What is this weird sensation I'm experiencing during certain movements of my eyes?
February 14, 2012 10:45 AM   Subscribe

I have a weird medical issue that has caused a couple internists to shrug their shoulders. It involves dizziness and an ability to hear my pulse when moving my eyes in a certain way.

Intermittently, for the past 4-5 years, I've had a bizarre issue related to eye movement. What happens is that, usually after 4pm, if I look down and then look way up and to either side, I hear two or three brief "swishes" (I assume this is my pulse), and each swish (think of the sound of dropping some sand on a hard surface) is accompanied by a very brief feeling of vertigo. The sound is always non-directional, not biased towards the left or the right.

I've told two of my primary care docs about this and their feeling was that, since I've lived with it for this long, it's probably not anything to worry about. This answer isn't especially satisfying to me, because the sensation that accompanies the "swishes" is very unpleasant, and it makes me just want to close my eyes and go to sleep. I feel slightly unsafe driving while it's happening, or doing anything that involves a lot of eye movement.

Does anyone out there experience anything similar to this?

I have a couple guesses at what might be happening, but I am definitely a layman about this kind of thing. One idea is that the muscles responsible for rotating my eyes (or maybe the ones that raise my brow when I look up) are somehow interfering with my inner ear when they contract, putting pressure on a blood vessel which results in hearing my own pulse.

My other hypothesis is that it is some kind of eye strain. I spend about 9-10 hours a day in front of a monitor, and the swishes typically happen towards the end of the day. That said, they also seem to happen on weekends, when I haven't been staring at a screen, so maybe that theory is busted.

If nothing else, I'd like some ideas in terms of what manner of specialist to book an appointment with. My first instinct would be to see an ear, nose & throat doctor, but maybe an opthamologist would be better?

I have been on a few medications for the entire time I've had to deal with the swooshes: Lyrica, tramadol, and trazodone, as well as Zyrtec. I'm a 32 year old dude with a BMI of around 29. Thanks in advance for any insight you may have!
posted by balistic to Health & Fitness (17 answers total) 3 users marked this as a favorite
Only thing I know that sounds similar to this: I had a friend who had somewhat similar symptoms (but getting much much worse over time with migraines and occasional blindness when looking in one direction), and she had to have brain surgery because there was too much fluid in her skull, and it was pushing against the back of her eyes.

Probably that's not the case here. But it could be something cranial, rather than a muscle/blood pressure thing.
posted by Jairus at 10:52 AM on February 14, 2012

Could it be the sound of your eyeballs moving? Apparently some people can hear their eyeballs moving.
posted by CutaneousRabbit at 10:57 AM on February 14, 2012

Best answer: Your symptoms sound a bit similar to those of one of my BFFs who has a very serious case of chronic labrynthitis*, so I would definitely recommend seeing an ENT person--she also had visual artifacts and dizziness with eye movement.

But obviously you want to see an opthalmologist as well. Book both appointments ASAP, as there is often a long wait to see specialists in both fields.

*She manages it with a bunch of meds, including inderal, and by following a pretty rigorous anti-inflammatory diet. There are still lots of things she can't do without getting dizzy and falling over, though.
posted by Sidhedevil at 11:01 AM on February 14, 2012

Response by poster: Thanks all.

I hadn't heard of the syndrome CutaneousRabbit mentioned, so I'll definitely be printing that link out.

Sidhedevil: yeah, the more I think about it, the more it makes sense to see both specialists. I'll get some recommendations from my PCP.
posted by balistic at 11:06 AM on February 14, 2012

I am afraid I would concur with your physicians--something stable for this long is is very unlikely to be problematic--I doubt if this can be assessed through Ask MeFi as the sensations are quite subjective. My guess is that it might be in someway related to a rapid change in the fluid in the inner ear. I have no idea about the sound unless it is the sound of vertebral cartilage grinding as you shift your head. I have difficulty imaging it is your pulse unless it is movement of blood moving through the carotid artery as you move your head. I suppose this could cause a slight sensation of dizziness. An important question is whether you feel faint ( blood supply to the brain) or dizzy (vertigo and ear). I would suggest you stop doing it and ignore it unless there are other neurological, circulatory or equilibrium problems.
posted by rmhsinc at 11:07 AM on February 14, 2012 [1 favorite]

Response by poster: rmhsinc: actually, there is no head movement involved. This is purely caused by the movement of my eyes in their sockets. Unfortunately I can't really stop looking around :)
posted by balistic at 11:10 AM on February 14, 2012

Response by poster: sorry, I missed your question about dizzy versus faint ... it's actually hard for me to say which describes it better. Faint might actually be a better descriptor, but it's so brief that I don't actually feel in danger of passing out.
posted by balistic at 11:12 AM on February 14, 2012

Based on your description, it sounds vaguely like a vasovagal response.

