Eyes

Eye flicker: causes, diseases and therapy


Flickering before the eyes

The term "eye flicker" (or "eye rush") usually describes a visual phenomenon in which small, glowing points move "flickering" in front of the eye or eyes, making clear vision difficult. The dots can appear very differently in terms of number and color. A distinction is also made between short-term and persistent eye flicker.

Flickering eyes are not an independent disease. Instead, it can be a symptom of very different diseases such as migraines, glaucoma or choroidal inflammation. In order to avoid severe, irreparable damage to the retina or, in the worst case, even blindness, an eye doctor should always be consulted for eye fibrillation.

Definition

The term "eye flicker" or "eye noise" describes a form of vision disorder in which small, snowflake-like points of light move in front of the eyes and thereby obstruct the view. It is characterized by a constant flickering of these points, which can occur quite differently in terms of number, intensity and color.

A distinction is made between short-term and permanent flickering of the eyes: While the short-term rushing of the eyes disappears after a certain time, those affected permanently suffer from the flickering points of light that do not disappear even when the eyes are closed. In some cases, a slightly blurred view is reported before the actual flickering begins - a feeling as if you were blinded or looked into a chain of lights.

The intensity of the flicker can vary widely. Sometimes it starts very abruptly and violently, in other cases it starts very slowly with diffuse visual disturbances, for example, in black waves that spill into the outer edges of the visual field (i.e. the area that people can see with the still eye) Pull the middle while getting stronger.

Often, those affected report that the attacks are very strenuous and that they result in severe fatigue and exhaustion. Other possible side effects are tension-related neck pain or back pain, dizziness, nausea or motor disorders.

Eye flicker due to fatigue and stress

The flickering dots are in most cases an expression of severe fatigue, eye strain or stress. In this case, the visual disorder usually disappears relatively quickly as soon as the person has recovered or stress and tension have been reduced.

If the eye rush occurs as a result of eye strain (for example due to long work on the PC), it can be prevented quite easily. For example, care should be taken to take regular breaks of about 10 minutes every two hours, during which the gaze is turned away from the screen so that the eyes can recover.

Cause migraines with aura

A so-called "migraine with aura" is often the cause, in which the flickering occurs before the onset of the headache as a neurological symptom. A migraine is characterized by attack-like, strong, throbbing, pulsating or boring headaches, which in most cases occur on both sides in adults and on both sides in children.

An attack can run in different phases and can manifest itself in very different symptoms. In many cases, this is announced by a “harbinger phase” that occurs a few hours to two days before an attack and usually lasts one to two hours.

In this phase, fatigue, increased sensitivity to noise, frequent yawning, fluctuations in appetite and mood are often seen as “harbingers”. Other “alarm signs” are cravings, increased irritability and gastrointestinal problems such as constipation, diarrhea or stomach pain.

In about 10 to 15% of migraine patients, the so-called “auraphase” follows the precursor phase, which is primarily characterized by visual disturbances. This is where the term "migraine with aura" comes from.

The aura can appear in many different ways: Often, those affected report glittering, jagged arches, stars, circles or rectangles in all possible colors that flicker or wander around in front of their eyes. Others describe this visual phenomenon as a cloudy, milky veil, glowing flashes, sparks, flickering dots or lines that gradually spread from the edge of the field of vision to the inside or vice versa and thus lead to a weakening or loss of vision (flicker scotoma ).

Often, there are parallel sensitivity disorders, such as the loss of touch or tingling sensations in the arms, legs and face, which slowly develop, but also disappear completely afterwards. Speech disorders as well as disturbances of smell and balance are possible during the aura phase. In rare cases, one-sided muscle weakness or paralysis in the arms and legs can occur.

How strongly the aura phase is perceived differs from patient to patient, in some cases the aura is so visually pronounced that those affected perceive themselves or their environment in a hallucinatory way ("Alice in Wonderland Syndrome").

The aura phase usually lasts no more than an hour and occasionally occurs without a subsequent headache phase. As a rule, however, the agonizing phase of the migraine follows, in which there are hammering, pulsating or stabbing headaches. These occur predominantly on one side in the area of ​​the forehead, temple and eye and are intensified during physical exertion. Rest, on the other hand, helps alleviate the symptoms.

