Visual Hallucinations
Type: Transitory aura symptom — typically develops gradually over 5–20 minutes and resolves within 60 minutes.
What is it?
Visual hallucinations during migraine aura are geometric patterns, flashes of light, or complex images that appear in your vision but are not caused by external visual stimuli. They are real visual perceptions created by your brain during a temporary alteration of cortical activity.
What it feels like
Visual hallucinations can range from simple flickering or sparkles to elaborate, intricate patterns. You might see zig-zags, spirals, checkerboards, or shimmering geometric shapes. The patterns often expand from the center of your vision outward, taking 5 to 20 minutes to fully develop. Some people find them beautiful, while others find them frightening. They are always temporary and harmless.
Animated fortification spectrum, 2002. This animation depicts the expanding arc of flickering zigzag patterns characteristic of the most common visual aura.
H. Airy’s illustration of the fortification spectrum (reproduced from Gowers, 1895) — one of the earliest accurate depictions of the visual migraine aura.
H. Klüver’s hallucinatory form constants: lattice, cobweb, tunnel, and spiral forms — the four basic geometric patterns underlying visual hallucinations across many conditions.
Visual hallucinations of lattice form dimension as seen in migraine aura.
How patients describe it
“And it scared the crap out of me… this was the second one I’ve had in my 53 years. The first was two Xmases ago… the classic aura started… growing from a bright spinning wheel in the upper left corner of vision of my left eye, very slowly, into the classic sawtooth arc or wheel, which then rotated across my left field of vision.” — Anonymous
“the classic aura started… growing from a bright spinning wheel in the upper left corner of vision, very slowly, into a full blown aura, the same arcing, slowly rotating sawtooth blade.” — Anonymous
“the rotating sawtooth blade… I learned that it had nothing to do with my eyes, the images were not happening in my eyes, they were manifestations of what was happening in the cerebral cortex.” — Anonymous
Subtypes
Random Form Dimension (TV Static, Dots, Flickering Points)
The most common visual hallucination: a field of randomly scattered sparkling dots, flickering points, or “TV static” patterns. This may also be called the scintillating scotoma or fortification spectrum.
Line Form Dimension (Straight Lines and Zigzags)
Straight lines, jagged zigzags, or sharp angular patterns. These often appear as bright, white or colored geometric lines moving across your field of vision.
Curve Form Dimension (Arcs, Curves, Spirals)
Smooth curves, arcs, spirals, or curved wave patterns. These often expand in concentric rings or rotate slowly.
Web Form Dimension (Net-Like or Mesh Patterns)
Net-like, mesh, or web patterns that resemble a fishnet or lace overlay on your vision.
Lattice Form Dimension (Regular Grid or Lattice)
Regular grid patterns or lattice structures, like a checkerboard or crosshatch pattern that fills your visual field.
Tunnel Form Dimension (Concentric Rings or Tunnel Effect)
Concentric rings or a tunnel-like effect where your vision appears to narrow toward a central point, as if looking through a tunnel.
Spiral Form Dimension (Rotating Spirals)
Rotating or expanding spiral patterns. These often start at the center of vision and expand outward.
Kaleidoscope Form Dimension (Complex Symmetric Patterns)
Complex, highly symmetric, intricate patterns that resemble looking through a kaleidoscope. These often involve multiple colors and rotating or shifting designs.
Complex Visual Hallucinations
Figures, faces, scenes, or recognizable objects. These are less common than geometric patterns but can include faces, people, animals, or familiar scenes.
Related symptoms
- Scintillating scotoma (flickering blind spot)
- Visual loss and blurred vision
- Visual illusions and metamorphopsia
- Depersonalization
Clinical note
Visual hallucinations during migraine aura are purely neurological and not a sign of psychiatric illness or vision problems. They are always temporary and completely resolve once the aura ends. If visual hallucinations persist after the aura phase or occur without accompanying migraine symptoms, seek medical evaluation.
If this is the first time you experience these symptoms, or they feel different from previous episodes, seek medical evaluation to rule out other causes.