White Light Visual Disturbances in High Myopia Patients

Abnormal vision with the perception of white light?

Hello Doctor, I have high myopia (right eye -600 degrees, left eye -500 degrees) and also experience floaters.
I regularly go to the clinic for dilated fundus examinations for my floaters.
Recently, I've noticed that when I close my eyes for a while before sleeping, instead of darkness, I see white light spots appearing in various positions in my vision.
Eventually, my entire field of vision seems bright white, and this lasts for about 5 to 10 minutes before gradually fading away.
This occurs specifically when I'm about to sleep.
When I open my eyes, I can't see the light spots, but they reappear when I close my eyes.
I'm concerned about what might be happening.
I researched online and found something similar to photopsia.
I have experienced photopsia before, where irregular light patterns would appear after closing my eyes, but this time it seems like clusters of bright white light spots that move, which makes me very anxious and a bit scared to sleep.
The last time I had a fundus examination was about a week ago because one day while reading, I suddenly saw a flash in my upper vision, like a light bulb flickering.
I went for an examination the next day, and the doctor indicated there were no tears or signs of detachment.
However, now this new symptom has occurred.
Could this be a precursor to retinal detachment or optic nerve pathology? Should I go to a larger hospital for further examination? Thank you for your attention.
Additionally, after the bright light spots fade, my eyes feel painful...

Miss Chen, 20~29 year old female. Ask Date: 2018/01/03

Dr. Cai Wenyuan reply Ophthalmology

Hello, this may not be a precursor to retinal detachment or optic nerve disease.
It is recommended to visit a medical center for examination.
Wishing you safety and health.
Sincerely, Dr.
Tsai Wen-Yuan, Director of the Department of Ophthalmology, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2018/01/03

More Info

Understanding visual disturbances, particularly white light phenomena, in patients with high myopia can be quite complex. High myopia, defined as a refractive error greater than -6.00 diopters, is associated with various ocular complications, including retinal detachment, macular degeneration, and vitreous changes. The symptoms you describe, such as experiencing white light or visual disturbances when your eyes are closed, can be concerning, especially given your history of high myopia and floaters.

The phenomenon of seeing white light or flashes of light when your eyes are closed may be related to several factors. One possibility is that these visual disturbances are a form of photopsia, which refers to the perception of light without an external light source. This can occur due to various reasons, including retinal irritation or changes in the vitreous humor, which is the gel-like substance filling the eye. In high myopia, the vitreous can become more liquefied and may pull away from the retina, leading to symptoms like flashes of light or floaters.

Another consideration is the possibility of visual migraines or ocular migraines, which can cause transient visual disturbances, including bright spots or flashes of light, often accompanied by headache. However, your description of the light phenomena occurring specifically when your eyes are closed and the associated pain afterward may suggest a different underlying issue.

Given your recent experiences, including the sudden flashes of light while reading and the subsequent visual disturbances, it is crucial to continue monitoring your symptoms closely. While your recent eye examinations did not reveal any retinal tears or detachments, the nature of your symptoms warrants further investigation. The fact that you are experiencing pain after these episodes could indicate some level of irritation or strain in the eye, which should not be overlooked.

It is advisable to seek a comprehensive evaluation from a specialist, particularly in a larger medical center where advanced imaging techniques such as Optical Coherence Tomography (OCT) can be utilized. This imaging can provide detailed views of the retina and vitreous, helping to identify any subtle changes that may not be apparent during a standard examination. Additionally, a visual field test may be beneficial to assess if there are any areas of vision loss that correlate with your symptoms.

In summary, while the symptoms you are experiencing may be related to the changes associated with high myopia, it is essential to rule out any serious conditions such as retinal detachment or other retinal pathologies. Regular follow-ups with your eye care provider and prompt reporting of any new or worsening symptoms are crucial in managing your ocular health effectively. If your symptoms persist or worsen, do not hesitate to seek immediate medical attention. Your vision is invaluable, and proactive management is key to preserving it.

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