Before I had my nose fixed, I could do kinda sorta what you describe by pinching the bridge of my nose just so. That doesn't work now, although if I do it right, I can make myself sneeze instead.
posted by Pogo_Fuzzybutt at 11:28 AM on February 14, 2012 [1 favorite]

I can totally hear my eyeballs creaking sometimes! And in fact so can my boyfriend, who will immediately attempt to get me to sleep it off because it creeps him the hell out. (Though I think that might be a different issue from the syndrome listed above, because I'm not the only one who can hear it.) Do you ever have any other issues with balance or nausea? Motion sickness? I have felt a similar sort of lightheaded feeling, I think, but it's definitely a blood pressure issue and not at all connected to any micro movement like moving my eyes. You could also try reducing the pressure on your eyes during the day or maybe moving your monitor around, in case it's just an intense reaction to your job. But if it isn't changing in intensity or frequency, it may just be something to consider when doing activities like driving at night.
posted by jetlagaddict at 11:51 AM on February 14, 2012

I've never had this last for such a short period of time, but it vaguely sounds like how I feel when I get an acephalic migraine. I have had to pull over from driving from it; sometimes they lead to actual migraines, but often it's just 15 minutes of feeling really strange and crappy. Happens 2-3 times a year, now.
posted by dpx.mfx at 12:16 PM on February 14, 2012

@balisitic--fine physician I would be--I do not even accurately listen to the patients complaints--This is certainly beyond me--I am just having difficulty imagining anything but a quirk but if it concerns you get it checked out. Are you sure you are not moving your head when you move your eyes--and just out of perverse curiosity--why are you moving your eyes to those positions (way up and right and left) or are you trying to relax them.
posted by rmhsinc at 12:41 PM on February 14, 2012

Response by poster: dpx.mfx: I do get migraines of the headache variety, although fairly infrequently. I will look into that!

rmhsinc: no worries. It does impact my quality of life, in that it makes me not want to do much after work when I'm having an episode, other than go to sleep. Sometimes I will be fine for a couple months, and then it will happen every day for a week. The unpredictability is annoying all by itself. Also, the fact that one's eye movements really aren't very voluntary. For example, if I'm looking at my desk and then glance up at the clock, that can do it, or looking from the speedometer to a traffic light while driving. Those don't provoke a response as extreme as if I look hard-down and then hard-up-left, but it still causes a little dizziness.

Anything that would make you look down and then up is a contender for the swishes, with or without head movement.
posted by balistic at 1:32 PM on February 14, 2012

Best answer: This may be way out in left field but I think the tramadol may be playing a role. It acts on serotonin and norepinephrin and is similar to Effexor. See this page for more info. I have taken tramadol for at least a year, and I have experienced minor physical symptoms very similar to what you describe whenever I miss or am late for a dose.
posted by miaou at 1:35 PM on February 14, 2012 [1 favorite]

Response by poster: miaou: you know ... I was on Effexor briefly a few years ago, and the "brain zaps" I experienced when I quit taking it are non totally dissimilar to the swishy sensation I've been describing. I've been on the same Rx of tramadol (3x50mg a day) ever since I started taking it. I'm very consistent with the timing of my first two doses (one at 5:30 am, and one around noon), but I treat the evening dose as optional, and half the time don't take it.

It seems easy enough to experiment with, while waiting to see a specialist. Thanks for the suggestion.
posted by balistic at 1:52 PM on February 14, 2012

Some time ago, I went through a period where I had swishy noises in my ears (often triggered by tensing the muscles around my eyes) and periodic feelings of dizziness, often associated with tilting my head but sometimes without apparent cause. It turned out to be because of excessive liquid in my inner ear (I think?), probably caused by allergies/hayfever. The Dr recommended an OTC cortisone nasal spray which fixed things up pretty quickly. (Obviously IANAD, TINMA, but I thought the symptoms and circumstances sounded potentially similar).
posted by Cheese Monster at 2:12 PM on February 14, 2012 [1 favorite]

Try an otoneurologist.

Like dpx.mfx I have some similar symptoms to yours, which are associated with migraines. Sometimes my "migraines" consist only of these type of ear-related symptoms - hearing various noises, ringing, vertigo or roller-coaster feelings, tightness around the ears, sensitivity to sound, feeling of fullness in the ear, one ear hearing much louder than the other, etc. I've also had extreme tightness in my eye muscles as a symptom, but not the associated sounds you describe. But on the other hand, sometimes when I have these episodes I can hear muscles and tendons moving when I turn my neck, so maybe that's similar.

Sometimes they lead into "classic" migraines with head pain, sometimes not.

An otoneurologist was able to rule out problems with the inner ear and prescribe a preventative medicine to reduce the occurrence. Larger cities typically have an otoneurologist, but in my experience they tend to be booked out far in advance (4-5 months), so if you're thinking about going, make an appointment now.
posted by scrambles at 2:17 PM on February 15, 2012 [1 favorite]

Response by poster: Hey guys, just to follow-up on this: I'm seeing an opthamologist first, and if they don't have any clue, my PCP is going to send me to an neuro-opthamologist.
posted by balistic at 12:31 PM on March 16, 2012

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