Why am I seeing light patterns under stress & circular movement phosphenes at night?

[andrewtj]

Hello,

I am a 30 y.o. male without any chronic diseases. I don't smoke or do any drugs, and the alcohol consumption is moderate (avg 1-2 beers 3 times a week). The only diagnosed condition I had before was visual migraine.

4 years ago, after a prolonged stress, I was hospitalized with acute vertigo and panic. After a series of tests (electroencephalography, hearing tests, vision tests including dilated exam & visual field, MRI, CT-angiogram, of course blood/urine as well), the doctors didn't find anything remarkable (in particular, my vision was perfect as usual) and told me the anxiety was the cause.

However, they indicated one white spot less than 4mm in size in lower brain ("brain leg" or so) on MRI with an unknown genesis, and recommended me to monitor it in case it was the onset of MS. Since I haven't done an MRI before, their another hypothesis was that it had been there from the birth or some trauma (I had a couple in childhood, but without any evident consequences). The vertigo seemed to come and go, so I didn't bother anymore.

I have since made a couple of MRIs on the same machine with the same doctors (roughly each 1,5 years) - the only spot they noticed seems to be now even smaller (less than 2mm), not reacting to contrast injection. No other visible spots. The machine is good, it's a 1,5 Tesla GE. The radiologist (and the neuro's) opinion is "no MS signs".

But the problem is that I got new symptoms. First there was some pain in calfs (crampy, but no real cramps, no weakness), then some "fascicullations" (harmless, chaotic, come and go, mostly legs, and under stress), then the outer thigh skin on one side went numb (and still is) after some intense sports. My neuro sent me to lumbar MRI that showed "Tarlov cysts", on both sides, appearing to compress the nerve roots.

But the biggest question I have now is the vision. One year ago, when climbing a relatively easy 1000m mountain in winter, I noticed flickering lights in vision in both eyes. They were not like migraine aura at all: there was no growing fluctuating spikes. Instead, they were like camera flash effect, I could only see them on bright sky background and only after blinking. No blinking = no lights. Eyes closed or dark background = no lights. After I had some rest, the lights went away.

But they return on and on when the sun is very bright and/or it's hot and/or I'm exhausted physically (or, sometimes, mentally). They are not floaters, because they don't move across the vision field, and not "blood cells" for the same reason: it's a steady pattern as if I have just looked at some very bright light. The pattern is always the same: it looks like a star or a sniper crosshair, a dot in the center of vision with "rays" going out. The more exhausted I get - like climbing mountains or riding a bike for a long time - the more "rays" are there. The two eyes are affected very similarly, but the left eye usually starts to flicker earlier. Some days I don't have it at all, the other day I can have it alreay when getting up from bed under a bright sunlight. Coffee and poor sleep increase the chance of getting these lights, also making them worse.

And the other thing that I got recently is electric circles of light when I wake up or fall asleep, and I move my eyes in the darkness. This happens once in each direction, then the movement is free of the effect for ome time. But if I wake up while it's still dark, a couple of movements will produce the rings again, until they go away.

I don't have problems with seeing colors, no eye pain, only tiredness sometimes. So I did a dilated retinal exam again after all the symptoms, measured eye pressure - everything is perfect. My vision remains perfect even when I have these "stars" in eyes, they don't really obstruct things, only for a blinking moment they are there. Of course, keeping in mind the MS idea, the optician has spent lots of time examining me and found nothing dangerous, so the neuro thinks this is still some benign condition.

The question is, what to do now, because these light "attacks" are here already for a year, and every exercise or even a fast walk brings them on, especially in the bright weather. Sometimes, I get them simply from huge stress or a quickly changing weather. On the other hand, these "movement phosphenes" are also here for a year, and I haven't had them before, so I can't understand what to do with the eyes? Does it sound like a high intracranial blood pressure during exercise/stress? Cysts should've be related to the pressure, as far as I understand, maybe there's a link? Or can it be some weird type of optical neuritis, but without vision loss/pain? I can surely live with it and will make a scheduled MRI next year, but what if there's another option to check and get treatment?

Thanks,
Andrey, Moscow

[Myka01]

Do you know what was the cause of those movement phosphens?