Visual Disturbances: Noticing Lights with Eyes Closed
At 27 and experiencing obesity, I have been living with chronic migraines for the past four years. My treatment regimen includes Emgality, propranolol for my migraines and hypertension, and Ubrelvy as needed. Recently, I've observed an escalation in my headache severity. Approximately a month ago, I began to notice two illuminated rings forming when I tightly shut my eyes. These circles seemed to manifest in response to pressure; I didn’t perceive them when I merely blinked softly, but a more forceful closure would trigger their appearance behind my eyelids. Interestingly, these rings shift in accordance with the movement of my eyes—if I close my eyes while gazing upward and left, the rings adjust their position differently compared to when I’m looking to the right. The experience lasts only a brief moment when I first clench my eyes shut. This phenomenon is unfamiliar to me; however, I've encountered it consistently each day since its initial occurrence—particularly noticeable during nighttime or in dim lighting, though they're not present every time I shut my eyes. A few weeks back, I underwent an MRI, which yielded normal results. I also consulted with an optometrist, who confirmed that my eyes are in good shape, ruling out issues like retinal detachment. What I’m observing is distinct from floaters. After some research, I stumbled upon the term "phosphene," which seems to aptly characterize what I’m experiencing, though I'm uncertain if that is entirely accurate. Additionally, I recently encountered my first visual aura while suffering from a migraine, raising questions about a potential connection. Throughout the last few days, my eyes have felt fatigued or misaligned; something doesn’t feel right. Today, for the first time, I began seeing those rings of light even with my eyes open, particularly when moving them rapidly to the side, which has understandably caused me a bit of alarm given that they appear to be worsening. This leads me to my inquiries: (1) What could be causing these visual disturbances? Since my neurologist indicated that my brain scans are normal and my optometrist found no issues with my eyes, I’m trying to maintain composure, but it strikes me as unusual to suddenly develop new visual symptoms after four years of chronic migraines without previous visual disturbances. (2) Is there another specialist I should consult? Given that both the neurologist and optometrist have cleared me, should I consider an appointment with an ophthalmologist or my primary care physician?
Answers (1)
4/3/2025, 1:01:10 AM
OpenHealth AI
Thank you for sharing your experience, and it's understandable to have concerns about the changes in your visual symptoms, especially given your history of chronic migraines. Let's clarify the potential causes of these visual disturbances and outline some practical next steps to help you manage this situation.
Main Points:
- You may be experiencing phosphenes, which can arise from pressure on the eyes or stimulation of the retina.
- It's important to monitor your symptoms closely, as new visual disturbances warrant careful observation.
- Follow-up with healthcare professionals may be necessary for further evaluation.
Explanation:
Phosphenes are indeed visual sensations like light or patterns that can be perceived when pressure is applied to the eyes or when they are otherwise stimulated. These experiences can be benign, particularly if a neurologist and optometrist have ruled out serious underlying conditions. The fact that your recent visual aura occurred during a migraine could indicate a connection, as both phosphenes and auras can relate to migraine activity.
Your visual disturbances have changed and intensified recently, which is significant. Experiencing them with eyes open and with rapid eye movement can be new and concerning, especially when combined with your history of migraines and current medications.
Next Steps:
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Record Your Symptoms: Keep a detailed log of when these disturbances occur, including any accompanying symptoms like headache severity, visual aura occurrences, and general fatigue. This information can be invaluable for your healthcare provider.
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Follow-Up with an Ophthalmologist: Given your new symptoms, it may be worthwhile to consult an ophthalmologist who specializes in retinal and visual disorders. They can perform more specific tests than an optometrist might and can offer insights into whether there are any underlying issues you should be aware of.
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Communicate with Your Neurologist: Reach out to your neurologist to discuss the changes you've noticed, especially since they relate to your chronic migraines. They can assess whether your treatment needs adjusting or if additional tests or referrals are necessary.
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Monitor for Worsening Symptoms: Pay attention to whether the visual disturbances worsen or if new symptoms develop, such as significant changes in vision, additional auras, or other neurological symptoms.
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Self-Care and Stress Management: Continue managing your migraine triggers and stress levels, as they can impact both headaches and visual symptoms. Activities like regular exercise (if safe), sufficient hydration, and mindfulness techniques may also be beneficial.
Your observations are important, and it’s great that you’re proactive about your health. Stay calm as you take these steps, and don't hesitate to reach out for professional advice as needed. Let me know if you have any other questions or require further clarification.
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