Join 3,557 readers in helping fund MetaFilter (Hide)


Lightning flashes
June 12, 2012 11:48 AM   Subscribe

"Lightning"-type flashes in my peripheral vision. What the hell?

In the past week, I've started seeing these flashes in my peripheral vision. They're almost like one of those old-fashioned flashbulbs is going off behind me. I see them on both sides simultaneously. It happens maybe 2-3 times a day, and I can't find a pattern to when it happens.

I have migraines (without aura) that are not terribly well-controlled as of yet, and thus appear at some point every day, so I can't point to these flashes as being related to them for sure.

I have issues with my vision in general, but nothing has changed since I started having the flashes. I have trouble focusing my eyes on objects and often feel that I'm looking through them instead of at them. I wouldn't say my vision is blurred.

I'm on Topamax for the migraines and just started Mag 64 as a supplement to that.

YANMD, and I do have a call in to my doctor that I am waiting to have returned.
posted by altopower to Health & Fitness (33 answers total) 1 user marked this as a favorite
 
You could ask an optometrist for an opinion or checkup as well. They'll examine your optic nerves.
posted by OnTheLastCastle at 11:53 AM on June 12, 2012


How's your health/daily intake overall? Caffeine? Sugars? Sleep? Exercise? Stress? Anxiety?

Could you be experiencing side effects of Topamax or Mag64?

Really there's so many things that could be causing it that it'd be really hard to diagnose online unless you really think about all the factors affecting your body.
posted by samsara at 11:58 AM on June 12, 2012


Ocular migraine?

http://www.allaboutvision.com/conditions/ocular-migraine.htm

Definitely follow it up medically but the migraine connection seems like the obvious one.

The medical term is photopsia.
posted by nanojath at 12:04 PM on June 12, 2012 [1 favorite]


I have this (although usually when my eyes are closed) and my eye doctor told me that for some people it is part of the aging of the eye - the vitreous humor is condensing (or clabbering or solidifying or getting all old and icky-like) and pulling away from the wall of the eye, producing the flashes. I have no idea if this is a just-so story or not, but he did not seem terribly concerned given that all my other eye stuff checked out fine on examination.
posted by Frowner at 12:04 PM on June 12, 2012 [2 favorites]


At my last eye checkup, my optician warned me that I should be wary of early symptoms of a detached retina. Lightning flashes in your peripheral vision is one such symptom.
posted by plinth at 12:04 PM on June 12, 2012 [1 favorite]


Didn't link the ocular migraine article
posted by nanojath at 12:04 PM on June 12, 2012


Sounds very much like a detached retina. I would see a doctor much sooner than later.
posted by procrastination at 12:08 PM on June 12, 2012 [1 favorite]


Seconding procrastination - my sister had a detached retina. These were one of the warning signs. Get that possibility ruled out ASAP.
posted by rongorongo at 12:11 PM on June 12, 2012


Is it in both of your eyes, or just one? Unlikely to be a detached retina if it's in both eyes the same. If it could be a detached retina, see an eye doctor today: don't wait until next week.
posted by Ery at 12:12 PM on June 12, 2012 [1 favorite]


Most likely what Frowner said; it's called Posterior Vitreous Detachment (also here). But rips in your vitreous make you more prone to retinal detachment, so it's strongly advised to have an eye exam as soon as possible so they can make sure that's not going on. As people said above, that's not anything to screw around with. It's much more treatable when caught early.
posted by still_wears_a_hat at 12:14 PM on June 12, 2012


I've been told pretty much my whole life that flashes are a sign of a detached retina - I'm very much at risk for that. Get yourself to an optometrist as soon as you can, it's serious business.
posted by Mizu at 12:32 PM on June 12, 2012


Re: the posterior vitreous detachment...what I just read states it happens mostly between the ages of 50 and 80. I'm only 34! I guess anything's possible, and the description does seem to fit, but I hate to think that my eyes would be going that bad this early.

samsara: I drink a small amount of caffeine (I find it helps keep the migraines at bay a little bit) and eat reasonably healthfully. I do deal with depression and anxiety, and my anxiety has been through the roof lately dealing with issues with my daughter.

