C-shaped Flashes in Vision

[Pleomorphism]

I am a 22 year old male who has been myopic for about 11 years. Initially I used to have to change glasses after regular intervals but luckily my visual acuity is now stable (-4 in both eyes).

A few years ago I started having flashes in both my eyes. They would start just to the left of the center of my vision, expand peripherally to form a C shape, and the C would continue to move peripherally (to the left) until it disappeared off the lateral most area of my visual field. The total duration would be about 20-25 minutes.

Initially I thought it was linked to certain stimuli like when I had less sleep or skipped breakfast but now I am unsure of these associations.

The flashes would initially occur after every couple months or so, but slowly the frequency increased. I wouldn't say that I frequently have them but the do occur once in a while.

I got it checked a couple of times. One time, it was dismissed as a case of "classical migraine" though I do not have headaches with it.

The second time, the ophthalmologist performed a lengthy and detailed examination of my eyes using triple lens and said there are areas of degeneration in my retina at 12 o' clock position, which is common in myopes. I was satisfied by her judgement.

Today however, I had an episode of these flashes on the right side for the first time (it was always left side before this). Is it possible the degeneration is spreading or increasing? Or could there be some other cause for it? What measures should I take now?

Any guidance would be appreciated.

[JohnHaganMD]

Your description is classic for an "eye migraine" or "ophthalmic migraine" which often have no headache or only mild headache. Since your eye exams are normal you have ruled out eye problems. You should see your personal physician for a general examination and discussion.  In very rare instances in young people other things besides migraine can cause these. Given you have had this problem for several years and no other symptoms develop its not likely you will need any special testing unless something changes or new develops.

[Pleomorphism]

Thanks for your advice, Dr. Hagan. Will get myself checked soon by my GP as well.

I also have episodes of distorted/altered sense of smell which occur a lot more often than these flashes. These are triggered by deep inspiration, sneezing or even laughing and relieved only by sleeping i.e. my sense of smell becomes normal only after I sleep and wake up again. Could this possibily be an "olfactory migraine" too????

Thank you.

[JohnHaganMD]

Could be but need a proper evaluation by your personal physician or/and neurologist before assuming migraine.