What are migraines with visual aura?

16/12/2025

Migraine is a common and debilitating neurological disorder that affects millions of people worldwide. It is characterised by intense, pulsating headache pain, which in many cases is accompanied by preceding neurological symptoms known as auras. These sensory auras may manifest in visual, auditory, or olfactory forms and usually precede the headache, although on some occasions they may occur independently.

What are visual auras in migraine?

Visual auras are among the most common symptoms of migraine with aura. Their onset is believed to be related to changes in electrical activity and cerebral blood flow, which may affect nerve cells in the brain. As a result, the individual experiences visual disturbances.

Typical visual symptoms

• Blurred areas within the visual field
• Zigzag lines or bright patterns
• Flashes of light or shimmering spots
• A spiculated (serrated) border in the affected visual areas

These images may be coloured or uncoloured and are often perceived as moving or slowly progressing. In some cases, they may occupy almost the entire visual field for several minutes.

How long do visual auras last?

Visual aura symptoms may last from a few minutes up to an hour and often precede the onset of the headache. However, not all people who suffer from migraine experience aura. There are different types of migraine:

• Migraine with aura
• Migraine without aura
• Mixed episodes: some individuals may experience both forms at different times

Migraine with aura: causes and risk factors

Although the exact cause of migraine and sensory auras is not fully understood, a number of genetic and environmental factors are thought to influence their development. Common migraine triggers include:

• Emotional stress
• Hormonal changes
• Sleep disturbances
• Consumption of certain foods or beverages
• Sensory stimuli such as bright lights or loud noises

When should you see a neurologist for migraine with aura?

It is important to pay attention to any changes in the usual migraine pattern. The sudden onset of a visual aura—especially if it has not occurred previously—should prompt immediate medical consultation. The neurologist will assess the symptoms and, if necessary, may refer you to an ophthalmologist to rule out other possible causes, such as:

• Ocular disorders
• Transient ischaemic attacks
• Visual epilepsy
• Other neurological conditions

The main objective is to ensure that the visual symptoms are indeed related to migraine and not to another underlying pathology.

Each person experiences sensory auras differently, making it essential to obtain an accurate diagnosis and establish a personalised treatment plan. Appropriate management can help control migraines, reduce their frequency and intensity, and improve quality of life.

If you experience visual or sensory symptoms associated with migraine, do not ignore them. Consult a neurology specialist to receive appropriate care and take preventive measures.

Dr. Alberto Lozano, ophthalmologist at Barraquer Ophthalmology Centre