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Dr. James
Dr. James, Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 2282
Experience:  Eye Physician and Surgeon
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Hi When I close my eyes I see flashes of light.. so I tried

Resolved Question:

Hi
When I close my eyes I see flashes of light.. so I tried keeping my eyes open and then covering them quickly with my hands.. even then .. I see these flashes of light.. especially when I watch TV in a totally dark room. or I have come in from bright sunshine..

It is driving my nuts.. I have read a lot abotu Opthalmic migraines.. to variosu neurological disease ..I hope I dont have anything serious.

I do nto haev eye pain.. I also see waves like heat waves when I lie down or when the room is has dim light
Submitted: 5 years ago.
Category: Eye
Expert:  Dr. James replied 5 years ago.
When did these flashes of lights start? One eye, both eyes? How old are you? Any medical problems (diabetes?)?
Customer: replied 5 years ago.

I am 30 no diabetes. lights started one year ago.. started in one eye.. now both eyes

 

I had retinal detachment in my right eye..am a very high myop and on top of that a baseball hit that eye.

 

I was very lucky in that I have been schooled on the symptoms of an RD.. so I rushed to a hospital and the surgeon (Dr. Michael Trese) put suckedsoem fluid that got behind the retina, froze it and then put a buckle in place.

 

Since then.. I went thru extrem,e anxiety and could nto sleep for a week.

 

My retinal docs have checked my repeatedly and they say both my retinas are great. One of the retinal docs decalred that I suffer from opthalmic migraines. :) but i dont know.. please ask me more questions so that I can give you a clearer picture

Expert:  Dr. James replied 5 years ago.
From what you described, your flashes do not sound like ocular migraines, which generally last from 20-30 minutes.

With your history of RD and subsequent surgery, it is possible that you are hyper-aware of flashes and the anatomic changes to the retina (buckle, cryo freezing) have made that part of the retina more sensitive and easier to illicit flashes.

I do not know what suckedsoem fluid is. Silicone oil is often used, but that that is eventually removed with a subsequent surgery.

If the flashes have been consistent for about 1 year, I would not worry too much. Flashes are not the problem. We tell patients to be aware of flashes, because it can be indicative of a retinal tear or detachment.

In your case, if you've had flashes, but all the exams have been normal, but that is your baseline. Your retina surgeon would only like to know if there has been a change in your flashes (such as sudden lightening storm or strobe light) or new floaters.

This change may need that the retina has change. So, if the flashes are about the same, no need to worry and keep your scheduled appointments.

I hope this helps. Please remember to press accept if I answered your question.

Dr. JMK
Customer: replied 5 years ago.

I would love to accept the answer.. but I have a few more questions. (I would gladly pay more to get them answered)

 

1. If I am hyper aware.. then why am I getting flahes in the other eye as well.

2. I see heat waves when I am in a area where the light is dim or when it is thundery outside OR when I am about to sleep.

3. When I yawn I sometimes see the same flashes.. but the funny thing is that I see flashes AFTER 10 - 15 seconds of yawning

4. I see flashes when I suddenly take a deep breath (the same sort of reaction that one gets when you take a suddn cold shower).

5. I see a bolt of lightning in my right eye.. once in a while.

6. i also see ring phosphenes ( read abt this in a web site) i.e. flash of light that travels around the circumfrence of my eye

 

The thing is that I can almost predict when the flashes are going to come..

 

note: 'suckedsoem fluid' that I had mentioned previously was a typo... I meant 'sucked some fluid' that got behind the retina.

 

Expert:  Dr. James replied 5 years ago.
To clarify:

#2-4: in both eyes, or only the eye that had surgery?

and what is the current vision in the right eye and left eye, with glasses or contacts?

Do you have a difference in prescription resulting from the surgery?
Customer: replied 5 years ago.

#2 - Heat waves started of in eye that had surgery.. now I get it in both eyes.. but when the heat waves start it still starts off in the right eye most of the time.

 

#4 - More flahes in my right eye (Rd eye) and fewer in my left eye

Customer: replied 5 years ago.

One more thing doctor.. after my surgery.. I got so firghtened that I complelely avoided contact with bright light for a few months.... could this also be a factor? ( read an article where prisoners, pilots and truck drivers who are in the dark for a longt time see flahes of light s and other visual disturbances.)

