Eye Pain and Visual Disturbances: When to Seek Help

Q: Eye Pain and Visual Disturbances: When to Seek Help

Hello Vicky： Based on your described symptoms, in addition to the pain around the eyes, you also experience headaches, shoulder pain, and visual disturbances. <br>If you are overusing your eyes at work, it may lead to eye fatigue and discomfort around the eyes. <br>Typically, dis

Eye problems

Hello Doctor: Recently, I have been experiencing pain in my right eye socket, headaches, and shoulder pain.
On September 26, I visited an ophthalmologist who informed me that my left eye had increased myopia by 100 degrees and my right eye by 25 degrees.
After changing the left lens, the pain in my eyes, headaches, and shoulder pain decreased.
My right eye remained at 625 degrees, while my left eye was changed from 725 degrees to 625 degrees.
I am 35 years old and work on a computer for at least six hours a day.

On October 4, around 6:40 PM, I noticed a large inverted "C" shape flashing in my right eye for about twenty minutes before it disappeared towards the upper right corner, followed by a headache.
I went to the ophthalmologist, who only conducted an interview without any examination and stated that it was not an eye problem.

On October 14, around 12:30 PM, while washing my face, I saw a half heart shape flashing in my right eye for about thirty minutes before it disappeared towards the upper right corner.
This time, I did not have a headache.

On October 17, around 7:30 AM, while I was waking up, I suddenly saw a circular shape flashing in my right eye, which then changed to a large inverted "C" shape.
I thought I was dreaming, but upon waking, the phenomenon persisted for about twenty minutes before it disappeared towards the upper right corner.
This time, there was no headache, but I did experience pain in my right eye socket.

1.
Could this be related to the lens change?
2.
Is the frequency of occurrences in my right eye too high? Should I get further examinations from an ophthalmologist, or should I see a neurologist?

vicky, 30~39 year old female. Ask Date: 2008/10/17

Dr. Liu Jingxian reply Ophthalmology

Hello Vicky: Based on your described symptoms, in addition to the pain around the eyes, you also experience headaches, shoulder pain, and visual disturbances.
If you are overusing your eyes at work, it may lead to eye fatigue and discomfort around the eyes.
Typically, discomfort caused by presbyopia is considered for patients who are around or over the age of 40.
For eye issues related to overuse, it is advisable to adjust your screen time, take regular breaks, and apply warm compresses to the eyes for relief.
Regarding whether the severity of your prescription lenses is a contributing factor, considering your age (36 years) and the degree of your prescription (25 diopters), it is likely not the primary cause.
However, the possibility of concurrent migraine cannot be ruled out, so consulting a neurologist may also be beneficial.
Wishing you good health.
Taiwan e-Learning Institute - Ophthalmology, Taipei City Hospital Zhongxing Branch.

Reply Date: 2008/10/17

More Info

It sounds like you are experiencing a range of concerning symptoms related to your right eye, including eye pain, headaches, and visual disturbances such as flashes of light. Given the complexity of your symptoms, it is essential to approach this situation with caution and seek appropriate medical attention.

1. Understanding Your Symptoms: The symptoms you describe, particularly the flashes of light (often referred to as photopsia) and the pain around your eye, can be indicative of several potential issues. These could range from benign conditions, such as migraines or ocular migraines, to more serious concerns like retinal detachment or vitreous detachment. The fact that you have experienced these flashes multiple times, along with accompanying pain, warrants further investigation.

2. Impact of New Prescription Glasses: You mentioned that you recently had your glasses prescription changed. While it is possible that an incorrect prescription could lead to discomfort or visual disturbances, the specific symptoms you are experiencing—especially the flashes of light—are less likely to be directly caused by the new lenses. However, if the prescription is significantly different from what you were previously using, it could lead to eye strain, which might contribute to headaches and discomfort.

3. When to Seek Further Evaluation: Given the frequency and nature of your visual disturbances, it is advisable to seek a comprehensive evaluation from an eye care professional. If your current eye doctor is not providing the necessary examinations (such as a dilated fundus exam or visual field testing), you may want to consider seeking a second opinion or visiting a specialist, such as a retinal specialist. Additionally, if your symptoms persist or worsen, it may be prudent to consult a neurologist to rule out any neurological causes for your symptoms.

4. Potential Causes of Your Symptoms:
- Ocular Migraines: These can cause temporary visual disturbances and are often accompanied by headaches. They are typically harmless but can be bothersome.

- Retinal Issues: Flashes of light can indicate that the retina is being stimulated, which can occur with conditions like retinal detachment or tears. These conditions require immediate medical attention.

- Vitreous Detachment: As we age, the vitreous gel in the eye can shrink and pull away from the retina, leading to flashes of light and floaters. This is usually not serious but should be monitored.

- Increased Eye Strain: Prolonged computer use can lead to digital eye strain, which may cause discomfort, headaches, and visual disturbances. Implementing the 20-20-20 rule (every 20 minutes, look at something 20 feet away for 20 seconds) can help alleviate some of this strain.

5. Recommendations:
- Follow-Up: Schedule a follow-up appointment with an eye care professional who can conduct a thorough examination, including checking for any retinal issues.

- Monitor Symptoms: Keep a log of your symptoms, including when they occur, their duration, and any associated factors (like stress or prolonged screen time). This information can be valuable for your healthcare provider.

- Adjust Work Habits: Given your extensive computer use, consider taking regular breaks, adjusting your screen brightness, and ensuring proper lighting to reduce eye strain.

In conclusion, while some of your symptoms may be related to the recent change in your glasses, the presence of visual disturbances and eye pain suggests that further evaluation is necessary. It is crucial to prioritize your eye health and seek the appropriate medical attention to rule out any serious conditions.

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