- When Chronic Fatigue Syndrome Harms Vision
- Blurred Vision and Headache: What Causes Them Both?
- Causes of blurred vision
- Diabetes and blurred vision
- Recognising blurred vision
- When to see your doctor
- 7,375 Possible Causes for Blurred Vision, Dizziness, Fatigue, Headache, Paresthesia
- Hashimoto’s, Fatigue, Dizziness, Blurred Vision, Brain Fog
- Dizziness (lightheadedness)
- Common causes of dizziness
- Less common causes of dizziness
- Headache • fatigue • blurred vision • Dx?
When Chronic Fatigue Syndrome Harms Vision
Many people diagnosed with chronic fatigue syndrome (CFS) also experience problems with their vision. Doctors believe that these vision-related chronic fatigue symptoms stem from brain dysfunction more than eye dysfunction. The signals that the brain sends to the eyes to let you know where you are and what you’re seeing may not be functioning properly when you have chronic fatigue syndrome.
Vision Problems and Chronic Fatigue Syndrome: It’s All a Blur
Most often, patients report having periods where everything appears blurry or seems foggy. “This will happen most commonly when they stand up and get lightheaded,” says Peter Rowe, MD, director of the Chronic Fatigue Clinic at Johns Hopkins Children’s Center in Baltimore.
Other vision problems that chronic fatigue syndrome patients report include:
- Difficulty or slowness in focusing on objects, usually those that are close up
- Not being able to see objects in side or peripheral vision — some say they feel as though they have tunnel vision
- Feeling dizzy and not being able to tolerate looking at moving objects
- Seeing floaters and flashes of light
- Being intolerant to light — “They find it uncomfortable to be in brightly lit rooms and outdoors in the bright sunshine,” Dr. Rowe says.
- Feeling as though eyes are dry or that they burn, itch, or feel gritty
The Effects of Vision Problems on Activities
Chronic fatigue syndrome patients usually find that their vision problems worsen toward the evening as they get more tired, Rowe says. As a result, people with chronic fatigue syndrome often find they have difficulty concentrating, particularly when reading.
Vision problems and the related discomfort also can make it hard for CFS patients to finish everyday tasks. You may have difficulty judging distances, which makes driving a problem. Also, headaches and dizziness may make it difficult to stand to cook or clean.
Getting the Right Eye Care When You Have Chronic Fatigue
Chronic fatigue syndrome patients will often visit an optometrist or ophthalmologist when they experience vision problems. “But usually the eye exam of someone with chronic fatigue syndrome is normal,” Rowe says. Prescription lenses may not help because vision changes rapidly. If you do wear glasses, tints may reduce sensitivity to light.
Because blurred or foggy vision is the most common problem, the solution is to improve the blood flow to the brain, Rowe says. “Visual blurring tends to be a temporary symptom and more related to lightheadedness and brain blood flow.” You may need to see a cardiologist or a neurologist to treat dizziness or lightheadedness.
Certainly, if you have chronic fatigue syndrome and find that you can’t tolerate bright lighting, you should wear good sunglasses when you’re outdoors, Rowe says.
Medications Can Help Vision Problems
Dry or irritated eyes can be treated with drops that lubricate the eyes; they may provide temporary relief. Warm compresses may also help, as will drinking fluids. Some chronic fatigue syndrome patients experience the opposite problem: watery eyes often caused by allergies; in this case, you may find it helpful to take over-the-counter antihistamines.
If you experience floaters, see an eye care professional immediately to be sure the cause is not a retinal tear. In patients with chronic fatigue syndrome, the floaters you see are generally harmless and do not require treatment. Over-the-counter pain medications or prescription drugs may help with headaches brought on by fatigue or dizziness.
Patients are likely to find that their chronic fatigue symptoms, including vision problems, worsen the more fatigued they are. You should talk to your doctor about the best way to treat the CFS symptoms that you find the most disruptive and disabling.
Blurred Vision and Headache: What Causes Them Both?
The following conditions can cause blurred vision and headache at the same time.
Migraine is a headache disorder that affects over 39 million people in the United States. Of these, 28 million are women. Migraine causes moderate to severe pain that’s often made worse by light, sound, or movement.
Aura is another word for blurred vision that accompanies a migraine. Other symptoms of aura include blind spots, temporary vision loss, and seeing bright flashing lights.
Migraine pain typically lasts three or four days. Common symptoms include nausea and vomiting.
Traumatic brain injury
Traumatic brain injury (TBI) is a type of head injury that causes damage to the brain. There are different types of brain injuries, such as concussions and skull fractures. Falls, motor vehicle accidents, and sports injuries are common causes of TBI.
Symptoms of TBI can range from mild to severe, depending on the extent of the damage. Other symptoms include:
- ringing in ears
- mood changes, such as irritability
- lack of coordination
- loss of consciousness
Low blood sugar
Low blood sugar, or hypoglycemia, often occurs in people who have diabetes. However, there are other things that can cause your blood sugar to drop, including fasting, certain medications, and consuming too much alcohol.
Signs and symptoms of low blood sugar include:
- irregular heartbeat
Symptoms become more severe as hypoglycemia worsens. If untreated, hypoglycemia can lead to seizures and loss of consciousness.
Carbon monoxide poisoning
Carbon monoxide poisoning is an emergency that requires immediate medical care. It results from a buildup of carbon monoxide in your bloodstream. Carbon monoxide is an odorless, colorless gas produced by burning wood, gas, propane, or other fuel.
Apart from blurred vision and headache, carbon monoxide poisoning may cause:
- dull headache
- nausea and vomiting
- loss of consciousness
Pseudotumor cerebri, also called idiopathic intracranial hypertension, is a condition in which cerebrospinal fluid builds up around the brain, increasing pressure.
