It has already been pointed out that ocular migraine is characterized by a visual aura – photopsy, scintillating scotoma, which is usually homonymous, namely, manifested in both eyes in the same half of the field of view. As a rule, at first a small paracentral scotoma appears, “expanding” towards the edges of the field of view, occasionally it is colored. Glittering images often replace the fall of the vision, often to its half (for example, homonymous hemianopsia).
Often, the appearance of aura is the occurrence of hallucinatory visual disorders.
With retinal migraine at the time of the aura, a central or paracentral scotoma appears, which may be of different shape and magnitude, in some cases complete blindness occurs to one or both eyes.
As a rule, the aura lasts only a few minutes, after which the headache develops, localized in the fronto-orbital zone on the side opposite to the visual defects.
Manifestations of aura of migraine are completely reversible. Headache is often pulsating, increasing for 0.5-1.5 hours, but sometimes the attack lasts up to 6 hours. At the peak intensity, a headache can be accompanied by nausea and vomiting.
Ophthalmoplegic migraine forms disturbances in the oculomotor nerve. This variant of migraine was called Mobius disease. This form of the disease is accompanied by transient ptosis of the upper eyelid, divergent paralytic strabismus, anisocoria, and impaired pupil functions on the side of mydriasis. Usually it occurs in children. The defeat of the oculomotor nerve can sometimes last for weeks.
Ophthalmic manifestations can also occur with associated basilar migraine if bilateral bilateral lesions occur, as well as ophthalmoparesis combined with other signs of lesions in the human brain stem.