Negative Scotomas?

This began back in November 2011.  Mid Nov I got a nasty cold - one of the nastiest I have had since I was a teenager (I just turned 31).  I was taking all sorts of OTC medication (Nyquil/Dayquil/Advil Cold/Zinc Drops).  The day I got better, I noticed a flash in my right eye.  Didn't think anything of it then a few days later I noticed when I woke up in the morning there were flashing lights in my peripheral vision.  Then the following happened:

1) Saw my regular eye doctor who did a dilated exam and found nothing wrong.  Suggested I see a retinal specialist.
2) Saw retinal specialist - he dilated eyes as well - did OCT's in both eyes.  Said everything was fine with the retina.
3) Follow-up visit 30 days later to retinal specialist - said he saw some dead eye cells but everything was fine.  Suggested this could be something to do with my viral illness back in Nov.
4) Fast Forward about a month ago and I noticed where the shimmering lights in my vision were, that these are actually blind spots - so I close one eye and have to find something to focus on (such as cable modem lights) and move my open eye left and right and the light disappears.
5) Went and saw regular eye doctor again who did another dilated exam and everything was fine.  Asked him about the scotomas (I did A LOT of googling recently) and he said I could very well have something lingering from the viral infection.

So now recently, I noticed these lights are beginning to happen a little more frequently.  I noticed pinhole flashes of light in the center where the scotomas would be.  The eye doc/retinal doc say everything is fine but it seems to have gotten a little worse.

Any thoughts on this?

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

A flashing light is not a negative scotoma its a positive scotoma. Negative are black areas. Suggest you see a neuroophthalmologist. Ask one of the two ophthalmologists you saw to refer you to one.

JCH MD

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

A flashing light is not a negative scotoma its a positive scotoma. Negative are black areas. Suggest you see a neuroophthalmologist. Ask one of the two ophthalmologists you saw to refer you to one.

JCH MD

[TheBigDeal20]

Thank you Doctor.  Just to clarify - when I am looking straight ahead I do not see anything abnormal in my vision (except for a few "sparkles" or "prisms" where I know the blind spots are) - when I close one eye and move my eye over something it just disappears - there is no black or white or anything - it's just gone.  Again, just in my peripheral vision only.  I thought if the patient was unaware of the scotoma it was a negative - which I have had this thing going on for about a year now and only JUST figured out that these sparkles in my eyes were actually blind spots.

I assume this is a "run don't walk" situation to the neuroophthalmologist?

[melinda68]

Are you sure that the peripheral flashing lights you have experienced haven't made you hypervigilant of your eyesight and that what your seeing is actually the physiological blind spot we all have?

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

walk don't run but get there. Melinda's observation is true. If you shut one eye seek out the blind spot you can make things (like the tip of your finger) disappear into it.
JCH MD

[TheBigDeal20]

Melinda - Thanks for your input.  No I assure you these are not the physiological blind spot.  I have what seems to be 3 of these spots in my right eye (at 12oclock 3oclock 5oclock) and 2 spots in my left eye (6oclock 10oclock).  I have looked up a blind spot test online and these are definitely separate than the normal blind spot.  I can close one eye and I can make almost 2 fingers completely disappear into each spot very easily.

Dr. Hagan - I first noticed these spots everytime I would get around bright light.  When I was in a darker room it seemed to go away.  Now almost a year later I notice the spots "flicker" when I'm outside and sometimes ill be a dimly lit room and I can see pinhole flashes of light exactly where the spots are.  I will certainly see a specialist about this.  I appreciate any further feedback regarding my comments to Melinda or You and will keep the board updated.  Thank you again.

[TheBigDeal20]

I guess I had better mention the most important thing - I have had these permanent now since November 2010 - the migraine question has come up - I did have an ocular migraine about 4 months ago but this was completely different in shape and location and most importantly it left my field of view in like 15 minutes.  These spots are part of the "decor" if you will.

[melinda68]

TheBigDeal,

The reason I chimed in is that I have something quite similar. I don't get the flashing lights, more like the after-effect of a camera flash. I've had this occurring in both eyes (not simultaneously) for the past 12 years. After the spots "settle down" - this varies from days to weeks to months - they leave a permanent negative scotoma in their place. I've seen many retina specialists over the years and had many tests, but no diagnosis.

I too suffer from migraine with aura and believe that while the visual manifestation is completely different, that the two are somehow related. I have spoken to numerous people with the same issue, and ALL have migraine with aura. So the correlation is anecdotal, but it's pretty convincing nonetheless.

[TheBigDeal20]

Melinda,

Very interesting.  Yes it seems we have something similar.  It has got to be genetic as my mother and grandmother both get horrible 72 hour straight migraine attacks with aura.  I personally have had only one in my life and that back a few months ago - again, it moved out of my field of vision within a few minutes and I got a nasty headache that lasted all day but was gone by the next morning.

This is why I came on here because I am worried that the Eye Docs/Retinal Specialists  found nothing wrong with the *eye* - but something could be terribly wrong with the brain or something else.  For several blind spots to be in your vision at once and not go away is odd - but I can't help but think this WAS related to that cold I had as, again, the day I got better this all happened.

Anyways, I appreciate your feedback and I am glad to know that I am certainly not the only one out there.  I will be even happier when we are free of these phenomena.  Take care!  

[chetna_nikhare]

hello sir... I saw ur precious suggestions here. I too have such shimmering light appearance in any field of vision. Initially its a very small region which later on spreads to almost whole of my visual field. Few months back, I had similar episodes which regressed within few minutes. Few dsys back, I had similar episode n now also having which wil regress in few min. I don't understand what to do because indirect and direct opthalmoscopy revealed nothing. Please suggest something sir.