (new flashes and a curtain-like shadow), transient ischemic attack (TIA) or stroke symptoms, and acute angle-closure glaucoma. A safety note: Sudden vision loss is an emergency—seek urgent care.

Symptoms: What They May Feel Like

Visual aura often includes one or more of the following:

Shimmering lights that sparkle or flicker
Zigzag or “fortification” patterns that slowly move
Blind spots (scotoma) or blurry patches that expand
Tunnel vision or loss of part of the visual field
Symptoms typically build over minutes and last 5–60 minutes
A headache may or may not follow; some people never develop pain

A simple at-home check (not a diagnosis)

During symptoms, gently cover one eye, then the other. If patterns appear with either eye covered, the visual disturbance likely involves both eyes (brain/visual cortex), which can be consistent with migraine aura. If it truly affects only one eye, mention this to your eye doctor promptly. This check is just for information to share with a clinician—not a diagnosis.

Causes and Common Triggers

Ocular migraines (often meaning migraine with visual aura) are thought to involve temporary changes in brain and blood vessel activity. Triggers are highly individual, but frequent contributors include:

Stress and anxiety
Poor sleep or irregular sleep schedule
Dehydration
Skipped meals or blood sugar swings
Hormonal changes
Bright lights, glare, or extended screen time
Caffeine changes (more, less, or sudden withdrawal)
Alcohol
Weather or barometric pressure changes
Certain foods (varies by person)

Because triggers differ from person to person, tracking is valuable. The American Migraine Foundation offers guidance on understanding migraine triggers.

When It’s Likely Migraine vs. When It Might Be Something Else

Symptoms that build over minutes, last less than an hour, and produce shimmering or zigzag patterns in both eyes are often consistent with migraine aura. Still, similar symptoms can occur with other conditions. Use these red flags to guide urgency.

Red flags: seek urgent care now

Sudden vision loss in one eye or a dark curtain in your vision
New weakness or numbness in face, arm, or leg
Trouble speaking or understanding speech; facial drooping
Severe, “worst headache of your life”
Symptoms after a head injury
Eye pain + redness + vision changes (possible acute glaucoma)

If you suspect stroke, call emergency services. Review the CDC’s stroke warning signs: CDC: Stroke Signs and Symptoms. For eye emergencies, including retinal detachment or acute glaucoma, see the American Academy of Ophthalmology’s resources on retinal detachment and acute angle-closure glaucoma.

Treatment Options: Short-Term Relief

During an episode, many people find relief with simple steps:

Rest your eyes in a dark, quiet room
Hydrate with water or an electrolyte drink
Gentle breathing or relaxation techniques to reduce stress
Avoid driving or operating machinery until vision clears
Over-the-counter pain relief may help if a headache follows (ask a pharmacist or clinician for advice that suits you)
Some people benefit from prescription migraine medicines—discuss options with your clinician

More information on treatments is available from the Mayo Clinic.

Prevention and Long-Term Management

Sleep routine: consistent bed and wake times
Stress reduction: brief daily relaxation, walks, stretching
Regular meals and hydration: avoid long gaps and keep a water bottle handy
Screen hygiene: adjust brightness/contrast, use breaks (20-20-20 rule), reduce glare
Trigger tracking: keep a journal of foods, sleep, stress, caffeine, weather, and timing
Manage underlying conditions: blood pressure, vision correction, and other health issues with clinician guidance
Preventive options: Some people may benefit from preventive medications or supplements; ask your doctor what’s appropriate for you

Use-Case Scenarios

First-time ocular migraine at work: You notice shimmering zigzags that spread over 20 minutes. Stop screens, hydrate, rest your eyes, and arrange a ride home if vision is impaired. Because it’s your first episode, consider same-day medical advice.
Older adult with sudden visual changes: A parent reports a dark curtain over one eye. Treat as an emergency—seek urgent eye care to rule out retinal detachment or vascular causes.
Frequent episodes disrupting life: If visual aura occurs several times a month, keep a trigger journal and ask your clinician about preventive strategies.
No headache afterward: Visual aura without headache can happen. Still track patterns and discuss at your next appointment, especially if the pattern changes.
Screen or bright light–triggered episodes: Try anti-glare settings, scheduled breaks, room lighting adjustments, and tinted lenses if recommended by your provider.

Local and Real-World Care Options

Optometrist vs. ophthalmologist vs. neurologist: For first-time or changing visual symptoms, an eye exam is a good start (optometrist or ophthalmologist). If migraine is suspected or symptoms are complex, your primary care clinician may also refer you to a neurologist.
Telehealth vs. in-person: Telehealth can be useful for triage and migraine management. New, severe, or one-eye vision loss usually warrants an in-person exam.
What to write down: duration, what you saw, one eye or both, any headache or nausea, possible triggers, recent sleep/caffeine/alcohol changes, and medications you took.

Mistakes and Pitfalls to Avoid

Assuming all visual disturbances are “just migraines”
Driving during symptoms
Ignoring sudden one-eye vision loss
Not tracking frequency and triggers
Overusing pain medication—can lead to rebound headaches; seek guidance

Decision Support Tools

Ocular Migraine Symptom Checklist

Shimmering lights, zigzags, or blind spots that build over minutes
Symptoms last 5–60 minutes
Occur with either eye covered (suggesting both eyes involved)
Headache may or may not follow
Known triggers present (stress, sleep loss, screen glare, etc.)

“Should I seek care today?” Self-Assessment

Yes—today/urgent: first-ever episode, sudden one-eye vision loss, new weakness/numbness, trouble speaking, facial droop, severe worst headache, eye pain/redness with vision changes, or symptoms after head injury.
Soon (next few days): increasing frequency, longer-lasting symptoms, or a change in typical pattern.
Monitor: familiar, short-lived symptoms that match your prior clinician-confirmed pattern; continue tracking and prevention.

Concise Decision Summary

First-time or severe: get checked.
Recurring and familiar: track + prevention plan.
Sudden vision loss or neurological symptoms: emergency care.