Flashing Lights During Sleep: When to See an Eye Doctor - Ophthalmology

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Waking up in the middle of the night to see flashes of light?


Dear Dr.
Gao,
I have been experiencing floaters for about four years, which are degenerative in nature.
I have researched a lot about floaters online and have been regularly undergoing dilated eye examinations, all of which have returned normal results.

1.
Recently, I am unsure if it’s due to reading too much information and becoming anxious, but I have been having trouble sleeping.
A few days ago, while I was half asleep, I turned over and seemed to see something resembling a flash of light.
At that moment, I was in a semi-conscious state.
I have also seen some images and information about flashes on YouTube, but it didn’t seem to be a strong flash; it was more like a brief white light while my eyes were closed.
After I opened my eyes, it did not reappear.
Today, when I was waking up with my eyes closed, I felt a yellow light, and when I blinked (with my eyes still closed), I felt that light flash again.
I would like to ask if this is a type of flash that warrants further medical attention regarding my floaters, especially since I had a dilated eye exam just two weeks ago, which was normal.
2.
Is there a concern about undergoing too many dilated eye examinations? I have had one every month for the past three months, and if I go for another, it would be the fourth time, with the last one being two weeks ago.
3.
For those with floaters, should we avoid frequently performing eye movement exercises? I am concerned about vitreous liquefaction and the potential risk of retinal detachment.
4.
I have been wearing RGP (rigid gas permeable) contact lenses for 10 years.
When removing the RGP lenses, I use my finger to press on my eyelid to allow air to get under the lens for removal.
Does this pressure on the eyeball pose a risk of pulling on the retina?
I apologize for the many questions.
Thank you for your assistance.

WS, 30~39 year old female. Ask Date: 2017/03/09

Dr. Gao Pilin reply Ophthalmology


Hello WS: After the dilated fundus examination, there is no need to worry if everything is fine.
Eye movements are not typically considered correct exercises, so it's best to avoid them.
Generally, regular exercise is acceptable.
Removing RGP (rigid gas permeable) lenses will not cause retinal detachment.
The ophthalmology department at Puzi Hospital in Taiwan is open Monday to Friday from 8:00 AM to 12:00 PM and Wednesday afternoons from 1:00 PM to 4:30 PM.
Online responses can only serve as a reference; if necessary, it is still important to seek medical care at a healthcare facility.
I hope to have the opportunity to serve you.
Gao Pilin

Reply Date: 2017/03/09

More Info


When experiencing flashing lights or visual disturbances, especially during transitions from darkness to light or while lying down, it is essential to understand the underlying mechanisms and when to seek medical attention. Your concerns about flashes of light, particularly in the context of having floaters (myodesopsia), are valid and warrant careful consideration.

Firstly, the phenomenon of seeing flashes of light, especially after being in a dark environment, can often be attributed to the way our eyes adapt to changes in light. When you suddenly move from a dark area to a brightly lit one, your retina, which is sensitive to light, may respond by sending signals that can be perceived as flashes. This is generally a normal response and is part of the eye's adaptation process. However, the fact that you are experiencing these flashes while lying down and in a semi-conscious state raises some questions.

Flashes of light can also be associated with the vitreous gel in the eye. As we age or due to certain conditions, the vitreous can begin to liquefy and pull away from the retina, leading to sensations of light flashes. This is particularly relevant for individuals with myopia (nearsightedness), as they are at a higher risk for vitreous detachment and retinal issues. Since you have a history of floaters and have undergone regular dilated eye exams with normal results, it is reassuring, but it does not entirely rule out the possibility of retinal changes.

Regarding your specific questions:
1. Is this flashing related to my floaters? While floaters themselves are typically harmless, the presence of flashes, especially if they are new or have changed in frequency or intensity, should be evaluated by an eye care professional. Even if your recent exams were normal, any new visual symptoms warrant a follow-up to rule out potential retinal issues, such as tears or detachment.

2. Frequency of dilated eye exams: There is generally no strict limit to how often you can have dilated eye exams, especially if you have ongoing concerns. However, it is essential to communicate with your eye doctor about your symptoms and the frequency of your visits. They can provide guidance on the necessity of further examinations based on your specific situation.

3. Should I avoid certain eye movements? While it is wise to be cautious with vigorous eye movements, normal activities and gentle eye movements are generally safe. However, if you notice that certain movements consistently trigger flashes or discomfort, it may be worth discussing with your eye doctor.

4. Removing RGP lenses: When removing rigid gas permeable (RGP) lenses, it is crucial to do so gently to avoid unnecessary pressure on the eye. While applying pressure to the eyelid to facilitate lens removal is common, be cautious not to apply excessive force, as this could potentially lead to discomfort or complications. If you experience any unusual symptoms during or after lens removal, consult your eye care provider.

In conclusion, while some visual phenomena can be benign, the presence of new or changing flashes of light, especially in the context of existing floaters, should not be ignored. It is advisable to schedule an appointment with your eye doctor to discuss your symptoms in detail. They can perform a thorough examination to ensure that your retina is healthy and that there are no underlying issues that need to be addressed. Regular monitoring and open communication with your eye care provider are key to maintaining your eye health, especially with your history of myopia and floaters.

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