I'm not sure about the ocular migraine, because this is more of an instantaneous kind of thing...it flashes and that's it.
posted by altopower at 12:32 PM on June 12, 2012


Oh, and retinal detachment: I'm definitely concerned about that, but Ery dittoes my thoughts in that it wouldn't be both eyes at once, would it? And the flashes are definitely bilateral and simultaneous.
posted by altopower at 12:34 PM on June 12, 2012


I had this. I am at increased risk for detached retina, of which this could potentially be a sign, freaked out and had it checked right away by a retina specialist. He told me it was exactly what Frowner said above. And aging doesn't necessarily mean old; I was 30 at the time.
posted by rabbitrabbit at 12:34 PM on June 12, 2012


Ive had these - I also have migraines without aura. My mother has the same thing but she has migraines with aura. We just figured it had to do with our headaches.
posted by KogeLiz at 12:35 PM on June 12, 2012


Go see an eye doctor. I am blind in one eye due to a detached retina and have had two surgeries on the other due to retinal detachments.. ( just to make you go and get it checked i then had a cataract after the first surgery that needed replacing with an IOL , which because it was a bit soft when done then needed a YAG capsulotomy ) I still have the flashes due to the reattachments. You want to get simple laser treatment not multiple full retinal reattachment surgeries if it is that.
posted by stuartmm at 12:37 PM on June 12, 2012


I, too, was told that these could be symptoms of a detached retina (I'm at risk). I would see an ophthalmologist.
posted by jb at 12:37 PM on June 12, 2012


I've had posterior vitreous detachment since my...hm...mid twenties. Do you have terrible vision? I do.

Perversely, though, my eye doctor says that my eye shape and particular form of nearsightedness make me less likely to develop retinal detachment.
posted by Frowner at 12:40 PM on June 12, 2012


From the linked article about vitreous detachment:

Although a vitreous detachment does not threaten sight, once in a while some of the vitreous fibers pull so hard on the retina that they create a macular hole to or lead to a retinal detachment. Both of these conditions are sight-threatening and should be treated immediately.

Nearsightedness raises the risk of vitreous detachment, apparently. Are you nearsighted?
Also, do you have floaters? I've had a ton as long as I can remember, and apparently they derive from this detachment process.

You can have double detached retinas but it's rare.

I guess the take-away here is that you should see your eye doctor ASAP but it's most likely migraine-related or vitreous detachment.
posted by Frowner at 12:45 PM on June 12, 2012


Just had the return call from my doctor...she is sending me to the ophthalmologist, which is on Thursday. They didn't seem to think I needed to get in sooner than that.

I am nearsighted with moderately bad vision, nothing too terrible though. And I do have a few floaters. My gut tells me it's vitreous detachment, after hearing that younger people do indeed experience it.
posted by altopower at 12:59 PM on June 12, 2012


In case they didn't tell you - the ophthalmologist is probably going to dilate your eyes a lot more than your regular optometrist does. You might not be able to drive home - I wasn't after my visit.
posted by still_wears_a_hat at 1:39 PM on June 12, 2012


I've had these too but they seemed to be more stress/anxiety related. I think you're on the right path getting the serious possibility checked out first. But if everything checks out ok, I'd consider adding some Dramamine to your daily dosage (a personal favorite of mine due to low side effects/interactions...definitely run it by your pharmacist first though).

