Visual Disturbances: Causes and Solutions for Eye Pain and Flashes

Every day upon opening my eyes (before sitting up), I see numerous transparent dots (that do not move) and my vision keeps flashing?

Both eyes have -200 degrees of myopia and -250 degrees of astigmatism.
Since mid-April, I have experienced eye pain until the end of May, with no change in vision.
I consulted a specialist three times, and they all said my eyes were fine.
Currently, my light sensitivity and eye pain have significantly improved; the pain is not constant, occurring four to five times a day, each episode lasting about ten minutes.
Sometimes, I also experience headaches.

Two weeks ago, I started noticing transparent light spots in my vision every morning upon waking (before getting up), and my field of vision keeps flashing (this happens not only in the morning but also when I take a short nap in the afternoon).
Additionally, when I look at a white wall, I perceive the sunlight on it flickering at a low frequency (though the clock hanging on the wall does not flicker).
Furthermore, when I look at the blue sky, I see transparent light spots moving erratically.
I visited an ophthalmologist again, who performed dilation (after which I saw a large black spot in my vision that kept changing shape and rotating, but it disappeared after ten minutes).
The doctor examined my retina and said everything looked normal.
I would like to know what issues might be present and what further examinations could be conducted.

pheonix, 20~29 year old female. Ask Date: 2014/07/06

Dr. Gao Chunde reply Neurology

Considering the recurrent occurrence of visual aura associated with migraines or occipital lobe epilepsy (recurrent discharges), it is recommended to promptly visit a neurologist for further EEG testing and pharmacological treatment.
If necessary, brain imaging studies should also be conducted.

Reply Date: 2014/07/06

More Info

Understanding visual disturbances, particularly those involving flashes of light and eye pain, can be complex and often requires thorough evaluation by an eye care professional. Based on your description, it seems you are experiencing a combination of symptoms that may include flashes of light, visual disturbances, and intermittent eye pain. Here’s a breakdown of potential causes and suggested approaches for managing your symptoms.

Potential Causes of Visual Disturbances and Eye Pain
1. Vitreous Detachment: As we age, the vitreous gel that fills the eye can shrink and pull away from the retina. This can lead to flashes of light, especially when moving your eyes. It’s often accompanied by floaters (the "transparent light points" you mentioned). While this is usually benign, it can sometimes lead to more serious conditions like retinal tears or detachment.

2. Retinal Issues: Although your recent eye exams indicated no retinal problems, it’s essential to consider that conditions like retinal tears or detachment can develop. Symptoms may include sudden flashes of light, a sudden increase in floaters, or a shadow over your vision. If you experience any of these, seek immediate medical attention.

3. Migraine-Associated Visual Disturbances: Even if you do not have a history of migraines, some individuals experience visual disturbances known as "aura" that can include flashes of light or zigzag patterns. These can occur without a headache and may be triggered by stress or fatigue.

4. Ocular Surface Disorders: Conditions such as dry eye syndrome can cause discomfort, light sensitivity, and intermittent pain. This could explain the eye pain you’ve been experiencing, especially if you spend long hours in front of screens.

5. Neurological Causes: Given the combination of headaches and visual disturbances, it may be worth considering a neurological evaluation. Conditions such as increased intracranial pressure or other neurological disorders can manifest with visual symptoms.

Suggested Management and Next Steps
1. Regular Eye Exams: Continue to have regular check-ups with your ophthalmologist. If your symptoms change or worsen, do not hesitate to return for further evaluation.

2. Visual Field Testing: This test can help assess your peripheral vision and detect any abnormalities that may not be visible during a standard eye exam.

3. Optical Coherence Tomography (OCT): This imaging test provides detailed images of the retina and can help identify any subtle changes that may not be apparent during a routine examination.

4. Neurological Consultation: If your symptoms persist or if you experience new symptoms such as severe headaches, visual field loss, or other neurological signs, a referral to a neurologist may be warranted for further evaluation.

5. Lifestyle Modifications: Ensure you are taking regular breaks from screens (the 20-20-20 rule: every 20 minutes, look at something 20 feet away for 20 seconds). Staying hydrated and using artificial tears can help alleviate dry eye symptoms.

6. Stress Management: Since stress can exacerbate visual disturbances, consider incorporating relaxation techniques such as mindfulness, yoga, or deep-breathing exercises into your routine.

Conclusion
While your symptoms can be concerning, many causes of visual disturbances are benign and manageable. It’s crucial to maintain open communication with your healthcare providers and report any changes in your symptoms. By following up with appropriate specialists and taking proactive steps in managing your eye health, you can work towards alleviating your symptoms and improving your overall quality of life. If you have any further questions or concerns, please feel free to reach out to your healthcare provider for personalized advice.

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