Vision Therapy for Migraine

Have you ever wondered if treating your vision could help with the frequency and severity of migraine attacks? As a long-time glasses wearer, this is something I’ve often thought about. Like most people, I see an ophthalmologist regularly. At my appointment each year I tell my doctor about my migraine, eye fatigue, and visual aura symptoms. And each year I’m told my eyes are healthy, and with perhaps a slight change in my glasses prescription, I’m sent on my way. Okay, I think my head has nothing to do with my vision. Or does it?

Just over a year ago my adolescent daughter suffered a mild traumatic brain injury after getting hit in the head with a softball. When her daily headache and migraine symptoms didn’t subside after several months, she was diagnosed with post-concussion syndrome and chronic migraine. After months of persistent daily headaches and frequent migraine attacks, her concussion specialist sent her to see a neuro-optometrist. This, he explained, is different than a regular optometrist or ophthalmologist in that they look at not only the health of the eyes and how well they are seeing, but also at how the brain and eyes are communicating and functioning together.

After a comprehensive eye exam and testing, the neuro-optometrist diagnosed my daughter with several vision issues. These were made worse as a result of her head injury, but were also likely genetic and had been quietly causing her issues all along.

The Diagnosis

My daughter was diagnosed with binocular vision dysfunction—which is when the brain and eyes don’t work together correctly. Rather than being able to see a single picture, they struggle to work together as a team, which can cause vision misalignment and double vision. This can lead to a host of visual and non-visual symptoms including:

• More frequent headaches and migraine attacks
• Fatigue
• Blurred vision
• Dizziness or lightheadedness
• Vertigo
• Trouble with reading and focusing
• Eye fatigue
• Light sensitivity
• Sensory issues
• Anxiety and panic
• Motion sickness
• Nausea
• Poor hand-eye coordination
• Trouble driving at night

She was also diagnosed with convergence insufficiency, which is an eye coordination problem caused by a lack of communication between the nerves and the muscles that control the eye movements. Convergence insufficiency can cause many of the above symptoms as well. Thanks to genetics, my daughter already had a history of headaches and migraine prior to her concussion. But her doctor explained that the injury further knocked her vision out of alignment, and this was making her symptoms worse as well as causing her recovery to take longer. He said this can also happen as a result of a stroke, certain viruses and diseases, or even physical and/or emotional trauma.

This had me curious about my own vision issues. I made an appointment with the same doctor, and the testing showed that I also have convergence insufficiency and astigmatism, which could very likely be triggering more headaches and migraine attacks.

The Treatment

The treatment plan included special prescription glasses with prisms lenses that correct misalignment by changing how light hits your eyes. This can help to calm the brain down and relieve tension. For my daughter, treatment also included vision therapy, which research shows to be widely known and effective.

The vision therapy program was tailored to my daughter’s specific vision issues. It included both in-office sessions led by a trained vision therapist, and at-home exercises. The exercises are intended to strengthen the eye muscles and retrain the eyes and brain to see in unison. Sometimes they were games or puzzles that helped with visual and mental acuity. Others times, they were more vestibular in nature, such as a walking in a straight line while moving her head from side to side and reading aloud. Progress was tracked after each exercise.

The therapy was taxing at times, especially in the beginning, and would leave her feeling more symptomatic and exhausted. But over time, her eyes strengthened, and we began to see results. Each appointment got easier and after several months, my daughter started having fewer headache days and migraine attacks. Her dizziness, fatigue, balance, and light sensitivity have also drastically improved.

The Takeaway

As is true with all migraine treatments, nothing is a magic bullet. My daughter and I still have migraine disease. We will still have migraine attacks. We still have to watch our triggers, maintain healthy lifestyles, take preventive migraine medications and use migraine devices. But overall, the prism glasses have helped to reduce our number of headache days, and vision therapy has helped my daughter come a long way since her injury.

Let Us Know!

Do you have comorbid vision issues and migraine? Could vision therapy be right for your treatment toolbox?

The above information is educational and should not be considered medical advice; please consult with your healthcare professional before making any changes to your migraine treatment plan.