Visual Disturbances: Zigzag Patterns and Light Sensitivity - Ophthalmology

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When looking at clouds in the sky or a surface illuminated by sunlight, one may observe a shimmering effect resembling water ripples?


Symptom description: Whenever I look at the sky, I experience very noticeable jagged flashes resembling water ripples.
It seems that above a certain brightness, the effect becomes more pronounced with increasing brightness.
This is especially evident on lighter surfaces; if I look at an overly bright field of vision, the water ripples are less noticeable, but it feels very glaring until the brightness drops below a certain level, at which point I can hardly see the ripples or only feel a slight sensation.
Symptom characteristics: The flashes are circular, and I can feel them extending outward from the center of my vision about 45-60%.
Beyond that, there is no flickering sensation.
Duration of symptoms: Two years.
Description of symptom characteristics: The flickering water ripples resemble flowers with distinct outlines, the color of which is slightly darker than the background, moving toward the center of vision.
It looks like a flower rapidly shrinking toward the center and then disappearing, appearing as if many petal-shaped flashes are continuously shrinking from the outside in.
The flickering occurs rapidly, and the shapes change as they shrink, creating a continuous cycle from the outer symptoms to the center before disappearing.
Timing of symptom appearance: The symptoms appear whenever the brightness exceeds a certain level, starting from a very small area (initially only the size of a petal).
As seconds pass, the flickering area enlarges until it reaches a certain size, at which point it stops expanding and continues to flicker.
Sometimes, after staying indoors for a while, I look outside at the sky and do not see these water ripple flashes (though sometimes I do).
If I walk from indoors to outdoors and look at the sky, it appears normal for about four seconds (just feeling glaring), after which the water ripples gradually increase in size.
Around 4 to 5 PM, looking at the sky does not produce water ripples.
Issues after symptoms appear: There is a slight swelling and pain in my forehead, and after looking at bright areas for a while, my eyes feel a burning sensation, and by the afternoon, I often have a headache.
Additional information: Some days, no matter how I look, there are no water ripples; even with slightly higher brightness, they may appear a little, but not as prominently as usual.
During those days, I was taking B vitamins, and it seems that the flickering sensation was less noticeable.
I wonder if it is due to a lack of certain nutrients.
Two years ago, I visited an ophthalmology clinic for a detailed examination, and the doctor said my intraocular pressure, retina, and macula were all healthy.
However, during the dilation test, I noticed extremely obvious water ripples on the wall illuminated by indoor lighting.
I mentioned this to the doctor, who said it was a normal phenomenon and suggested I check for any issues with the optic nerve.
I have researched a lot online, such as vitreous degeneration or vitreous traction, but my vision is 0.8 in the right eye and 0.7 in the left, while those symptoms typically occur in individuals with high myopia.
Later, I came across information about normal-tension glaucoma, and I wonder if I might have this condition.
I also have poor blood circulation (I hardly exercise) and feel anemic; my little finger and ring finger often feel numb.
I later read about optic nerve circulation disorders and wonder if my lack of exercise is causing poor blood circulation, leading to insufficient blood supply to the eyes.
I usually perceive things as slightly darker.
When I shower and rinse my eyes with hot water (eyes closed), it feels very comfortable, and when I open my eyes, the bathroom light appears very bright, not dark.
I would like to ask the doctor which department I should visit at a major hospital for examination and treatment, as the symptoms have persisted for two years without worsening or an increase in my prescription.
If poor circulation persists, could it damage the optic nerve? I read online that the optic nerve has self-repair capabilities, but of course, I cannot rely solely on that.
Due to various issues over the past two years, including a car accident, I have not had time to see a doctor, and I am unsure which department to consult.
These water ripples affect my enjoyment of beautiful scenery, and I want to seek thorough treatment.
In the first half of the year, due to the car accident, I rested at home for a long time, and during my hospital stay, my blood pressure was consistently at a very low level.
At that time, the flickering sensation on brighter walls was very pronounced.
My symptoms closely resemble this: http://glaucoma2014.xclub.tw/viewthread.php?action=printable&tid=563.
Additionally, I often stay up late, but I plan to start sleeping earlier (staying up late must have an impact).
I developed these symptoms about six months after consistently staying up late.
I have not exercised for about four to five years.
Thank you, doctor, for your response.
There is no rush; I just hope for a thorough treatment of my symptoms.

