Visual hallucinations - no other symptoms

[Whatamiseeing2]

Hi I'm just wondering if anyone has experienced something like this or if it rings any bells. I know I can't rely on MN for medical advice or anything - I'm just curious.

For the last few weeks I've been seeing things - at first normal "eyes playing tricks on you" type of things like shadows appearing to be something else for a second, maybe just slightly more frequently than usual. Today it became more definite - seeing a couple of things that seemed completely real until they switched back to what was actually there.

I take hydroxychloriquine which can sometimes affect eyes so I wondered if this might have happened and that I was seeing things slightly differently and my brain was filling things in in a strange way or something, but I had an OCT scan in opticians and everything was fine. Optician did say there might be a slight prescription change in long range vision.

I went through menopause abruptly 2 years ago as I had chemotherapy that stopped periods completely - so I'm even wondering if there could be a hormonal element.

It could just be that I'm tired. It happened this morning and hasn't happened since.

Like I said I am not going to put my responsibility for my health onto lovely Mumsnet people. If it keeps happening I will go to the doctor - if it doesn't happen again I'll leave it. Just interested...

Not sure what things you’re seeing, but i’ve had visual migraines that manifested as weirdly neon flashing jagged lines at the periphery of my vision and gradually got more central and more defined. no headache.

If that’s similar, they usually want to check you to rule out a TIA (mini stroke) before confirming migraine.

Thanks @RubaiyatOfAnyone It's not really like that but did start at periphery of vision so I'll keep that in mind. One was today on the bus - I saw someone stand up ready for their stop and they had dark dreadlocks, some with beads. Then they sat back down as the bus was stuck in a traffic queue and I saw it was actually a man with short blonde hair. It looked completely normal and real and solid both ways. I think probably it was just a trick of the light that my brain misinterpreted for a second. I'm googling now and apparently it's pretty normal for people to occasionally have a hallucination without any underlying condition.

Have a look at Charles Bonnet syndrome

Thanks @36and3

How old are you? Parkinson’s can cause visual hallucinations but very much hoping it isn’t that. Probably not Charles bonnet syndrome - that affects people who have been blind/partially sighted for a long time

Thanks @Allsizes8to14 I'm late 40s. I have a family member with Parkinsons, don't know if there's a genetic element.I don't have any other symptoms that would suggest it. Sorry if you're living with this disease, in yourself or someone close.

I was also going to suggest Charles bonnet.
From my patients experience it can be a sign of eye changes at the start of macular issues , not necessarily end stage

Thanks @Wonkywinky that's interesting. Would the optician have been able to see that on the scan though? I did tell her why I was asking for it.

Was it breast cancer you had? I would see a GP and push for a CT head to make sure no recurrence of any cancer than could metastasise to the brain tbh. Especially in light of normal optician check, though it is reassuring so signs of damage or pressure etc. Charles Bonnet tends to occur when more advanced visual loss/blindness.
The GP can screen for Parkinsonism and refer to neuro if appropriate.
So I would book in with GP rather than wait to see if happens again.

Thank you @Ihatewinding This is one thing that flickered across my mind, although just among the other possibilities. Again I don't have any other symptoms of this but you're probably right that I should get it checked as if it did turn out to be something I'd feel stupid for waiting.

Edit to say yes it was breast cancer. I was supposed to have an oncology follow up today where I could have mentioned this but it was cancelled - they mostly get cancelled and rescheduled ad infinitum. It was rescheduled for early November but I'm fairly confident this will be cancelled too so maybe the GP is the better option.

Are you on tamoxifen? That can also cause ocular side effects - any other medications?
I would start by having another eye exam (I'm an optometrist), I would then refer you back to the GP with the findings. (But do it that way round as the GP will ask you to have an eye exam, if you see them first.)

Thanks @theeyeofdoe Yes I'm on tamoxifen and also methotrexate. I did inform the optometrist of this yesterday though and she said everything looked ok. I had my regular full eye test in February, at which point I was already on methotrexate and tamoxifen, but hadn't started the hydroxychloriquine, and everything was ok then. Do you think I should have another full eye exam already? The symptoms have only appeared recently. The optometrist I saw yesterday said she would email me the results of the scan in case I want to show them to my regular optometrist to compare to earlier scans.

Sorry I probably should have mentioned the tamoxifen and methotrexate in the first post, don't mean to drip feed - it's just that hydroxychloroquine is the one where I was specifically warned about effects on the eyes when I started taking it, so was the one I was concerned about yesterday.

Do you have any way to contact your GP other than a normal appointment?
With mine, I can send messages through the app. When I did this for an eye problem the doctor sent me back a phone number which you call which triages eye issues and refers you. I spoke to first some kind of admin, then they got an optometrist to call me and talk it through, then they made me an appointment with an optician and the referral meant the optician did extra investigation than they do normally.

So, you could try that, or 111 may give you the same access.

Your GP is bound to send you for another eye test, so just get that bit out of the way, but more formally.

Hi @Negroany I'm not in the UK so no app and no 111 or equivalent - but I could probably just email the practice to ask what they suggest - good idea, thank you.

By the way I haven't had anything happen since yesterday morning so maybe was just one of those fleeting unexplained things.

@Whatamiseeing2 CT head is just for worst case scenario then can consider other causes.
I'm a HCP and anyone with a history of cancer, even if in remission, that has headaches/neuro symptoms or back pain gets a scan from me. I asked if it was breast cancer as it's the second most likely to metastasise to the brain after lung cancer. So I don't want to unduly worry you but I would get yourself checked out. I'm pretty investigation trigger happy though!
For completeness I could liaise with eye clinic given your meds that can contribute to visual disturbances.
Stress/tiredness, etc can also cause visual disturbance but I would be wary of diagnosing that over more serious potential causes until they're ruled out. And whether a neuro referral would be appropriate, etc.

Thanks @Ihatewinding that's all really useful to read. I think I'm going to contact GP with the details and take it from there as @Negroany suggested.

Yes, you should definitely have another eye exam, as your visual symptoms started more recently. We can see signs of raised intercranial pressure which can sometimes be a cause of visual hallucinations. I would go in the next week and sooner if you're noticing headaches or that your colour vision is changed.

It definitely needs more investigation and soon as you're on quite a lot of meds with a potential for ocular side effects.

Get a blood test to check B12, if it's low that can be a reason for hallucinations.

Thanks @theeyeofdoe no headaches or changes in colour vision but will get it checked out anyway.

Oh yes...thanks @HelpNeededBeforeIHaveABreakdown that possibility had crossed my mind before but then I forgot about it, thanks for the reminder.

I had this when I was incredibly low on ferritin and wasn't sleeping more than a couple of hours a night for weeks.

Was seeing people and things that weren't there. One day my husband walked in and asked me what I was doing, I said I was stroking the cat.

We don't have a cat.

Wow @wheresthebigcarrot that sounds pretty full on! Were you hallucinating the feel of the cat as well? Could you remember afterwards? I think my ferritin is ok but definitely something I will keep in mind.

I was seeing all sorts; people in corners of the room, at one point I was chatting to someone who was fixing my laptop... except there wasn't anyone there. I was barely sleeping for weeks though and my ferritin was 3, so was a pretty extreme situation!

And yes - remembered vividly after!!