I also have optical migranes. I understand from my Dr. that some people have have a terrible headache with theirs, but fortunately I don't. I just get these multicolored zig-zags that float around and can be seen with my eyes open or shut.
Years ago I would get the zip zags so bad I'd have to pull off the road while driving. I would also sometimes get them along with tunnel-vision. If as soon as I seen the zip zags I would take 3 or 4 extra strength Tylenol or Ibuprofin, I would avoid the bad pain, but for the next 24hrs I sure didn't want to bend over or the pressure in my head felt like it would explode! If I didn't take the meds within an hour, NOTHING would stop the intense headaches.
Since I quit taking in so much caffeine, those episodes are history. Now I'm even more sensitive to caffeine and it makes my heart palpitate. I've likely cut my caffeine intake about 90%.