What causes ocular migraines?
I read your question carefully and I understand your concern.
Prevention of migrainous auras is similar to that of migraine attacks themselves. It is important to avoid sleep deprivation, stress, eat on a regular schedule, pay attention to the possibility of certain foods which may trigger the episodes. Relaxation exercises, activities like yoga may help with your anxiety and reduce the episodes as well.
If such conservative measures do not work, then medication for migraine prevention can be considered. The decision to start such medication depends also on how frequent these auras are and how much they affect your quality of life. That is because medications can have side effects so should be started only when really necessary.
Regarding the choice of medication considering the anxiety you describe an antidepressant like amitriptyline may be considered as it would help with anxiety as well. It may cause some side effects such as sedation, orthostatic hypotension dry mouth etc. If such side effects appear or you simply do not want to try it then another alternative might be anticonvulsants like valproic acid which is also a first line treatment for migraine prevention.
I remain at your disposal for other questions.
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