Dizziness and Visual Disturbances: When to Seek Help

Dizziness/headache with visual disturbances?

Hello Doctor, last weekend I experienced a sudden sharp pain on the left side of my head, and since then I have felt as if a layer of bright glitter has been placed over my vision, which has persisted for about five days.
(However, the headaches are infrequent; sometimes I feel a dull, heavy, tight sensation along with dizziness.) This sensation makes it seem like everything I see, whether bright or dark, is covered with countless tiny bright spots.
It doesn't obstruct my vision, but it is quite bothersome (I see this whether my eyes are open or closed).
Two days ago, I underwent a dilated eye exam, and the ophthalmologist mentioned that there was nothing significant, suggesting it might just be fatigue, and provided me with artificial tears.
I would like to confirm whether this bright sensation could indicate a potential issue in the brain that might be affecting the optic nerve.
Although my friend mentioned that he sometimes experiences a similar bright sensation, my condition is constant.
Additionally, I also have a heavy and tight feeling in my head, which makes me a bit anxious.
I apologize for the lengthy question, and thank you for your response!

Niming, 20~29 year old female. Ask Date: 2018/10/17

Dr. Jiang Junyi reply Neurology

Hello, based on your description, it may be necessary to consider a migraine with aura.
Symptoms include visual disturbances such as seeing stars and lightning-like flashes, as well as blurred or distorted vision, which are all common migraine auras.
A few minutes after the aura appears, you may experience tingling, weakness, or numbness in the face, hands, or legs.
During the attack, symptoms such as nausea, vomiting, photophobia, phonophobia, and pallor may accompany the headache.
Once the aura subsides, you may experience severe unilateral throbbing pain in the head.
These migraine symptoms typically last for several hours, and can even extend up to 2-3 days.
It is advisable to consult a neurologist for further evaluation and treatment, as members of headache societies are generally more familiar with such cases.
Wishing you good health and peace of mind.
Dr.
Jiang from Taoyuan Medical Center is concerned about you.

Reply Date: 2018/10/17

More Info

Dizziness and visual disturbances can be concerning symptoms, and it's important to understand when to seek medical help. Based on your description, it seems you are experiencing a combination of headaches, visual disturbances (specifically, a persistent overlay of bright spots), and feelings of heaviness or tightness in your head. These symptoms can be indicative of several underlying conditions, and while they may not always signify a serious issue, they warrant careful evaluation.

Firstly, the bright spots you are seeing could be related to a phenomenon known as "visual snow," which is characterized by the perception of tiny flickering dots in the visual field, similar to the static seen on a television screen. This condition can be exacerbated by stress, fatigue, or migraines. Given that you mentioned experiencing headaches, it is possible that your symptoms are linked to a migraine aura, which can include visual disturbances without necessarily leading to a headache.

The fact that your eye examination showed no significant issues is reassuring, but it does not completely rule out neurological causes. The persistent nature of your visual symptoms, coupled with the headache and dizziness, suggests that further investigation may be warranted. Conditions such as migraines, tension-type headaches, or even more serious issues like increased intracranial pressure or neurological disorders could potentially cause similar symptoms.

It is crucial to monitor your symptoms closely. If you experience any of the following, you should seek immediate medical attention:
1. Sudden onset of severe headache: If the headache is sudden and severe, often described as a "thunderclap" headache, it could indicate a serious condition such as a subarachnoid hemorrhage.

2. Neurological deficits: If you notice weakness, numbness, difficulty speaking, or changes in coordination, these could be signs of a stroke or transient ischemic attack (TIA).

3. Changes in vision: If your vision changes suddenly or you experience a loss of vision, this could indicate a retinal issue or other serious condition.

4. Persistent or worsening symptoms: If the visual disturbances or headaches become more frequent or severe, it is essential to follow up with a healthcare provider.

In terms of management, since your eye doctor suggested fatigue as a potential cause, it may be beneficial to evaluate your lifestyle. Ensure you are getting adequate rest, managing stress, and staying hydrated. Sometimes, simple lifestyle changes can significantly alleviate symptoms.

If your symptoms persist despite these measures, consider consulting a neurologist. They may recommend further testing, such as MRI or CT scans, to rule out any neurological conditions. Additionally, keeping a headache diary can help identify triggers and patterns, which can be useful for your healthcare provider in determining the best course of action.

In summary, while your symptoms may not immediately indicate a serious condition, they are concerning enough to warrant further evaluation, especially given the combination of visual disturbances and headaches. It is always better to err on the side of caution when it comes to neurological symptoms.

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