A Long, 20~29 year old female. Ask Date: 2018/09/20

Dr. Cai Wenyuan reply Ophthalmology


Hello: If there are no issues after your examination at the hospital or clinic, try to coexist peacefully with it.
Wishing you safety and health.
Sincerely, Dr.
Tsai Wen-Yuan, Director of the Ophthalmology Department, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2018/09/20

More Info


Based on your detailed description of visual disturbances, it seems you are experiencing a complex set of symptoms that could be related to several underlying issues. The zigzag patterns and light sensitivity you describe, particularly when looking at bright surfaces or the sky, may be indicative of a few potential conditions that warrant further investigation.


Understanding Your Symptoms
1. Visual Disturbances: The zigzag patterns and water-like waveforms you see, especially in bright light, could be a manifestation of visual migraines or a type of visual aura. These phenomena are often associated with migraine headaches, even in the absence of a headache. The fact that these symptoms have persisted for two years is significant and suggests that they should not be overlooked.

2. Light Sensitivity: Your sensitivity to light, particularly in bright environments, could be linked to a condition known as photophobia. This can occur due to various reasons, including migraines, dry eyes, or even underlying retinal issues. The burning sensation and headache you experience after exposure to bright light further support this possibility.

3. Potential Retinal Issues: Although previous examinations indicated that your retina, optic nerve, and intraocular pressure are normal, the presence of persistent visual disturbances could suggest the need for a more thorough evaluation. Conditions like vitreous detachment or even early signs of retinal issues can sometimes present with similar symptoms, especially if there is a history of trauma (such as your car accident).

4. Nutritional Factors: You mentioned that taking B vitamins seemed to alleviate some of your symptoms. While this could be coincidental, deficiencies in certain nutrients, particularly B vitamins, can affect nerve health and potentially influence visual processing. However, it is essential to consult with a healthcare provider before making any significant changes to your diet or supplement regimen.

5. Circulatory Issues: Your concerns about blood circulation and its impact on your vision are valid. Poor circulation can affect the delivery of oxygen and nutrients to the optic nerve and retina, potentially leading to visual disturbances. Engaging in regular physical activity can improve circulation and overall health, which may help alleviate some of your symptoms.


Recommendations for Further Evaluation
Given the complexity and duration of your symptoms, it would be prudent to seek a comprehensive evaluation from a specialist. Here are some recommendations:
1. Ophthalmologist: Return to an ophthalmologist for a thorough eye examination, including a dilated fundus exam and possibly imaging studies like Optical Coherence Tomography (OCT) to assess the retina and optic nerve more closely.

2. Neurologist: Since your symptoms may be related to migraines or other neurological conditions, consulting a neurologist could provide insights into whether your visual disturbances are part of a migraine aura or another neurological issue.

3. Primary Care Physician: Discuss your symptoms with your primary care physician, especially regarding your blood circulation and nutritional status. They may recommend blood tests to check for deficiencies or other underlying health issues.

4. Lifestyle Modifications: Consider implementing lifestyle changes such as regular exercise, a balanced diet rich in vitamins and minerals, and establishing a consistent sleep schedule. These changes can significantly impact your overall health and may help reduce the frequency and intensity of your symptoms.


Conclusion
Your symptoms of zigzag patterns, light sensitivity, and associated discomfort are concerning and deserve thorough investigation. While some of these symptoms may be benign, the persistence and impact on your quality of life suggest that a comprehensive evaluation is necessary. By consulting with the appropriate specialists and making lifestyle adjustments, you can work towards understanding and potentially alleviating your symptoms. Remember, early intervention is key in managing any potential underlying conditions effectively.

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