Eye Symptoms: When to See an Eye Doctor or Neurologist

Eye problems

Experiencing flashes in the eyes and persistent discomfort from floaters for about two weeks, I underwent an eye examination.
The doctor confirmed that the retina was fine with no tears or holes, but diagnosed me with mild entropion (inward turning of the eyelid).
My vision is generally okay both indoors and outdoors, although I find it more challenging to look at the computer screen due to the persistent floaters.

Two weeks later, I developed new symptoms: I had a headache at night (thinking it was a cold), and the following night while watching TV, I noticed a shadow (I felt it was a shadow cast by the curtains).
This has occurred two more times while using the computer, where I experienced a strange sensation while looking at the screen, seeing flashes of white on a gray-black background.
When I turned to look at the wall, I saw a pattern resembling a "回" character, with a small white center and a larger black outline, transitioning from white to gray and then to black (I could only see the shadow when I relaxed my focus).
When I concentrated, the shadow seemed to disappear, lasting for about one to two minutes before resolving.
I would like to know if I should consult a different specialist since the ophthalmologist previously stated there were no issues, or should I continue to follow up with the eye doctor? (I had my eye examination at a specialized clinic, not a general practice.) Additionally, could you provide an idea of what condition this might be? I haven't found similar symptoms online.

A-Feng, 30~39 year old female. Ask Date: 2013/12/23

Dr. Wang Zhishun reply Ophthalmology

Hello, thank you for your hard work.
Floaters are a result of vitreous degeneration, and they can take on various shapes.
Due to their movement, they may also have different effects on your visual field.
You can alternate covering each eye to see if there are any fixed dark spots; if so, you should undergo further ophthalmologic examination.
Additionally, your new symptoms may also indicate the possibility of migraines.
If they persist or recur, it would be advisable to consult a neurologist.

Reply Date: 2013/12/23

More Info

Based on your description of the symptoms, it seems that you are experiencing a complex interplay of visual disturbances and headaches, which can be quite concerning. The symptoms you've outlined, including flashes of light, the appearance of black spots or shadows, and headaches, warrant careful evaluation to determine their underlying cause.

Firstly, it’s important to understand that visual symptoms such as flashes and floaters (the "black mosquito" effect you mentioned) can be associated with various ocular conditions. While your eye doctor has ruled out retinal issues, such as tears or holes, the persistence of these symptoms, especially in conjunction with headaches, suggests that further investigation may be necessary.

The presence of headaches, particularly if they are occurring in conjunction with visual disturbances, raises the possibility of a neurological issue. Conditions such as migraine with aura can present with visual symptoms like flashes or zigzag patterns, followed by a headache. However, your description of the symptoms evolving into more complex visual phenomena, such as seeing shadows or changes in the appearance of objects, could indicate a need for a neurological evaluation.

Given that your symptoms have changed and new ones have emerged since your last eye examination, it would be prudent to consult a neurologist. A neurologist can perform a thorough assessment, which may include imaging studies such as an MRI or CT scan, to rule out any neurological conditions that could be contributing to your symptoms. Additionally, they may conduct tests to evaluate your visual pathways and overall neurological function.

In terms of whether to continue seeing your ophthalmologist or to switch to a neurologist, it may be beneficial to do both. You can keep your ophthalmologist informed of your new symptoms while seeking a neurological evaluation. This collaborative approach ensures that all potential causes are explored, and it allows for a comprehensive understanding of your condition.

As for the potential underlying conditions, while it is difficult to provide a definitive diagnosis without further evaluation, some possibilities include:
1. Migraine with Aura: This condition can cause visual disturbances and is often accompanied by headaches. The aura can manifest as flashes of light or visual distortions.

2. Visual Snow Syndrome: This is a rare neurological condition characterized by visual disturbances, including seeing "static" or "snow" in the visual field, which can be exacerbated by stress or fatigue.

3. Retinal Migraines: These can cause temporary visual disturbances and are often linked to migraine headaches.

4. Neurological Disorders: Conditions such as multiple sclerosis can present with visual symptoms due to demyelination of the optic nerve.

5. Ocular or Neurological Inflammation: Conditions like optic neuritis can cause visual disturbances and may require immediate attention.

In conclusion, it is essential to take your symptoms seriously and seek further evaluation. A neurologist can provide insights into whether your symptoms are purely ocular or if there is a neurological component that needs to be addressed. Meanwhile, maintaining a healthy lifestyle, managing stress, and ensuring adequate rest can help alleviate some symptoms. Always prioritize your health and seek medical attention when symptoms change or worsen.

Similar Q&A

Understanding Diplopia: When to See an Eye Doctor or Neurologist

I have had diplopia since elementary school, but I didn't pay much attention to it back then because I thought others experienced it the same way. A few days ago, I researched online and found that my condition is classified as "binocular diplopia." It mentioned th...

Dr. Zhang Yanrui reply Ophthalmology
Hello. Your condition seems more like strabismus-related diplopia caused by congenital strabismus. You should follow up with an ophthalmologist, as there are many causes of diplopia, and an ophthalmologist can perform a comprehensive differential diagnosis. Wishing you a speedy r...

Understanding Eye Symptoms: When to See an Eye Specialist

Hello, doctor. This morning, I noticed that my right eye felt slightly red, so I moved my eyes around to relieve the discomfort. However, I found that when I looked upward with my right eye, it felt like something was pressing against it, although it wasn't painful. My left ...

Dr. Gao Pilin reply Ophthalmology
Hello Ms. Li: Your symptoms seem to be localized issues with your eyes. As for the sensation of pressure, it is difficult to determine the cause. It would be advisable to see an ophthalmologist to check for any localized lesions. Additionally, it would be a good idea to check if ...

Understanding Eye Discomfort: When to See a Neurologist or Ophthalmologist

Hello, doctor. For the past three months, I have been experiencing a sensation where my right eye does not fully open upon waking up (it feels like it only opens about 80-90%). This results in my left eye appearing normal in size while my right eye looks slightly smaller, creatin...

Dr. Zhang Junwei reply Neurosurgery
You can schedule an appointment with either the neurosurgery or neurology department.

Understanding Eye Strain and Headaches: When to See a Neurologist

Hello Dr. Yeh: I have been experiencing these symptoms for a while. Initially, I noticed my vision becoming somewhat blurry (it feels like I can't focus properly, and it also feels like I'm seeing stars), but I can still see things. Once this symptom subsides, I start t...

Dr. Ye Boshou reply Neurology
The most likely cause is eye fatigue, which should improve with rest. Otherwise, further evaluation by a neurologist may be necessary to check for any neurological issues.