Morning Vision Disturbances: Grid-Like Shadows in Your Eyes

Q: Morning Vision Disturbances: Grid-Like Shadows in Your Eyes

Hello Johnny： 1. It is likely to be floaters. 2. If the intraocular pressure is temporarily elevated but controlled, there should be minimal damage to the optic nerve; however, an examination is still necessary to confirm. 3. Yes, because sleeping can cause

Upon waking up in the morning without wearing glasses, there are noticeable grid-like black lines?

Hello Doctor, I recently experienced eye inflammation, and my ophthalmologist prescribed Maxitrol ointment.
After using it for a month, my intraocular pressure increased, so the doctor prescribed Alphagan.P for me to use.
The next morning, I noticed that when I wore my glasses, the lights appeared somewhat blurry.
When I took off my glasses, I saw grid-like black lines in my right eye, and some in my left eye as well; these were fixed.
Additionally, about half an hour after getting up, the lines became less noticeable.
This situation has persisted every morning since then.

I have a few questions for you:
1.
What could be the issue?
2.
Could using this ointment for a month, along with the increased intraocular pressure, cause damage to the optic nerve?
3.
If it is floaters, is it common for them to be particularly noticeable upon waking?
4.
Why would both eyes be affected simultaneously?
Thank you, Doctor.

JOHNNY, 20~29 year old female. Ask Date: 2016/02/24

Dr. Gao Pilin reply Ophthalmology

Hello Johnny:
1.
It is likely to be floaters.
2.
If the intraocular pressure is temporarily elevated but controlled, there should be minimal damage to the optic nerve; however, an examination is still necessary to confirm.
3.
Yes, because sleeping can cause the floaters to settle, making them more noticeable as they may come closer to the retina.
4.
That is also a possibility.

At the E-Hospital in Puzi, Taiwan, the ophthalmology department is open Monday to Friday from 8:00 AM to 12:00 PM and Wednesday afternoons from 1:00 PM to 4:30 PM.
Online responses should only be used as a reference; it is essential to seek medical attention at a healthcare facility if needed.
I hope to have the opportunity to serve you.

Gao Pilin

Reply Date: 2016/02/24

More Info

Morning vision disturbances, particularly the appearance of grid-like shadows or patterns, can be concerning and may stem from various underlying issues. Based on your description, it seems you have experienced a series of visual disturbances after using Maxitrol, a topical corticosteroid, which can sometimes lead to increased intraocular pressure (IOP). This is particularly relevant given your history of eye inflammation and the subsequent treatment with Alphagan P, which is designed to lower IOP.

1. Possible Causes: The grid-like shadows you are experiencing could be attributed to several factors. One possibility is that they are related to the vitreous humor, the gel-like substance in the eye that can become more liquid with age or due to certain conditions. This can lead to the formation of floaters or shadows, particularly in low light conditions, such as when you first wake up. Another potential cause could be related to the corneal changes due to the medications you have been using. Corticosteroids can sometimes lead to changes in the cornea or exacerbate existing conditions, which might manifest as visual disturbances.

2. Impact of Medication on Eye Pressure: Regarding your concern about the Maxitrol ointment and its effect on your eye pressure, it is known that prolonged use of corticosteroids can lead to increased IOP, which, if left unchecked, can potentially damage the optic nerve over time. However, if your eye pressure is being monitored and managed appropriately with medications like Alphagan P, the risk of significant damage is reduced. It is crucial to have regular follow-ups with your eye care provider to monitor your IOP and assess any potential damage to the optic nerve.

3. Visibility of Floaters Upon Waking: Yes, it is possible for floaters or visual disturbances to be more pronounced upon waking. This can occur because, during sleep, the vitreous gel can settle, and upon waking, the sudden change in position and light exposure can make these floaters more noticeable. The phenomenon you describe, where the disturbances seem to diminish after about half an hour, aligns with this idea, as your eyes adjust to the light and your visual system stabilizes.

4. Bilateral Symptoms: The fact that both eyes are experiencing similar symptoms can be attributed to several factors. If the vitreous humor is causing the disturbances, it is not uncommon for both eyes to be affected, especially if there is a systemic issue or if both eyes have similar anatomical or physiological characteristics. Additionally, if the visual disturbances are related to the medications or any underlying condition, it is plausible for both eyes to exhibit similar symptoms.

In conclusion, while the symptoms you are experiencing could be related to the vitreous changes or the effects of your medications, it is essential to consult with your ophthalmologist for a comprehensive evaluation. They may recommend further tests, such as a dilated eye exam or imaging studies, to rule out any serious conditions and to ensure that your eye health is being adequately managed. Regular monitoring and open communication with your healthcare provider are key to addressing these visual disturbances effectively.

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