Many people with migraine have changes in their vision around the time of their headaches. Blurry vision and sensitivity to bright lights are two commonly mentioned problems. They can begin before the headache itself and may last throughout the migraine attack.

Some people, though, have more dramatic changes in vision that doctors refer to as visual aura. In visual aura, the vision changes might include such things as losing part or all of one’s vision for a short period of time, or seeing zig-zag or squiggly lines. Typically these visual symptoms come on gradually, develop over a period of about half an hour, and fade away as the migraine headache begins. The entire episode usually does not last longer than an hour. Some people with migraine have other types of aura, in which they experience problems such as numbness, tingling or weakness. An interesting fact, though, is that almost all of them also experience visual aura.

Only about a third of people with migraine have migraine with visual aura, and aura may occur with only some and not all of their headaches. It is also possible to have an aura that is not followed by a headache; this becomes more common as people get older.

It is not always easy to tell the difference between some of the typical vision changes that accompany migraine and those that are considered to be true visual aura.  Doctors commonly try to divide people with migraine into those who have migraine without aura and those who have migraine with aura. Why does this matter? Treatment of the two kinds of migraine is usually the same but other advice may be different. Migraine with aura slightly increases the risk of having a stroke, for example, and women who have migraine with aura need to think carefully about the risks of treatments such as birth control pills that contain estrogen.