Anxiety can do some pretty scary things. It can also lead you towards neglecting some of your body's basic needs (sleep, nutrition, hydration, etc). If I had to guess..I would attribute this greatly to the anxiety you're experiencing. Get rested. Cut the caffeine for a bit, and stay well hydrated and nurished (vitamin supplements if necessary, in particular B12 or iron which when in deficit can cause flashy lights)

Again though, continue down the path you're on currently if your insurance can handle it. But if things show up negative definitely look into blood work and a re-evaluation of the meds you're currently taking.
posted by samsara at 1:50 PM on June 12, 2012


In case they didn't tell you - the ophthalmologist is probably going to dilate your eyes a lot more than your regular optometrist does. You might not be able to drive home - I wasn't after my visit.

Oh great. I have to go to work afterwards. They didn't say anything about dilation, and it didn't occur to me to ask. I'll call them tomorrow and ask...thanks for cluing me in!

samsara, I'm confused what you're recommending the Dramamine for. I get good sleep every night and as I said, eat reasonably well. Hydration level does leave something to be desired, admittedly. I had vitamin levels checked last year and I was on the low end of normal for B12 and deficient in D so I take supplements. I don't remember about whether iron levels were done or not. I agree that anxiety could be contributing to whatever this is, because the change in my anxiety level has been relatively recent (since maybe March or so) and it has inched ever higher since then.
posted by altopower at 2:06 PM on June 12, 2012


I would bet on Topomax side effect. Talk to whoever prescribed your meds. This isn't a "NEED TO GO TO ER!" emergency, but visual disturbances aren't really a sign of anything good neurologically speaking. It could be a harmless med side effect where you either get the fun of "Oh hey, I see shit sometimes" or have your dosage adjusted. Or it could be a sign that your migraines are - for lack of better term - evolving, in which case your neuro will want to keep an eye *pardon the pun* on it.

Getting in to see the eye doctor is absolutely the best place to start as problems there are way more serious than a meds side effect. If they don't find anything though, look into getting your Topomax dosage checked. Anticonvulsants can do so some pretty wonky things.
posted by sonika at 2:37 PM on June 12, 2012


I get these, too, as well as some other odd flashy vision things that I found very disturbing. Dr. Google and Dr. AskMe were concerned it might be a detached retina, but after multiple visits to several eye doctors, including a specialist, and including having them look specifically for optic nerve and retina issues, I have been assured that there's nothing wrong with my retina or optic nerve. No one seems to know what's actually going on, and the unsatisfactory answers from eye docs usually have something to do with blood pressure, physical pressure on my eye, or ocular migraines. Not exactly helpful, except that now you know it might be nothing serious at all.
posted by rhiannonstone at 2:53 PM on June 12, 2012


Having had a retinal detachment and ocular migraines, this sounds more like the detachment. But it's on both sides simultaneously, which is weird. I went for a checkup because things just didn't look right, but I couldn't figure out why.
Bright white flashes that disappear before you can look to see where they came from is also how my detachment looked. I'm glad you're going to an ophthalmologist!

They'll dilate your eyes as much as possible, yes, so they can see the periphery of your retina.
posted by BigJen at 2:56 PM on June 12, 2012


I had a friend who had a congenital deformity of the rear surface of the eye who had simultaneous detachment.

But it is probably rare - his doctor had never seen that and in fact their initial thought was that the issue was some kind if blood pressure issue or a neuropathy or MS.
posted by rr at 3:27 PM on June 12, 2012


I'm confused what you're recommending the Dramamine for.

It's a recommendation for the elevated anxiety while being on anti-seizure/nervous system medications. Dramamine is one of those cheap, low interaction, over the counter medications that to me is somewhat a side-effect inhibitor. It's primaily recommended for combating nausea/motion sickness, but due to it also being a depressant, it may very well help smooth out any stress or anxiety spikes without you having to go to something more serious/pricey like Xanax.

