Visual Disturbances: Light Flashes and Surface Waves

Flashing lights and road surface undulations?

Hello Dr.
Gao, due to my work, I need to operate a computer for long periods.
I would like to ask you about the following:
1.
About two years ago, I frequently experienced overlapping images of the ceiling lights and decorations when I first woke up and was still lying in bed.
The overlapping images would gradually separate and return to normal, similar to the focusing process of a single-lens reflex camera.
Closing my eyes for a few minutes or blinking several times would resolve the issue.
This problem usually occurs after a long, exhausting day at work.
2.
This issue seems a bit strange; it has only happened at the same convenience store, around 4:30 PM when the sky is still bright.
In the past year, it has occurred twice, approximately six months apart.
After waking up in the evening, about half an hour later, I felt awake and my vision was normal.
However, when I rode my motorcycle to the brightly lit convenience store, I suddenly saw a bright spot in my vision, with blurred vision in both my left and right eyes, presenting as a semi-transparent light in the center of my sight.
Rubbing my eyes did not change anything.
This lasted for a minute or two, but after leaving the store, while waiting at a red light, I noticed the wide road surface slowly undulating, resembling gentle waves on a calm sea! I thought it might be Ménière's disease again, but I did not feel dizzy, and everything else around me appeared normal—straight lines were straight, and circles were round.
I decided to pull over and stared at the road surface like I was in a daze, and after about a minute, everything returned to normal (still sitting on my motorcycle).
3.
I conducted a self-test using an Amsler grid I found online.
Aside from the double vision I have had since I was young, all the horizontal and vertical lines appeared normal without distortion.
A pharmacy I know also performed a vision test for me, and my results were 0.9 for the left eye and 0.8 for the right eye.
At my age in my fifties, these results are quite good.
I apologize for the lengthy explanation and hope you can take the time to clarify these issues for me.
Thank you.

Lao Zhang, 50~59 year old female. Ask Date: 2020/05/09

Dr. Gao Pilin reply Ophthalmology

Hello Mr.
Chang,
1.
It is possible that you have a strabismus issue.
When you are overly fatigued or just waking up, the images from both eyes may not align, leading to this phenomenon.
2.
This is likely a liquefaction phenomenon caused by vitreous degeneration.
Cavities begin to form within the vitreous body, and the phenomenon occurs when fluid enters these cavities.
3.
The double vision does not cause distortion; it only results in ghosting.
A vision of 0.9 and 0.8 is considered quite good.
Taiwan E-Hospital Puzi Hospital Ophthalmology:
Monday, Tuesday, Thursday, Friday: 8:00 AM - 12:00 PM
Wednesday: 2:00 PM - 4:30 PM
Please note that online responses are for reference only.
If necessary, you should seek medical attention at a healthcare facility.
I hope to have the opportunity to serve you.
Best regards,
Gao Pilin

Reply Date: 2020/05/09

More Info

Understanding visual disturbances, particularly light flashes and surface waves, can be quite complex, especially for individuals who spend long hours in front of a computer screen. Your experiences, as described, suggest a few potential underlying mechanisms that could be contributing to these phenomena.

1. Visual Disturbances Upon Waking: The overlapping images you experience upon waking could be attributed to a phenomenon known as "visual persistence" or "afterimages." This occurs when the photoreceptors in your eyes continue to send signals to your brain even after the stimulus (in this case, the light from the ceiling fixture) has been removed. This effect can be more pronounced when you are extremely tired, as fatigue can affect the way your brain processes visual information. Additionally, your eyes may still be adjusting from a state of rest to an active visual state, leading to temporary distortions in perception.

2. Transient Visual Disturbances in Bright Light: The bright light and blurred vision you experience in the convenience store could be related to several factors. One possibility is that you are experiencing a form of "visual snow" or "photopsia," which can manifest as transient flashes of light or visual distortions. This phenomenon can be exacerbated by sudden changes in lighting conditions, especially when moving from a dimly lit environment to a brightly lit one. The sensation of a "wavy" road surface could be a visual distortion known as "oscillopsia," which can occur when there is a disruption in the normal processing of visual information, often related to vestibular function or eye movement control.

3. Amsler Grid Testing: Your self-administered Amsler grid test results indicate that there are no significant distortions in your central vision, which is a positive sign. The fact that you have a history of diplopia (double vision) could suggest that your brain is still adapting to visual inputs, especially if you have experienced fatigue or stress. The normal results on the vision chart further suggest that your overall visual acuity is within acceptable limits, which is reassuring.

Given your symptoms, it is essential to consider a few key points:
- Fatigue and Eye Strain: Prolonged computer use can lead to digital eye strain, which may cause symptoms such as blurred vision, dry eyes, and visual disturbances. Taking regular breaks using the 20-20-20 rule (every 20 minutes, look at something 20 feet away for 20 seconds) can help alleviate some of these symptoms.

- Neurological Considerations: While your symptoms may not indicate a severe underlying condition, it is crucial to monitor them closely. If you experience any new symptoms, such as persistent visual disturbances, headaches, or changes in your overall health, it would be wise to consult a healthcare professional for a comprehensive evaluation.

- Regular Eye Exams: Given your age and the nature of your symptoms, regular eye examinations are essential. An eye care professional can assess your visual health, check for any underlying conditions, and provide recommendations tailored to your specific needs.

In summary, while your experiences with visual disturbances can be disconcerting, they may be related to fatigue, environmental changes, or temporary visual processing issues. Maintaining good eye health practices and consulting with an eye care professional will help ensure that any potential issues are addressed promptly and effectively.

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