Dots in my vision, dots on my arm, and uh, hmm, what's the word?

April 28, 2009 11:05 PM

Since I last posted I've been feeling much better, but now have very new and strange symptoms. I've been seeing flashes in my vision, felt like I was misreading text or having difficulty expressing myself verbally (words came a bit more slowly than usual), and went to the ER when I saw (and a friend confirmed) my pupils were unevenly dilated. I've also had a recurring, painless rash of tiny red dots that is only ever present on my right hand, and comes and goes rather quickly. All symptoms started two or three weeks ago. I can't see a doctor for a week or two, but when I can, what kind should I see and what should I ask about?

When I was in the ER they tested my intraocular pressure with a tonometer and that was totally normal. The attendant doctor did not observe and problems with my pupils. An eye exam (non-dialated) didn't turn anything up. A CT scan was done as a precaution and (to my great relief) no abnormalities were found.

The flashes of light started occurring in my peripheral vision, and in those cases it's not really like I'm seeing anything so much as I visually detect movement out of the corner of my eye (turning my head, I see nothing. Since this started I've become hyperaware of my peripheral vision and occasionally experience what I think is a "flash" only to see it was a glint of sunlight off a car's hood or some other normal cause). I also see dots in my central visual field that are usually pinprick sized and stationary, lasting only a few moments, an experience not unlike seeing the cue dots in film. Occasionally these very tiny, bright, dots will meander about for a few moments (maybe a second at most) and then disappear. The largest "dots" subtend a portion of my visual field about as large as my thumb from knuckle to finger nail held at arm's length (these rarely move, but last slight longer than others). These are not afterimages... they seem to occur spontaneously in environments without obvious sources of concentrated light.

As far as the language use symptoms go, I feel like I make many more mistakes than usual reading - typical examples would be combining letters or sounds from two adjacent words and detecting a nonexistent one for a moment, or skipping over words entirely and having to backtrack when a sentence stops making sense grammatically. I find it's taking me longer to read in general. Likewise, I'm usually a pretty easygoing conversationalist and rarely have trouble expressing myself, but lately I've had bouts where words come with difficulty or I have to pay particular attention to form sentences. I ask people to repeat themselves fairly often.

All of these symptoms are episodic, seeming to occur for a few hours at a time, with no obvious pattern save that I generally feel better at night.

No real headaches outside a very dull ache every now and then. A bit fatigued. No fever or anything.

I'm going to see an ophthalmologist in a few weeks, and a neurologist after that, but in the mean time I'd like to figure out some likely causes of these symptoms.

posted by elektrotechnicus to health & fitness (10 answers total)

Also, I had a scintillating scotoma once about two years ago, and that's not what I'm talking about here.
posted by elektrotechnicus at 11:12 PM on April 28, 2009

I have no idea what is preventing you from seeing a doctor or ophthalmologist tomorrow morning, but whatever it is, get rid of it and get in to see one yesterday. Seriously. This is not normal behavior for eyes or brain.
posted by barc0001 at 12:02 AM on April 29, 2009

And by that poorly put together sentence I mean you need to see someone about this immediately. If your ophthalmologist has no space for you for a few weeks, find another one who can see you tomorrow.
posted by barc0001 at 12:03 AM on April 29, 2009

I agree with barc0001 that you need to see someone right away. Don't wait two weeks for symptoms like these. They are exactly the examples my eye doctor gives when talking about vision issues that need immediate attention and may indicate serious underlying problems.
posted by hurdy gurdy girl at 12:35 AM on April 29, 2009

Has anyone mentioned migraines to you? They could be manifesting differently in you.

But two weeks is too long to wait.
posted by barnone at 12:38 AM on April 29, 2009

Agreed, get thee to a doctor ASAP.

Agreed also, some of this sounds like it could be a migraine headache. I too once had a situation where I was seeing funny things in my field of vision - but no head pain (although I didn't feel really 'right'). The optometrist confirmed this was a 'textbook example' of a migraine headache.

Similarly high blood pressure (I had a bit of that too) can create effects in your vision like flashing dots, which I've also seen.

But again let the Dr. make the call.
posted by thermonuclear.jive.turkey at 1:47 AM on April 29, 2009

Since you mentioned scintillating scotoma, we know you have a history of migraine. Everything else you mentioned could all be migraine symptoms, and in your last question you mentioned stress, which is often a migraine trigger. Some of this could also just be the result of you noticing every last detail since you're already anxious about your health (and who wouldn't be, given how you've been feeling).

Anyway, it seems like there's a reasonable chance all of this is annoying but not serious. But you won't know that until you see a doctor, so just go see a doctor asap.
posted by dseaton at 4:02 AM on April 29, 2009

When you went to the ER, did they arrange for you to be seen by a neurologist or neurosurgeon? If not, go to a different ER.
posted by megatherium at 4:23 AM on April 29, 2009

Any time you see repeated unexpected flashes of light that you do not attribute to migraine, you should see a retina specialist within a day. If you have a retinal detachment, an appointment two weeks from now is not going to save your vision.

Note that if you have medical insurance, that is what covers the retina specialist. Eye care coverage that includes glasses prescriptions is not involved.

Here's a link to help you Find a Retina Specialist, if you're in the US or Canada.
posted by Ery at 6:12 AM on April 29, 2009

Correction: the link I just posted to Find a Retina Specialist is good world-wide, not just in the US or Canada as I had thought.
posted by Ery at 6:14 AM on April 29, 2009