Visual Disturbances: A Neurological Perspective on Eye Symptoms

Seeing upon waking up

Hello doctor, I have autonomic nervous system dysfunction.
Since February of this year, whenever I focus on an object for a prolonged period, that object appears to vibrate back and forth, although my eyes themselves do not shake.
This sensation sometimes correlates with my heartbeat.
When I wake up and open my eyes, or after using the computer for a long time, or when transitioning from a dark environment to a bright one, I experience a flickering sensation in my eyes that feels like an electrical discharge, not like flashes.
In the morning, when I open my eyes and look at the wall, I sometimes see transparent grids, black lines, or images resembling branches.
At night, when I turn off the lights to sleep, I see images that look like transparent fans spinning, which eventually fade away.
I also have floaters, so I have undergone a dilated fundus examination, which showed no issues.
The ophthalmologist suggested it might be a neurological problem, so I would like to ask the doctor what might be causing my symptoms.
Thank you.

Xin, 20~29 year old female. Ask Date: 2015/12/04

Dr. Gao Chunde reply Neurology

These symptoms can often occur in healthy individuals and fall within the range of physiological responses, so there is no need for excessive concern.
It seems that you have a keen sense of observation and are noticing subtle physiological changes in your nervous system.
As long as you relax and redirect your attention, you will be able to coexist peacefully with these sensations, just like everyone else.

Reply Date: 2015/12/04

More Info

Your symptoms suggest a complex interplay between visual disturbances and potential neurological issues. Given your history of autonomic nervous system dysregulation, it’s important to consider how this might be affecting your visual perception.
1. Visual Disturbances: The sensations you describe, such as objects appearing to vibrate or move when you focus on them, can be attributed to a phenomenon known as "visual motion perception." This can occur when the brain misinterprets signals from the eyes, leading to a perception of motion that isn’t actually present. This can be exacerbated by fatigue, stress, or anxiety, which are often associated with autonomic nervous system dysregulation.

2. Flashing or Flickering Sensations: The flickering sensation you experience, especially when transitioning from dark to light environments or after prolonged screen time, may be related to a condition known as "visual fatigue" or "computer vision syndrome." This occurs when the eyes become strained from extended use, particularly with screens, leading to symptoms like blurred vision, dry eyes, and visual disturbances. The feeling of "electric" sensations in your eyes could also be related to ocular migraines, which can occur even without a headache.

3. Transient Visual Phenomena: The transparent grids, black lines, or branch-like images you see upon waking could be manifestations of visual snow syndrome or other forms of visual disturbances. These phenomena can be benign but may also indicate underlying neurological issues, especially if they are persistent or worsening.

4. Neurological Considerations: Given that your eye examinations have ruled out significant ocular pathology, it’s prudent to explore neurological causes. Conditions such as migraines, particularly those with aura, can cause transient visual disturbances. Additionally, conditions affecting the brain's visual processing centers, such as occipital lobe issues, could lead to similar symptoms.
5. Recommendations:
- Consult a Neurologist: Since your eye doctor suggested a potential neurological issue, it would be beneficial to see a neurologist for a comprehensive evaluation. They may recommend imaging studies, such as an MRI, to rule out any structural abnormalities.

- Monitor Triggers: Keep a diary of your symptoms, noting when they occur, their duration, and any potential triggers (e.g., stress, screen time, lighting changes). This information can be invaluable for your healthcare provider.

- Visual Hygiene: Implement strategies to reduce eye strain, such as the 20-20-20 rule (every 20 minutes, look at something 20 feet away for 20 seconds), ensuring proper lighting when using screens, and taking regular breaks.

- Stress Management: Since autonomic dysregulation can exacerbate symptoms, consider incorporating stress-reduction techniques such as mindfulness, yoga, or cognitive behavioral therapy.

In conclusion, while your symptoms may be benign, they warrant further investigation to rule out any underlying neurological conditions. Early intervention can help manage symptoms and improve your quality of life. Please ensure you follow up with your healthcare providers to address these concerns comprehensively.

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