Most patients not only suffer from headaches during this phase - there are also other symptoms such as loss of appetite, nausea and vomiting, diarrhea, chills and extreme sensitivity to noise and light. If the trigeminal nerve is activated during the attack, neck pain may also occur.

This is followed by the "regression phase", in which the hammering or stinging in the head subsides and the accompanying symptoms gradually disappear. This phase can be of different lengths, in some patients it can take up to 24 hours to become symptom-free again. In these cases there is often severe exhaustion and tension.

The causes of the migraines have not yet been finally clarified, instead there are a number of theoretical approaches to explain the neurological disorder. These include, for example, circulatory disorders in the brain or genetic factors, since the disease often occurs multiple times within a family.

The so-called “trigger factors” play a central role, which are used to denote various triggers of a migraine attack. A large number of such triggers are known, for example hormonal influences (period, menopause, pregnancy, pill), stress, a disturbed bio-rhythm or sleep-wake rhythm or certain foods such as chocolate or cheese. Likewise, seizures often begin when those affected have not had enough fluids beforehand. Furthermore, bright light, alcohol, nicotine, heavy physical exertion, caffeine withdrawal or certain weather conditions can be considered.

Glaucoma

Rushing eyes can be a symptom of a so-called "green star" or glaucoma, which refers to a group of different eye diseases. With these, increased cavity pressure (excavation) and circulatory disorder of the optic nerve head (papilla) develops due to increased intraocular pressure, which leads to visual disturbances that restrict the visual field (visual field loss). In the worst case, you could even go blind.

Glaucoma is a treacherous disease because in most cases it develops gradually and shows no symptoms for a long time. Accordingly, the disease is usually in a later phase when it is diagnosed. Many sufferers initially notice reduced vision, as some things are no longer perceived correctly and, for example, orientation problems arise in road traffic. In addition, there may be other symptoms that vary depending on the type of glaucoma.

The most common form of glaucoma is "primary open-angle glaucoma". The optic nerve is slowly but steadily damaged, but those affected do not feel any restrictions over a long period of time. Older people from the age of 65, diabetics, patients with cardiovascular diseases, eye inflammation or myopia are particularly affected. There is also an increased risk for people whose families have a large number of glaucoma.

Another form is the so-called "glaucoma attack" or "acute glaucoma", which is a very serious case that requires immediate treatment. Here the eye is very red, the pupil no longer reacts to light stimuli and the eyeball feels hard. Eye pain and disturbances in vision (for example flickering, seeing double images, bright spots, lightning, "tunnel vision") occur, which can lead to blindness if not treated. Some patients also suffer from symptoms such as headache, nausea and vomiting. Farsighted people are particularly often affected due to the shortened eyeball, as are those with many cases of glaucoma within the family.

Congenital or hereditary glaucoma is another variant. This is mainly characterized by a strong sensitivity to light, cramped eyelids and watery eyes. In infants, unusually large eyes in some cases indicate congenital glaucoma - therefore, a doctor should always be consulted for any suspicion.

It can also be a "secondary glaucoma", which is triggered as a result of another (eye) disease, an injury to the eye or in some cases also by certain drugs. Depending on which disease is responsible for the glaucoma, this is often asymptomatic, but can also be similar to a glaucoma attack.

Choritis (choroiditis)

The flickering spots in front of the eyes can be caused by choroidal inflammation (or medically "choroiditis"). The "choroid" represents the largest section of the middle eye skin (tunica media bulbi) and forms the middle layer between the white eye skin (sclera) and the retina (retina) in the back half of the eyeball. It contains many blood vessels and fulfills two important functions by regulating the nutrient supply and temperature regulation of the outer retinal layer.

If the choroid becomes inflamed, this gradually leads to loss of vision in the affected eye. This can be triggered by chronic sources of inflammation (e.g. teeth, tonsils) or rheumatic diseases. A connection with the infectious diseases toxoplasmosis and syphilis is also suspected. In many cases, the inflammation develops with no apparent cause.