 

My bathroom is also pretty dimly lit.

 

IMPORTANT: the moment I step out of the hous eand I start driving my car all heat wabes stop

Expert:  Dr. James replied 5 years ago.
I'll try to answer them one by one.

#1: Being that you are a high myope, your left eye is presdisposed to retinal problems as well. High myopes have longer eyes, but the same amount of retina as most people. This means that the retina is thinner in the perphery. You may also have lesions called 'lattice geneneration'. These lesions have firm attachments to the vitreous and when you eyes moves the vitreous, can cause stimulation (flashes).

#2: The heatwaves you are seeing can be you seeing the material within your eyes. The vitreous is in the middle of your eye and is about the consistency of Jello. In the right eye, it was removed during the surgery and filled with a watery fluid (initially a balance salt solution, but now filled with aqueous fluid that the eye naturally produces). I have not had patients comment on seeing the fluid, but it makes sense that it can be visualized, especially in dim light or low contrast light (such as thunderstorms, cloudy days).

Now why in the other eye? In high myopes, you can have an early liquefaction of the vitreous (like jello when it is left outside). So it likely the same thing that is occuring with the right eye. You are looking there a more watery substance and can see the fluid better. Bright lights cuts through the watery stuff and clears it up.

#3-5: This is likely due to stimulation of the retina. When you eye moves, the liquid vitreous moves as well. It may lag behind a bit (likely accounting for the 10-15 second delay). You still have vitreous in both eyes (just less of it in the right eye) that is still connected to the retina. So movement of the vitreous will cause stimulation of the retina. Now, if you notice a change in the character of the flash, then it may mean the retina was not only stimulated, but could have been torn. Then you'll need a repeat exam to verify that there is not damage.

#6: Phosphene is defined as the sensation of light without actual light (aka flashes). This could be due to the surgery. You have a sceral buckle that likely encircles your eyes 360 degrees. You likely also have extensive cryo (areas that were frozen) as well as areas of internal laser. The retina/photoreceptors are not completely dead those areas. At times, they can misfire and causes flashes.

I don't think your light avoidance after the surgery is a cause. Also, if you are left in the dark for long time, you mind can play tricks on you and start to see light (trying to trouble shoot why it is not seeing).

Phew... I'm still happy to clarify if needed.
Customer: replied 5 years ago.

Doc

 

Firstly I apologize for having unknowingly mislead you , the fluid was not removed from my right eye.. only the bit that had gotten behind the cracked portion of the retina was somehow removed. No new solution was put in the eye.

 

After having read countless posts on opthalmic migraines one thing that stood out was the Heat waves (like the waves one sees coming off hot tarmac). I have them. (along with a C shaped scintillating scotoma in my right eye - I read about this in another journal)

 

Do you think I should go to a neurologist or a neuro opthalmologist to see if my brain is OK? ( please tell me that I don't need to). This post is my last Doctor.

 

I really appreciate the time and effort you have taken to answer my questions. Your answer about the 10-15 second delay and the ring phosphene make a lot of sense and have eased my confusion regarding them.

Expert:  Dr. James replied 5 years ago.
There are two types of retinal detachment surgery. One is to drain the fluid from the ouside of the eye, freeze it, then place a scleral buckle. Another is to have the vitreous removed and drain the subretinal fluid internally (vitrectomy). In young people, it is possible that her did the surgery from the outside of the eyeball. This is preferable because it limits cataract formation (is advisable in select patients, such as young patients with limited detachments that can be easily drained).

Ophthalmic migraines are typical in appearance. You can have these heat waves. Other characteristic descriptions has been cracked glass, zig-zag lines. These things increase over 15-20 minutes and then starts to fade away. These can happen anytime, but any lighting condition. Yours sound more reproducible, so it leads me to believe that it's coming for within your eyes.

Even if you did have ophthalmic migraines, it doesn't need to be treated. If you have them often, and it obscures your vision often enough that it is bothersome, then you can consider treatment. But most patients with ophthalmic migraines just needs reassurance and make sure it is not a retinal detachment. In your case, the retinal issues are known, and no need to treat ophthalmic migraines unless it evolves into typical migraines with headache. I don't believe that is the case with you.
Dr. James, Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 2282
Experience: Eye Physician and Surgeon
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