Evans and Grosberg proposed criteria for monocular visual symptoms (retinal migraine, ocular migraine). The criteria are an extension of the 2004 IHS criteria. The authors are from Houston, Texas, and Albert Einstein College of Medicine in New York City.


The 2 major types of monocular visual symptoms:

(1) transient

(2) permanent visual loss or defect


Criteria common to both:

(1) monocular visual disturbance

(2) headache that has both of the following:

(2a) fulfills criteria for migraine with or without aura

(2b) occurs during or within 60 minutes of onset of visual disturbance (before or after)

(3) abnormal findings in the affected eye during the attack

(4) headache and visual changes not due to another cause





number of attacks

>= 2

>= 1 (usually only 1)

monocular positive and/or negative visual phenomena

fully reversible


ophthalmological exam between attacks


abnormal (retinal vascular abnormality or optic neuropathy)



• An example of a positive visual phenomenon is the occurrence of scintillations.

• An example of a negative visual phenomenon is blindness.


Evaluation of the affected eye during the attack should document one or more of the following:

(1) signs of ipsilateral retinal or optic nerve abnormality on an ophthalmological exam

(2) a drawing made by the patient showing a monocular field defect

(3) description of the visual phenomena by the patient and confirmed by occluding each eye individually during the attack


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