Visual Disturbances: When to Seek Eye Care

Q: Visual Disturbances: When to Seek Eye Care

Hello Shan： This is more likely related to vitreous degeneration, commonly known as floaters. <br>As for the purple flashes, they resemble photopsia, which is a physiological phenomenon. <br>I recommend that you have an eye examination. <br>If everything is fine, you can rest ass

In a dark room without lights, I saw purple lightning?

Hello, doctor.
I do not have myopia, but when I look at the sky, I see a small invisible line and a tiny dot, which I am unsure if it has increased recently.
I use my phone for over 14 hours a day, sometimes even in the dark.

1.
Previously, when looking at my phone screen, I noticed a dark blurry spot in my left eye.
When I close my eyes, I see a small light circle, and when looking at a white sheet of paper, I see small black dots that disappear in a few seconds, but they appear when I blink; currently, I can hardly see the small black dots.

2.
Recently, what has been bothering me is that in the dark or in a room without lights, whether my eyes are closed or open, I see strange phenomena that severely affect my sleep.
Initially, when my eyes are closed, I see white squares rapidly sliding by, and the corner of my left eye seems to have something flashing; when I open my eyes, it disappears.
The next day, with my eyes closed, I saw many very small light dots flying around, and when I opened my eyes, they turned into small dots flying around, along with line-shaped lights.
The following day, whether my eyes are closed or open, I saw purple lightning, sometimes in a swirling pattern, and I have also seen green ones.
Yesterday, my right eye felt a bit sore and swollen.
After turning off the lights to sleep, the previously described symptoms took turns appearing, with each symptom lasting longer than before, repeating continuously.

Doctor, is this situation serious? Under what circumstances should I seek immediate medical attention? Is this a precursor to retinal detachment, or is it already in the process of being pulled? Or could it be symptoms of another condition? Additionally, could you describe what the flashes or lightning that people mention might look like? Is it possible to see these phenomena with both eyes open or closed in relation to retinal detachment? In the past few days, during the day or with the lights on, I have also noticed afterimages that look like small mosquitoes flying by very quickly; is this related to retinal detachment as well? Thank you for your response, doctor.

Shan, 30~39 year old female. Ask Date: 2022/10/22

Dr. Gao Pilin reply Ophthalmology

Hello Shan: This is more likely related to vitreous degeneration, commonly known as floaters.
As for the purple flashes, they resemble photopsia, which is a physiological phenomenon.
I recommend that you have an eye examination.
If everything is fine, you can rest assured.

Reply Date: 2022/10/22

More Info

It sounds like you are experiencing a variety of visual disturbances that can be quite concerning. Based on your description, you are noticing several symptoms, including the appearance of lines, spots, and flashes of light, particularly in low-light conditions. These symptoms can be indicative of several underlying issues, and it is essential to understand when to seek medical attention.

Firstly, the presence of floaters (the small black dots or lines you see) is common and often benign, especially if they appear sporadically and do not significantly impair your vision. However, if you notice a sudden increase in floaters, especially if accompanied by flashes of light or a shadow in your peripheral vision, it could be a sign of retinal detachment or a tear. This is a serious condition that requires immediate medical evaluation.

The flashes of light you describe, particularly the "lightning" or "whirling" sensations, can also be concerning. These phenomena can occur due to various reasons, including:
1. Vitreous Detachment: As we age, the vitreous gel that fills the eye can shrink and pull away from the retina, leading to flashes of light. This is usually not serious but should be monitored.

2. Retinal Tear or Detachment: If the vitreous pulls too hard on the retina, it can cause a tear, leading to retinal detachment. Symptoms include sudden flashes of light, a significant increase in floaters, and a shadow or curtain effect over your vision.

3. Migraine Aura: Some individuals experience visual disturbances as a precursor to a migraine, which can include flashes of light or zigzag patterns. These symptoms usually resolve within a short period.

4. Ocular Migraines: These can cause temporary visual disturbances, including flashing lights or spots, but typically resolve without lasting effects.

Given your symptoms, particularly the changes in vision in low-light conditions and the increasing frequency and duration of the visual phenomena, it is crucial to seek an eye care professional's evaluation. An ophthalmologist can perform a comprehensive eye exam, including a dilated fundus examination, to assess the health of your retina and vitreous.

When to Seek Immediate Care:
- Sudden onset of flashes or floaters: If you experience a sudden increase in floaters or flashes, especially if accompanied by a shadow or curtain effect in your vision.

- Changes in vision: Any sudden changes in your vision, such as blurriness or loss of vision, should prompt immediate evaluation.

- Persistent symptoms: If the symptoms persist or worsen over a few days, it is advisable to seek medical attention.

Understanding Flashes and Floaters:
Flashes of light can be described as brief bursts of light that may appear as streaks or spots in your vision. They can occur in both light and dark environments and may be more noticeable when you move your eyes. Floaters, on the other hand, are tiny specks or strands that drift through your field of vision, often more visible against a bright background.

Conclusion:
While some visual disturbances can be benign, the combination of symptoms you are experiencing warrants a thorough examination by an eye care professional. Early detection and intervention are key to preventing potential complications, especially concerning retinal health. If you have any doubts or if your symptoms escalate, do not hesitate to seek immediate medical attention. Your vision is invaluable, and taking proactive steps to protect it is essential.

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