Black Tree-Like Flashes When Opening Eyes: Causes and Concerns - Ophthalmology

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The symptoms you are experiencing, particularly the black tree-like flashes when you open your eyes after sleeping or when closing and reopening them, can be concerning and warrant further understanding. These phenomena are often associated with a condition known as "photopsia," which refers to the perception of flashes of light or visual disturbances that are not caused by external light sources.
In your case, the description of seeing black, tree-like structures could be indicative of a few potential underlying issues. One possibility is that these flashes are related to the vitreous humor, the gel-like substance that fills the eye. As we age or due to certain conditions, the vitreous can begin to shrink and pull away from the retina, leading to sensations of flashes or floaters. This is particularly common in individuals with myopia (nearsightedness), as you mentioned you have significant myopia in both eyes.

The fact that these flashes occur specifically when you wake up or after closing your eyes could suggest that the sudden change in pressure or movement of the eye is triggering these sensations. When you open your eyes after a period of closure, the rapid shift in focus and light exposure can cause the vitreous to tug on the retina, leading to the perception of flashes or shapes.
It's also important to consider the possibility of retinal issues. While your eye doctor has indicated that your retina appears normal, it is crucial to monitor any changes in your symptoms. Conditions such as retinal tears or detachments can sometimes present with similar symptoms, and they require immediate attention. Although your current examinations have shown no issues, if you notice an increase in the frequency or intensity of these flashes, or if you experience new symptoms such as a sudden increase in floaters, a shadow in your peripheral vision, or a decrease in vision, you should seek further evaluation promptly.

Regarding your question about whether this is related to peripheral retinal thinning, it is possible. Myopia is associated with changes in the structure of the eye, including thinning of the retina, particularly in the peripheral regions. This thinning can increase the risk of retinal tears or detachments, which could explain the visual disturbances you are experiencing.
In summary, while your current symptoms may be benign and related to the normal aging process of the vitreous, it is essential to remain vigilant. Regular eye examinations are crucial, especially given your history of myopia and the presence of floaters. If you have any concerns or if your symptoms change, do not hesitate to consult your eye care professional for further assessment. They may recommend additional imaging studies, such as optical coherence tomography (OCT), to get a more detailed view of the retina and vitreous, ensuring that any potential issues are identified and managed appropriately.
In conclusion, while the symptoms you describe may not be immediately alarming, they do warrant careful monitoring and follow-up with your eye care provider to ensure that your vision remains healthy and any underlying issues are addressed promptly.