Dizziness and Eye Strain: When to Seek Medical Help

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I have a job that requires me to sit for long periods and use my eyesight.
Recently, when I look away while working, I experience a feeling of dizziness and discomfort.
I have been in this job for almost six years, but this sensation has only started in the past two months.
I also noticed that in poor lighting, even with the lights on, I have a sensitivity to light and feel dizzy, and the lighting still seems dim and uncomfortable for my eyes.
Over the past few days, I have been experiencing dizziness (I have a history of dizziness for about ten years), along with nausea and a feeling of wanting to vomit, which has happened several times.
Additionally, I feel weak in my limbs, lack energy, and have difficulty concentrating, which has affected my work.
I consulted an internist, but the doctor seemed unsure of the cause.
I have a mild cough that resembles a cold, but it doesn't seem like gastroenteritis, as I have no abdominal pain, just nausea.
I received IV fluids, which temporarily restored my strength, but the discomfort returned the next day.
Due to my job and my tendency to be overweight, I also have tightness in my shoulder muscles.
I experience numbness in my hands upon waking, which may be related to sleeping with my head resting on my hands.
Should I go to a major hospital for further examination? Which specialty should I consult? What tests should I undergo? Additionally, I have a history of depression.
I have reduced my medication intake from three times a day to twice, and now I only take it once a day as my condition has improved over the past ten months.
Recently, I ran out of medication and have only been off it for a day or two, but I am experiencing dizziness, nausea, and weakness again.
I am unsure if this is related to stopping my depression medication.
Please help me with these questions.
Thank you!

Xiao Zhu, 20~29 year old female. Ask Date: 2004/09/12

Dr. Lai Lunxiang reply Neurology

I believe that the reduction in the medication dosage has a significant impact.
Consult your physician to adjust the dosage.

Reply Date: 2004/09/12

More Info

It sounds like you are experiencing a complex set of symptoms that are affecting your daily life and work. Given your history of dizziness, eye strain, and other related symptoms, it is important to approach this situation with a comprehensive understanding of potential underlying causes and the appropriate steps to take.

Understanding Your Symptoms
1. Dizziness and Eye Strain: The dizziness you are experiencing, especially when looking sideways, could be related to several factors. Eye strain, particularly from prolonged computer use, can lead to discomfort and visual disturbances. This is often exacerbated by poor lighting conditions, which you mentioned. The combination of eye strain and inadequate lighting can contribute to feelings of dizziness and discomfort.

2. Light Sensitivity: Your sensitivity to light (photophobia) and the feeling of discomfort in poorly lit environments can be indicative of several issues, including eye strain or even a potential underlying eye condition. It’s essential to ensure that your workspace is well-lit and ergonomically designed to reduce strain.

3. Nausea and Vomiting: The nausea and vomiting you are experiencing, along with the dizziness, could be linked to a variety of factors, including anxiety, medication side effects, or even vestibular issues. Since you have a history of dizziness, it’s crucial to consider whether this is a recurring issue or something new.

4. Fatigue and Weakness: The feelings of weakness and lack of energy could be related to several factors, including your mental health condition, medication side effects, or even lifestyle factors such as diet and exercise.

5. Numbness and Tingling: The numbness in your hands upon waking could be related to your sleeping position, especially if you are pressing on nerves. This could also be exacerbated by tension in your shoulders and neck, which is common in individuals who spend long hours at a desk.

When to Seek Medical Help
Given the complexity of your symptoms, it is advisable to seek medical attention. Here are some steps you can take:
1. Consult a Primary Care Physician: Start with a visit to your primary care doctor. They can perform a thorough evaluation of your symptoms, review your medical history, and determine if further testing is necessary.

2. Eye Examination: Since you are experiencing significant eye strain and discomfort, it would be wise to see an ophthalmologist. They can assess your vision, check for any underlying eye conditions, and provide recommendations for managing eye strain.

3. Neurological Evaluation: If your dizziness persists, a referral to a neurologist may be warranted. They can evaluate for any neurological issues that could be contributing to your symptoms.

4. Mental Health Assessment: Given your history of depression and the recent changes in your medication regimen, it may be beneficial to consult with a psychiatrist or psychologist. They can assess whether your symptoms are related to your mental health condition or medication adjustments.

Recommended Tests
- Vision Tests: Comprehensive eye exams, including visual acuity tests, refraction tests, and possibly OCT (Optical Coherence Tomography) to assess the health of your retina.

- Blood Tests: To check for any underlying metabolic or nutritional deficiencies that could be contributing to your symptoms.

- Neurological Tests: If indicated, tests such as MRI or CT scans may be performed to rule out any neurological conditions.

Conclusion
Your symptoms are multifaceted and could be influenced by a combination of factors, including your work environment, mental health, and physical health. It is important to take these symptoms seriously and seek appropriate medical care. By consulting with the right specialists and undergoing necessary evaluations, you can work towards finding relief and improving your overall well-being. Remember to communicate openly with your healthcare providers about all your symptoms and concerns, as this will help them provide the best possible care.

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