Brief Blackouts and Visual Disturbances in Your Eyes

Q: Brief Blackouts and Visual Disturbances in Your Eyes

Hello Jason： Based on your description and the fact that so many doctors have examined you, there should be no issues, and it is likely not a case of retinal detachment. <br>These phenomena are probably a type of floaters.

The eyes may flash black for a moment (for a few seconds), and when the eyes are unfocused, there is a sensation of something moving in the surrounding area?

Hello Doctor, I am 42 years old.
My left eye is -6.50 and my right eye is -8.00.
Symptoms: 1.
I almost experience brief flashes of darkness in my eyes daily (lasting a few seconds), occurring about 3-4 times a day, with better conditions on weekends when I experience fewer flashes.
2.
When my eyes are at rest and I focus on a specific object, I feel that it slightly moves, or I perceive slight movements in my surroundings, or I notice something moving nearby (I also have some floaters, which appear as dark lines or cloudy spots passing by).
These symptoms started in mid-2020.
I have seen 3-4 doctors at Mackay Memorial Hospital, Chang Gung Memorial Hospital, and National Taiwan University Hospital, all of whom said my examinations were normal, but I am still very anxious because I feel that the symptoms are increasing, and I am particularly afraid of the flashes (doctors have mentioned that it is not a case of amaurosis fugax).
I have also had a neurological examination that was normal, and I underwent a brain MRI in August 2020, which was also normal.
I kindly ask for your response, and I would be very grateful.

jason, 40~49 year old female. Ask Date: 2021/09/18

Dr. Gao Pilin reply Ophthalmology

Hello Jason: Based on your description and the fact that so many doctors have examined you, there should be no issues, and it is likely not a case of retinal detachment.
These phenomena are probably a type of floaters.

Reply Date: 2021/09/18

More Info

Hello! Thank you for sharing your concerns regarding your visual disturbances. Based on the symptoms you've described, it seems that you are experiencing a combination of transient visual phenomena, which can be quite distressing. Let's break down your symptoms and provide some insights.

1. Transient Blackouts: The brief episodes of seeing black or dark spots for a few seconds, occurring multiple times a day, could be related to several factors. One possibility is that these are related to the phenomenon known as "visual migraines" or "ocular migraines." These can cause temporary visual disturbances, including blackouts or flashes of light, without a headache. Another potential cause could be related to the vitreous humor in your eye. As we age, the vitreous can shrink and pull away from the retina, leading to symptoms such as floaters or brief visual disturbances. Given that you have a history of myopia (nearsightedness), you may be at a higher risk for these changes.

2. Perception of Movement: The sensation that objects appear to be moving or that your surroundings are slightly swaying when you fixate on something could be related to a phenomenon called "visual motion perception." This can occur due to the way your brain processes visual information, especially if you have underlying conditions such as anxiety or visual fatigue. Additionally, your experience with floaters (the black, shadowy lines you see) can contribute to this perception, as they can interfere with your visual clarity and create a sense of movement.

3. Previous Medical Evaluations: It's reassuring that you have consulted multiple specialists, including ophthalmologists and neurologists, and that your MRI results were normal. This suggests that there are no significant structural issues in your brain or eyes that would explain your symptoms. However, persistent symptoms can understandably lead to anxiety and concern, especially when they seem to worsen over time.

4. Psychological Factors: Anxiety and stress can exacerbate visual disturbances. If you find yourself worrying about your symptoms, this could lead to a cycle of increased awareness and sensitivity to your visual experiences. Cognitive-behavioral strategies or relaxation techniques may help manage this anxiety.

5. When to Seek Further Evaluation: While your previous evaluations have returned normal results, if your symptoms continue to worsen or if you experience new symptoms (such as significant changes in vision, persistent headaches, or other neurological symptoms), it would be prudent to seek further evaluation. A comprehensive eye exam, including a dilated fundus examination, can help rule out any retinal issues, especially given your history of myopia.

In conclusion, while your symptoms are concerning, they do not appear to indicate a serious underlying condition based on your medical evaluations. However, it is essential to continue monitoring your symptoms and maintain open communication with your healthcare providers. If you feel that your symptoms are impacting your quality of life, consider discussing this with your doctor, who may recommend further testing or a referral to a specialist in visual disturbances or neuro-ophthalmology. Remember, your health and peace of mind are paramount, and it's important to address any ongoing concerns with your healthcare team.

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