Dramamine was the one thing that got me through the anxiety of having a haital hernia a few years ago. (and believe me on anxiety...it was playing havoc on my vagal nerve...a twitchy little bugger that runs from the stomach to the brain. I would have episodes of vagal syncope where my blood pressure would suddenly drop and I'd see flashes of lights or twinkily stars in both eyes, ringing in my ears...it basically helped break me out of a cycle of my condition triggering my nervous system, and my nervous system triggering my condition). Now I only take it as a poor man's sleeping pill. Still...a very handy and often overlooked medication that is not often pushed by pharmas due to the low profit margins I suppose. YMMV, I just wanted to offer that as something low risk to try.
posted by samsara at 4:14 PM on June 12, 2012



I get these, too, as well as some other odd flashy vision things that I found very disturbing. Dr. Google and Dr. AskMe were concerned it might be a detached retina, but after multiple visits to several eye doctors, including a specialist, and including having them look specifically for optic nerve and retina issues, I have been assured that there's nothing wrong with my retina or optic nerve. No one seems to know what's actually going on, and the unsatisfactory answers from eye docs usually have something to do with blood pressure, physical pressure on my eye, or ocular migraines. Not exactly helpful, except that now you know it might be nothing serious at all.


This was my experience as well. Opthalmologists and opticians have found nothing out of the ordinary, and one told me to consider the phenomenon my own private light show. This started over ten years ago, so that now I hardly notice them. I don't get migraines but I do have low blood pressure - he did not mention either one as related to the flashes.

So yes, see a doctor, but don't wear yourself out worrying in the meantime. It could be nothing.
posted by caryatid at 4:39 PM on June 12, 2012


My gut tells me it's vitreous detachment, after hearing that younger people do indeed experience it.

I'm going with your gut (plus the several comments suggesting vitreous detachment), and I think sonika is right that it's a side-effect of Topamax:
Topiramate and the vision: a systematic review

Topiramate (TPM) is a sulfa-derivative monosaccharide that is used mainly for treating epilepsy and preventing migraine. Within the gamut of side effects attributable to this drug, ophthalmologic manifestations are of crucial importance. In this study, for the first time, the aim was to provide a systematic literature review regarding this issue.
...
In another report on two cases, authors attributed the evolution of rhegmatogenous retinal detachment to long-term administration of TPM (in one case 18 months and in another case 12 months).75 In both cases, the presenting symptom was flashing. Also, one of the cases presented lattice degeneration. In response to this report, Natesh99 in a letter to the editor suspected the relation of TPM to rhegmatogenous retinal detachment and related the symptoms to posterior vitreous detachment. He emphasized that rhegmatogenous retinal detachment has a completely different mechanism from ciliochoroidal effusion syndrome.
[my emphasis]

I think you experienced the flashes in both eyes simultaneously because, as I Googled this stuff, I saw a bunch of anecdotes saying that the flashes associated with vitreous detachment occur when you shift your eyes suddenly, which you do with both eyes, obviously, and which could put the same kind of tension on both at the same time.
posted by jamjam at 6:17 PM on June 12, 2012


jamjam, that's really interesting...lots to think about there. The doctor I spoke with is the one that I work with for my migraines, so she's definitely on the ball with those.

I've got transportation worked out for my appointment tomorrow so I don't have to worry about driving with the crazy dilated eyes. I'll still have to go to work, but that'll be fine.
posted by altopower at 2:31 PM on June 13, 2012


Well, the ophthalmologist has deemed this to be ocular migraines. I'm not sure I buy it completely, but we'll go with it for now since there's nothing to be done for vitreous detachment anyway. I still think it's weird to consider them migraines as they are instantaneous flashes.
posted by altopower at 10:14 AM on June 14, 2012


Migraines might not involve pain. There are types of migraine that mimic seizure activity or just come as auras. Some quick searching on ocular migraine describe what you're talking about - visual disturbance without headache.

In any case, glad to hear your retinas are fine and best of luck!
posted by sonika at 4:41 PM on June 14, 2012


« Older We dated for quite a while, bu...   |  Is there sufficient likelihood... Newer »
This thread is closed to new comments.