TMJ Dysfunction as a Trigger for Refractory Retinal Migraines

Retinal migraines are a rare migraine subtype causing transient monocular visual disturbances, such as scotomas or temporary blindness, often accompanied by migraine headaches. This report presents a case of a 34-year-old female with refractory retinal migraines that did not resolve with standard pharmacologic and nonpharmacologic therapies. Alongside the retinal migraine symptoms, the patient reported worsening facial pain, jaw pain, increasingly frequent headaches, snoring, fatigue upon awakening, and nocturnal awakenings. An MRI confirmed TMJ dysfunction and mandibular hypoplasia, while a sleep study confirmed obstructive sleep apnoea (OSA). Although the link between TMJ dysfunction and migraines is well-established, its association with retinal migraines has not been previously documented. The patient’s condition was further complicated by OSA and secondary hypoxia, both of which likely contributed to the persistence and severity of her symptoms. This report demonstrates the importance of considering all structural and systemic etiologies for medically refractory retinal migraines with atypical presentations, as significant relief can be achieved with a surgical approach. Further research is needed to explore the relationship between craniofacial abnormalities, TMJ dysfunction, and retinal migraines.