Migraine Triggered by Rubbing the Eyes

A patient with recurrent exertional headaches was able, on multiple occasions, to trigger his typical headaches within 30 minutes of rubbing his eyes gently and inducing bilateral photopsias. No intracranial or orbital lesions were identified. His EEG, obtained while rubbing his eyes and inducing photopsias, did not show epileptic discharges or background changes. His ophthalmologic examination, including visual field testing, was normal. Ocular pressure and massage of the carotid sinuses failed to cause bradycardia to imply vagal mediation of his physically induced headaches. It is hypothesized that in this patient mechanical displacement of the eyes precipitated retinal auras leading to migraines.