Since the choroid itself lacks sensitive nerves, pain only occurs in the event of inflammation if adjacent areas are affected. Many sufferers, however, show increased eye pressure, as well as a marked deterioration or impaired vision in the form of fibrillation or distorted vision.

Eye flicker due to retinal detachment

Another possible cause is retinal detachment. This happens rather rarely, but must be treated immediately in any case, otherwise blindness could result. When the retina is detached, the retina of the eye lifts up from the choroid (pigment epithelium) underneath, which can result in fluid accumulation in the gap between the layers.

The so-called "photoreceptors" are located in the retina, which absorb light and color stimuli and thereby make vision possible. The retina is normally supplied with oxygen and nutrients through the choroid - but if the two layers are separated from each other, the supply can no longer be maintained. If this condition lasts longer, there is serious retinal damage, which is usually irreversible.

A retinal detachment is usually caused by a tear (rhegmatogenic retinal detachment), which occurs because the gelatinous glass body that lines the inside of the eyeball becomes smaller over the course of life. If it shrinks, it exerts tension on the retina where it can adhere until it tears. As a result, small holes are created through which liquid pushes out of the vitreous body, which ultimately leads to the retina being raised.

In most cases, rhegmatogenic retinal detachment affects older people. Furthermore, myopia due to the lengthening of the eyeball or the operation of the so-called “cataract” can have a beneficial effect. This form of retinal detachment can also be the result of external influences such as a bruise on the eyeball.

Another form is the so-called "exudative retinal detachment". Vascular fluid collects in the gap between the light-sensitive layer of the retina and choroid, which leads to detachment of the retina. In most cases, the cause of this is an eye infection. A tumor such as choroidal melanoma (or malignant uveal melanoma), which is the most common primary tumor of the eye, is less common.

The reason for detachment of the retina can be the scarring of vitreous tissue and / or retinal layers (tractive retinal detachment). Here the area around the scar is shortened, which exerts a tensile effect on the retina. This form is triggered by severe retinal damage due to longstanding diabetes mellitus or by injuries. It can also occur as a late consequence of retinal damage in premature babies. (Premature retinopathy, short: RPM).

If the retina is detached, it can only perform its functions to a limited extent. In most cases, this leads to flashes of light or fibrillation of the eyes, which occurs especially when the eyes move suddenly and at night or in the dark.

If blood vessels are injured due to the tear, black dots or floating small particles may appear, which usually fly back and forth in large numbers and remind of a swarm of black mosquitoes ("soot rain"). However, this symptom should not be confused with the suddenly occurring so-called "mouches volantes" (French for "flying mosquitoes"), which are a kind of transparent streaks or dots, which are mainly used when reading or looking at things, for example on a bright wall. Because black spots in front of the eyes are often harmless and only signs of a vitreous opacity. Nevertheless, an ophthalmologist should always be consulted as a precaution.

A lifting of the retina usually results in a restriction of the visual field. How this looks exactly depends on where the detachment took place. For example, a separation in the lower area of ​​the retina can result in those affected perceiving a shadow coming from below. When detached in the upper area, the shadow or the black wall appears from above.

However, it should be borne in mind that there is no clear scheme. The loss of the visual field can be very different, but in most cases it occurs unilaterally. If the retinal detachment takes place in the middle of the retina ("yellow spot" or "macula"), the person affected can no longer see clearly. However, pain usually does not occur when the retina is detached.

Myopia

With strong myopia (myopia from "Myops": Greek "Blinzelgesicht"), eye flickering can occur. Short-sightedness is a visual defect in which sharp vision in the distance is not possible or only possible to a limited extent. The reason for this is that the so-called "far point" of the eye in short-sighted people is not in the infinite, as in normal-sighted eyes, but in front of the retina.

How close it depends on the number of diopters. With a value of -2.0 diopters, for example, the far point is 0.50 meters. A nearsighted person with -2.0 diopters can see everything in focus up to 50 cm in front of his eye, but beyond that the focus decreases further and further. A distinction is usually made between mild (usually 3.00 D or less), moderate (between 3.00 and 6.00 D) and strong myopia of 6.00 D or more.

