Strange Eye Symptoms During Sleep: Causes and Solutions - Ophthalmology

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Your symptoms of experiencing strange visual phenomena, such as flashes of light when you are about to fall asleep or just waking up, can indeed be concerning and disruptive to your sleep quality. Based on your description, it seems you have already consulted multiple doctors and undergone eye examinations, which is a good first step in ruling out serious ocular conditions.
The visual disturbances you are experiencing could be attributed to several factors, including but not limited to, retinal issues, vitreous changes, or neurological conditions. Given your history of myopia (800 degrees), it is not uncommon to experience floaters or flashes of light, which are often related to changes in the vitreous gel that fills the eye. As we age or with high myopia, the vitreous can become more liquid and may pull away from the retina, leading to these visual disturbances. However, since you have been monitored for retinal health and no significant issues were found, we can consider other potential causes.

One possibility is that your symptoms could be related to a phenomenon known as "visual snow" or "phosphene." Phosphenes are the perception of light without light actually entering the eye, often described as seeing flashes or flickers. This can occur during transitions between wakefulness and sleep, particularly when the brain is in a state of relaxation or semi-consciousness. Stress, fatigue, and irregular sleep patterns can exacerbate these symptoms, which might explain why you notice them more frequently during periods of tiredness.

Another consideration is the possibility of a neurological component. Conditions such as migraine aura can cause visual disturbances, including flashes of light, even in the absence of a headache. If you have a history of migraines or if there is a family history of migraine, this could be a relevant factor. Additionally, sleep-related disorders, such as sleep paralysis or hypnagogic hallucinations, can also lead to unusual visual experiences as you transition into or out of sleep.

Given that you have recently returned to Taiwan and experienced significant changes in your lifestyle and sleep patterns, it is possible that these changes are contributing to your symptoms. Stress, irregular sleep schedules, and changes in your environment can all impact your sleep quality and overall well-being.
To address your symptoms, consider the following recommendations:
1. Sleep Hygiene: Establish a regular sleep schedule by going to bed and waking up at the same time each day. Create a calming bedtime routine to help signal to your body that it is time to wind down.

2. Stress Management: Engage in relaxation techniques such as meditation, deep breathing exercises, or yoga to help reduce stress and anxiety, which can contribute to sleep disturbances.

3. Limit Stimulants: Reduce caffeine and nicotine intake, especially in the hours leading up to bedtime, as these can interfere with your ability to fall asleep and stay asleep.

4. Consult a Neurologist: Since you have already seen multiple eye specialists, it may be beneficial to consult a neurologist to explore any potential neurological causes for your symptoms. They may recommend further testing, such as an EEG or MRI, to rule out any underlying conditions.

5. Follow-Up Eye Care: Continue to monitor your eye health with regular check-ups, especially since you have a history of myopia and floaters. If your symptoms worsen or change, seek immediate medical attention.

In conclusion, while your symptoms may not indicate a serious underlying condition, they are certainly affecting your quality of life. By addressing lifestyle factors and consulting with the appropriate specialists, you can work towards finding relief and improving your sleep quality.