Unlike in retinal migraine, a scintillating scotoma involves repeated bouts of temporary diminished vision or blindness and affects vision from both eyes, upon which patients may see flashes of light, zigzagging patterns, blind spots, or shimmering spots or stars. Causes
Retinal migraine is caused by the blood vessels (that leads to the eye) suddenly narrowing (constricting), reducing blood flow to the eye, which causes aura in vision.It may be triggered by:

Stress
Smoking
High blood pressure
Oral contraceptive pill
Exercise
Hay Fever
Bending over
High altitude
Dehydration
Low blood sugar
Excessive heat
Eating chocolateAfterwards, the blood vessels relax, blood flow resumes and sight returns. Usually there are no abnormalities within the eye and permanent damage to the eye is rare. Retinal migraine tends to be more common in:

Women
People aged under 40
People with a personal or family history of migraines or other headaches
People with an underlying disease (lupus, hardening of the arteries, sickle cell disease, epilepsy, antiphospholipid syndrome, and giant cell arteritis)

Diagnosis
The medical exam should rule out any underlying causes, such as blood clot, stroke, pituitary tumor, or detached retina. A normal retina exam is consistent with retinal migraine. Treatment
Treatment depends on identifying behavior that triggers migraine such as stress, sleep deprivation, skipped meals, food sensitivities, or specific activities. Medicines used to treat retinal migraines include aspirin, other NSAIDS, and medicines that reduce high blood pressure. Prognosis
In general, the prognosis for retinal migraine is similar to that of migraine headache with typical aura. As the true incidence of retinal migraine is unknown, it is uncertain whether there is a higher incidence of permanent neuroretinal injury.
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