Depending on when myopia develops, four types of ametropia are distinguished: firstly, the form in which it is present from birth and secondly, the form that develops at the age of 10-12 years and its constant intensification in usually ends at around 22-25 years. Third, there is a short-sightedness that only begins to develop from the age of 20, as well as the rare form of myopia, which only develops from around 40 years of age.

In addition, a distinction is made with regard to the degree of visual impairment due to myopia: While the common form "Myopia simplex" with up to approx. -6 dpt is strong and therefore "moderate", "Degenerative Myopia" or malignancy Myopia with significantly more than -6 dpt represents an eye or visual impairment.

Various causes can be considered for myopia. The most common is the so-called "axis myopia", which is usually inherited recessively and affects premature babies much more often than "mature" newborns. This form - which in most cases develops over the course of the first three decades of life - gradually leads to a strong elongation of the eyeball.

The reasons for this development have not yet been clarified; in addition to the genetic predisposition, external influences such as insufficient sunlight or daylight, reading in poor light or constant work close to the PC screen would be conceivable. Refractive myopia is less common than “axis myopia”, which can be caused by an increased curvature of the cornea or lens, but also by an increase in the refractive index of the lens due to clouding of the lens nucleus. This also causes the image on the retina to be out of focus.

The ametropia is only clear when seeing in the distance, because nearsighted people can usually look well without a visual aid and therefore have no problems when working on the screen or reading. The first sign of developing myopia is often poor vision in the distance in the dark, which is particularly noticeable when driving. Adolescents, on the other hand, often do not notice the beginning at all, but only realize later that they can no longer clearly see the blackboard, for example. Other signs include Problems reading street names and house numbers, out-of-focus illuminated signs, lamps, or faces of people. In addition, there is often a headache due to the increased effort in activities that require “focusing” or distant vision of the eyes.

In the case of severe myopia there is a risk of vitreous detachment. In this case, the vitreous body rises spontaneously from the retina, which can usually lead to visual disturbances such as small black dots, spots or thread-like structures in the visual field ("Mouches volantes") as well as eye flickering or flashing on the periphery of the visual field.

If eye flickering occurs, it is important to consult a doctor immediately. This is the only way to prevent serious, irreversible damage to the eye or, in the worst case, blindness. It is advisable to see a general practitioner in addition to an ophthalmologist to thoroughly check whether the trigger for the flickering may be another disease. If this is the case, the next step is to treat the disease in a targeted manner so that it can also be used to combat eye flicker.

Treatment for migraines

People who have suffered from migraines for years have been unable to treat them successfully. Instead, it's primarily about relieving symptoms and avoiding further attacks. In acute attacks, it helps most of those affected if they retreat to a dark, quiet, low-stimulus room, relax in their sleep and put on cold compresses. Proven home remedies for migraines are, for example, teas with willow bark and butterbur or a temple massage with peppermint oil.

In order to get a grip on the disease in the long term, it is advisable to deal intensively with the trigger factors in question and, accordingly, to avoid certain foods or alcohol. In addition to this, it is important to pay attention to a balanced "bio-rhythm" and to always keep an eye on the personal stress level or to alleviate increasing pressure and tension with suitable techniques and exercises to reduce stress.

There are a number of medications that can be taken for the condition. The mild to moderate form often uses over-the-counter pain relievers such as acetylsalicylic acid, paracetamol or ibuprofen. Combination preparations of acetylsalicylic acid, paracetamol and caffeine are often recommended, which are said to be more effective due to their composition.

In more severe cases, so-called "triptans" can be used: they interfere with the serotonin metabolism, constrict the blood vessels and thus act against the headache. However, the remedies must not be taken for coronary heart disease or other vascular diseases. If sufferers have to deal with nausea and dizziness during a migraine attack, "anti-emetic agents" (antiemetics) can be helpful, which have the additional positive side effect that the pain medication is better absorbed by the body and the effectiveness increases.

