Flash in the dark

[kep31070]

A couple weeks ago, I noticed that when I woke up in the middle of the night to look at the time, I saw a bright star like image (like a droopy star) in the upper left part of my left eye.  After a second or two it fades away.  I close my eyes again, and when I open them it appears again only for a second or two before it fades away.  I would open and shut my eyes for 10 min and it would happen every time.  This seems to only happen in the dark when I first open my eyes.  I assume it may be happening in the daylight but just can't be seen as easily.  Lately, the "star" has changed into a "branch like" image.  Instead of a larger image, it is just lines all connected by a center branch.
Again, this only happens in the dark when I first open my eyes. Even if I lay down during the day with my cap over my eyes, it may still appear when I open my eyes, shaded by my cap, only after my eyes have been closed for awhile. I never see it during the day or in the light and my vision does not appear to have changed at all.
I do have chronic sinus problems and get headaches and eye pain often.  Could this be a result of sinus pressure/problems?  I am scheduled to see an eye doctor in a couple weeks.  Should I try to make a sooner appointment or just hang tight?

[J.A-M]

I am a type 1 diabetic and have had diabetes for 22 years. Quite recently I have been getting dark flashes, more often at night but occasionally a couple during the day. A month ago I was experiencing a dull ache in my eye but this has since stopped. I have been getting better control over my diabetes with a HBA1c of 5.9 and have even managed to reverse the mild retinopathy which was .5 on the scale. I made an appointment to go back and see my diabetic eye opthamologist after I had been experiencing these dark flashes which are more visible at night. I also get floaters but they are very small but on rare occasions I noticed a slightly larger floater coming down in my peripheral vision which goes and then I don't get it for quite a while. My opthamologist dilated my eyes and found that my viterous gel looked great and that my diabetes was doing really good. He did not see any tears or retinal detachment. I am getting quite anxious and not fully convinced though my Dr is very good. He wants to see me back in a month, could this mean that i will likely get retinal detachment?
Joanna

[John C Hagan III, MD, FACS, FAAO]

Hello Kep  It is very unlikely this is due to sinus. Most likley you are observiting an entoptic phenomenon. When you eyes are dark adapted they are much more sensitive than during daylight adaptation. They are sensitivie that pressure from pushing on the eye or a blink or a sudden movement of the eyes or head can cause a flash, pulse, arch.  Your description does not sound like a retinal detachment or posterior vitreous detachment.

Please use an internet search engine and read about entoptic phenomena. The entry on wikipedia is quite good. Keep your appointment. You do not have to be seen sooner unless something changes.

JCH III MD Eye Physician and Surgeon