Is My Eye Pain a Sign of Migraine? Symptoms and Genetics - Neurology

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Symptoms of migraine include: 1. Intense, throbbing headache, often on one side of the head. 2. Nausea and vomiting. 3. Sens


Hello Doctor, I would like to ask about a symptom that occurs once every 2 to 3 years.
It starts with blurred vision and seeing shadows, followed by pain in the eyes that feels like it is pulsating with my heartbeat.
Then I begin to feel unwell, experiencing dizziness and nausea, but resting for a while alleviates the symptoms.
The entire episode lasts about 4 hours.
Could this symptom be a migraine? (There is a family history of migraines.) However, my family says that migraines typically cause pain in the head, not in the eyes.
Could you please tell me if my symptoms are indicative of a migraine? Thank you!

Mr. Wang, 20~29 year old female. Ask Date: 2016/01/23

Dr. Gao Chunde reply Neurology


The nerves of the eyes are also considered part of the head.
If the eye pain is not caused by conditions such as acute glaucoma or inflammation, along with other accompanying symptoms, a more reasonable explanation would be a prodromal migraine, also known as a typical migraine.

Reply Date: 2016/01/23

More Info


Your symptoms certainly raise important questions regarding the possibility of migraines, particularly given your family history of migraine headaches. Migraines can manifest in various ways, and while they are commonly associated with head pain, they can also present with ocular symptoms, which may lead to confusion about their origin.

From your description, it seems that you experience a series of symptoms that begin with visual disturbances, such as seeing shadows or blurred vision, followed by pain in the eye that correlates with your heartbeat. This is often referred to as "ocular migraine" or "retinal migraine," where the visual disturbances can occur with or without the typical headache. The pain you describe, which feels like it is pulsing in time with your heartbeat, can be indicative of increased sensitivity in the eye or surrounding structures, which can occur during a migraine episode.

The fact that you also experience dizziness and nausea suggests that your body may be reacting to a migraine attack. Migraines are known to cause a range of neurological symptoms, including visual disturbances, aura (which can include flashing lights or blind spots), and systemic symptoms like nausea. The duration of your symptoms, around four hours, is consistent with a typical migraine attack, which can last anywhere from a few hours to several days.

It is also important to consider the genetic component of migraines. If you have a family history of migraines, it increases the likelihood that you may also experience them. Migraines can be hereditary, and many individuals with a family history report similar symptoms.
However, it is crucial to differentiate between migraines and other potential causes of your symptoms. For instance, conditions such as cluster headaches, tension-type headaches, or even more serious issues like retinal detachment or other ocular conditions could present with similar symptoms. Therefore, it is essential to consult with a healthcare professional who can perform a thorough examination, possibly including imaging studies or referrals to a neurologist or ophthalmologist, to rule out any serious underlying conditions.

In the meantime, keeping a headache diary can be beneficial. Documenting when your symptoms occur, their duration, associated symptoms, and any potential triggers (such as stress, dietary factors, or lack of sleep) can provide valuable information to your healthcare provider. This information can help in diagnosing the condition accurately and developing an appropriate treatment plan.

In summary, while your symptoms could indeed be indicative of migraines, particularly given the visual disturbances and accompanying symptoms, a comprehensive evaluation by a medical professional is essential to confirm the diagnosis and rule out other potential causes. If you experience any sudden changes in vision, severe pain, or other alarming symptoms, seek immediate medical attention.

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