In the case of more severe courses, migraine prophylaxis is advisable, for which the doctor selects the "right" active ingredient after carefully considering the case. There are also non-drug options for prevention, such as relaxation methods (progressive muscle relaxation, autogenic training), acupuncture and, if necessary, behavior therapy, which can significantly reduce the risk.

Glaucoma treatment

A glaucoma always requires treatment to avoid serious visual disturbances that restrict the visual field (visual field loss) or, in the worst case, blindness. How the treatment is carried out depends on the type of glaucoma:

Acute glaucoma is a medical emergency that must be treated promptly to minimize the risk of blindness. First of all, the most important task is to lower the high intraocular pressure. This is done with medication, for example, with so-called "carbonic anhydrase inhibitors" (such as acetazolamide) in combination with beta-blocker drops.

In order to prevent further acute glaucoma, a small hole can be surgically created in the iris through which the eye water can get directly from the back into the anterior chamber and thus the intraocular pressure can be regulated. With frequent primary open-angle glaucoma, eye drops (for latanoprost or timolol) are usually used as the first to minimize the pressure inside the eye. If these do not work, laser treatment of the eye helps in many cases. If this is unsuccessful, there is usually only an operation that creates a drain for the eye wash.

While the congenital form is usually treated surgically as early as possible, treatment for secondary glaucoma depends on the underlying condition that needs to be treated in the first step. In addition, eye drops are also usually used.

Treatment for choroidal inflammation

If there is inflammation of the choroid, eye drops containing cortisone are prescribed as soon as possible, which in combination with cortisone-free anti-inflammatories (in the form of eye ointments or drops) are sufficient in many cases. In order to avoid sticking between the iris and lens due to the inflammation and thereby possible visual disturbances, drops are often given to dilate the pupil (mydriaticum). If the choroidal inflammation is based on a bacterial infection, targeted antibiotic therapy is carried out. This must be carried out in sufficient dosage and over a sufficient period of time to completely kill the pathogens.

Treatment for retinal detachment

If a retinal detachment is suspected, a doctor must be consulted immediately in any case. If the state of undersupply of the retina lasts longer, there is a risk of irreparable damage and, in the worst case, blindness. If the suspicion is confirmed, detachment of the retina and a tear cannot be treated with medication. Instead, laser therapy is often used in the preliminary stages of retinal detachment, through which an injured area can be “glued” and thus prevented from being lifted off.

If the retina has already detached, an operation by a specialist is required in any case. The respective method is chosen depending on the severity of the detachment and the cause. The aim of the operation is to fix the retina again and to fix the causes as much as possible. Since such an operation is very demanding, those affected should get as much information as possible about where they can have it performed. At the same time, however, the urgency of the procedure should not be underestimated, because if the retina is not surgically removed, there is a risk of blindness.

Therapy for myopia

In the case of myopia, glasses or contact lenses are primarily used for the purpose of correction. In addition, there is the possibility to correct the ametropia by means of an eye operation (for example laser), which has become increasingly popular in recent years due to cosmetic aspects. From a medical point of view, an intervention is only necessary in very few cases.

Naturopathy for fibrillation of the eyes

If serious causes such as retinal detachment could be ruled out, naturopathy offers a variety of therapeutic alternatives for fibrillation. Since the visual disturbance is very often an expression of overexertion or stress, exercises and techniques for stress relief such as autogenic training, hypnotherapy or martial arts such as Tai Chi and Qigong are particularly suitable.

In order to relax the eyes, it helps - especially when you are constantly working on the PC screen - to take a short break of about 10 minutes every two hours, in which the eyes are closed briefly or a brief moment is spent in the fresh air. A small eye massage quickly has a beneficial effect in many cases. For this purpose, for example, the upper edge of the eye sockets with closed lids is gently massaged in a circular motion from the root of the nose to the outer edge of the lid.

Eye exercises can be carried out easily and quickly in between with flickering eyes and help to relieve tired, overworked eyes. There are various options here: stroke or pat your face e.g. slightly with your fingertips from top to bottom. Or loosen the facial skin by gently pinching or pinching it. This creates new energy quickly and you can see more clearly again

When you are working hard on the screen, shield your eyes from the stimuli for a moment to relieve them.

