To describe the characteristics of patients who visited Korean ophthalmology clinics complaining of visual symptoms and were diagnosed with migraine.

A retrospective study was performed by evaluating the patterns of visual symptoms, timing of headaches, and results of ophthalmologic examinations in 31 migraine patients who were recruited from a neuro-ophthalmology clinic.

The patients consisted of 9 men and 22 women, with a mean age of 38.1 years (range, 12-71). The average age of symptom onset was 35.7 years (range, 12-64 years). The most common three visual symptoms were blurred vision (35.5%), blind spots (22.6%), and flashes of bright lights (22.6%). Visual symptoms disappeared within 5 minutes in 16 patients (51.6%) and 13 patients (41.9%) experienced visual symptoms before the onset of a headache. Brain magnetic resonance imaging findings in 14 cases revealed normal results and the remaining three patients showed minimal small vessel disease. Except for one patient who had exotropia, there was no other specific abnormality observed upon ophthalmologic examinations.

Most of the migraine patients who first visited an ophthalmology clinic with visual symptoms had no definite ocular abnormalities. Thus, ophthalmologists must be aware that migraines could first present with various visual symptoms in order to make an early diagnosis of migraine.