Ophthalmoplegic migraines or ocular migraines are considered as uncommon types of migraine headaches where the eye region is the central point of the pain. This headache often occurs along with momentary weakness of the eye muscles or paralysis that can persist for days up to weeks after the resolution of the headache. The initial manifestation of ocular migraine usually occurs during childhood. The intermittent attacks can persist up to adulthood.
Severe headache in the eye region
The characteristic symptom of ocular migraines is the severe headache that is focused in the area around one eye. The symptoms of this migraine have been observed in infants younger than a year old. Even though the initial attack usually occurs during childhood, the condition can persist up to adulthood.
Changes in the pupil and eyelid
A drooping eyelid on the affected side due to an ocular migraine is a distinctive symptom of this condition. Always bear in mind that the eyelid usually recovers its normal functioning but it might take weeks for this symptom to fully resolve.
Ocular migraine involves the third cranial nerve or oculomotor nerve. Take note that this nerve is responsible for controlling the eye muscles including the muscle that determines the pupil size. Partial or full paralysis of this muscle connected with an ocular migraine causes the pupil to become unusually large. Normally, the pupil becomes smaller if exposed to bright light. If the pupil is affected by ocular migraine, it may have no reaction or become slightly smaller as response to exposure to bright light.
Problems with eye position and vision
Incomplete or full paralysis of the muscles controlled by the oculomotor nerve can cause the affected eye to assume an unusual position. The distinctive situation of the eye that has oculomotor nerve paralysis is usually “down and out”. The eye position is fixed downwards and to the side.
Double vision or other issues with the vision can occur with ocular migraines. Remember that these visual problems can occur due to the temporary partial or complete paralysis of the muscles controlled by the oculomotor nerve. The loss of control of these muscles on one side prevents the eyes from moving together in a coordinated manner. The result is disorganized input from each eye that is perceived as double vision or intersecting images. Take note that the visual disruption resolves as the eye muscles regain normal functioning in days to weeks after an ocular migraine.
If this type of migraine is suspected, a doctor should be consulted so that proper assessment can be carried out. Early discovery of the condition is also beneficial so that appropriate treatment and preventive measures can be started.