Exercise against eye flicker
  1. Cover your eyes with your hands so far that no light comes in
  2. The elbows are supported loosely, the back should be as straight as possible
  3. Close your eyes and take a deep breath in and out
  4. And consciously perceive what is “visible” behind the closed eyes - for example colorful dots, colors, lines or spikes
  5. As soon as only black is visible, a deep state of relaxation usually occurs
  6. Enjoy this state intensely for a moment
  7. Then the palms are removed from the eyes and the eyes are opened
  8. Pause for a moment until your eyes get used to the brightness again

Since fibrillation is very common in connection with migraines, there are a number of naturopathic therapeutic approaches that can help to alleviate the associated symptoms. In addition to acupressure and yoga, transcutaneous electrical nerve stimulation (TENS) has proven itself. In this case, two or four electrodes are attached to the patient's head, through which weak electrical currents are conducted. Deren Stärke und Häufigkeit ist frei einstellbar, bis eine Schmerzlinderung eintritt.

Die so genannte Biofeedback-Therapie (feed back, engl.: zurückleiten) wird häufig bei Betroffenen als Alternative zur klassischen medikamentösen Behandlung eingesetzt. Hier lernt der Patient, in sich hineinzuhören und seinem Körper soweit zu mobilisieren, dass Migräne-Anfällen vorgebeugt und Schmerzen reduziert werden können – vorausgesetzt, es besteht seitens des Betroffenen die Bereitschaft zur Mitarbeit.

In der Biofeedback-Sitzung werden dem Patienten dann beispielsweise am Kopf Elektroden angebracht, welche Blutdruck, Hautleitfähigkeit und Gehirnströme messen. Die Ergebnisse dieser Messungen können sowohl der Therapeut als auch der Patient an einem angeschlossenen Monitor ablesen, werden dem Patienten also sozusagen „zurückgeleitet“, wodurch jede Form von Anspannung und Entspannung direkt erkennbar wird. Dadurch erhält der Betroffene also sofort eine Rückmeldung darüber, wie er in belastenden Situationen körperlich reagiert und welche Wechselwirkungen zwischen psychischen und körperlichen Prozessen bestehen.

Es bestehen weitere Möglichkeiten, eine Migräne und damit auch unangenehmes Augenflimmern mit alternativen Heilmethoden zu lindern: Hierzu zählen unter anderem physikalische Therapieformen wie die Wärmetherapie (Kopf- und Nackenzone), Massagen sowie zahlreiche Hausmittel bei Kopfschmerzen. Dazu zählen Kräutertee aus Pfefferminze, Melisse, Baldrian und Auflagen mit Hopfen, Quark, Lehm oder Kohlblättern. Ebenso bietet sich die Bachblütentherapie an, um die Beschwerden auf natürliche Weise zu behandeln. (No)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dipl. Social Science Nina Reese, Barbara Schindewolf-Lensch

Swell:

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  • Douglas J. Rhee: Glaukom (grüner Star), MSD Manual, (Abruf 06.09.2019), MSD
  • Hartmut Göbel: Migräne - Diagnostik, Therapie, Prävention, Springer Verlag, 2012
  • Gerhard K. Lang, Gabriele E. Lang: Augenheilkunde, Georg Thieme Verlag Stuttgart, 1. Auflage, 2015
  • Christoph Schankin et al.: Clinical characterization of "visual snow" (Positive Persistent Visual Disturbance), The Journal of Headache and Pain, (Abruf 06.09.2019), PubMed
  • Ping-Kun Chen, Shuu-Jiun Wang: Non-headache symptoms in migraine patients, F1000 Research, (Abruf 06.09.2019), PubMed
  • U. Beyer, C. Gaul: Visual Snow, Nervenarzt (2015) 86: 1561, (Abruf 06.09.2019), Springer

ICD codes for this disease: H53ICD codes are internationally valid encodings for medical diagnoses. You can find yourself e.g. in doctor's letters or on disability certificates.


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