Ideally, prophylactic therapy would prevent the occurrence of repeated episodes and prevent the development of permanent eye muscle palsies, but reports suggest that therapy has met with only limited success. A trial with calcium channel blocking drugs such as verapamil or beta blocking drugs such as propranolol or even methysergide may be warranted if the attacks are frequent. The IHS code is 1.4 for retinal migraine. Other ocular or structural vascular disorder must be ruled out. This condition may be broadly defined as a transient or permanent monocular visual disturbance accompanying a migraine attack or occurring in an individual with a strong history of migrainous episodes.
Retinal migraine occurs more frequently than ophthalmoplegic migraine.
We estimate the frequency of strictly monocular visual phenomena occurring in conjunction with migraine to be one of 200 migraine sufferers. Frequently, however, homonymous visual field phenomena in migraineurs is incorrectly attributed to a single eye. For example, a patient with transient right homonymous hemianopia might think that the right eye is affected, because normally the right temporal hemifield is 30-40 degrees larger than the left nasal hemifield. While a definite diagnosis of migraine was impossible to prove, the mode of onset, the associated headache, the relatively brief duration of the attack, the family history of migraine, the occurrence of other attacks more typically migrainous, and the absence of all neurologic abnormality between episodes made the diagnosis of migraine most likely. Therapy for these patients has included ergonovine maleate, propranolol, phenytoin, and primidone.