The pressure causes headaches that are usually felt at the back of the head and are worse at night or upon wakening. It can also cause vision problems, such as blurred or double vision.
Other symptoms may include:
- persistent ringing in the ears
- nausea and/or vomiting
Temporal arteritis is an inflammation of the temporal arteries, which are the blood vessels near the temples. These blood vessels supply blood from your heart to your scalp. When they become inflamed, they restrict blood flow and can cause permanent damage to your eyesight.
A throbbing, persistent headache on one or both sides of your head is the most common symptom. Blurred vision or brief vision loss is also common.
Other symptoms may include:
- jaw pain that worsens with chewing
- scalp or temple tenderness
- muscle aches
High or low blood pressure
Changes in your blood pressure can also cause blurred vision and headache.
High blood pressure
High blood pressure, also called hypertension, happens when your blood pressure increases above healthy levels. High blood pressure typically develops over years and without any symptoms.
Some people experience headaches, nosebleeds, and shortness of breath with high blood pressure. Over time, it can cause permanent and serious damage to the retina’s blood vessels. This can lead to retinopathy, which causes blurred vision and may result in blindness.
Low blood pressure
Low blood pressure, or hypotension, is blood pressure that has dropped below healthy levels. It can be caused by dehydration, certain medical conditions and medications, and surgery.
It can cause dizziness, blurred vision, headache, and fainting. Shock is a serious possible complication of very low blood pressure that requires emergency medical treatment.
A stroke is a medical emergency that occurs when the blood supply to an area of your brain is interrupted, depriving your brain tissue of oxygen. There are different types of strokes, though the ischemic stroke is the most common.
Stroke symptoms may include:
- a sudden and severe headache
- trouble speaking or understanding
- blurred, double, or blackened vision
- numbness or paralysis of the face, arm, or leg
- trouble walking
One of the common signs of diabetes mellitus is blurred vision, which refers to the loss of sharpness of vision and the inability to see fine details.
Blurred vision can affect one eye (unilateral blurred vision) or both (bilateral blurred vision) eyes, and can occur often or rarely.
Regardless of how often it occurs, it should never go untreated as it could be an indicator of another, more serious eye problem
Causes of blurred vision
Blurred vision can occur by simply forgetting to wear your prescribed corrective lenses. But in many cases, it is usually a sign of an underlying eye disease.
Eye diseases include:
- Age-related macular degeneration
- High blood sugar levels
Other causes of blurry vision include:
- Cataracts and other eye conditions such as conjunctivitis, dry eye syndromen, and retinal detachment
- Certain medications (including cortisone, some antidepressants and some heart medications)
- Diabetes mellitus
Diabetes and blurred vision
High levels of blood sugar resulting from diabetes can affect your ability to see by causing the lens inside the eye to swell, which can result in temporary blurring of eyesight.
Blurring of vision may also occur as a result of very low blood sugar levels If this is the case, your vision should return once your blood glucose levels have returned to the normal range.
If your blood sugar levels are fluctuating over time, you may notice that your vision improves and worsens for periods of time.
Recognising blurred vision
There are various different interpretations/understandings of what blurred vision is, but in most cases the term is used to describe the inability to see fine details and a lack of sharpness of vision.
When to see your doctor
If you’re experiencing sudden blurred vision together with eye pain, you should go see your doctor and have your eye(s) checked
If your vision has become blurred over time, it could be a sign of an underlying condition, which could be diabetes amongst other possible causes.
Your doctor should be able to help distinguish why your vision may have worsened.
7,375 Possible Causes for Blurred Vision, Dizziness, Fatigue, Headache, Paresthesia
Hashimoto’s, Fatigue, Dizziness, Blurred Vision, Brain Fog
I truly believe that God directs our path to certain people and I am so glad that he directed me to Dr. Mark Flannery! Dr. Flannery has helped me so much, but let me start from the beginning. I am a mother of two boys and one of my boys has a muscle disease. Since he has been born there has been extra stress on me to make sure his health needs are taken care of all the time. I also work long hours, which complicates things. I wouldn’t eat for half the day and I drank two pots of coffee a day to keep me going. Despite all that coffee I was still tired all of the time.
I knew that something was going on with me when I literally could not get off the couch to make my children dinner one night. I was sick all the time. I also started to have night sweats and I would feel dizzy on and off. I look back now and wish I treated my body better, but I just didn’t have the knowledge that I do now. I can now see that chronic stress plus treating my body bad for so long manifested as sickness.
It just hit me one night. I had not eaten since breakfast and I was making dinner. All of a sudden I felt faint and I fell to the floor. I was so lucky I had a friend over to help me that night. He administered several spoonfuls of sugar into my mouth and I ate a little dinner to bring my blood sugar up, but I felt bad! I had tremors, terrible anxiety, and I was still feeling faint. I asked him to take me to ER. The doctors there told me my blood sugar was low, but that is all they could find wrong with me and sent me home.
I got worse: I couldn’t work, I couldn’t sleep, I had tremors, I felt like I could feel my thyroid in my throat. I started having increased hot flashes and I lost tons of weight. I went to my primary doctor and told her that something was wrong with me. She told me that it was stress and prescribed me antidepressants, sleeping pills, and did more tests that came up negative.
I went to multiple doctors and they all told me that there was nothing wrong with me. In the meantime I was getting worse. I started having blurred vision, dizzy spells, brain fog, and I couldn’t think right. I was still so tired, and jittery. I had these spells where I could feel the blood rushing to my head and now I was gaining weight.
I took my health issues into my own hands and started looking for answers. I thought it was perimenopause or thyroid issues even though the other doctors tested me and said that it wasn’t my thyroid. I finally found a doctor that would listen to me. She did some tests and diagnosed me with Hashimoto’s disease. She prescribed Synthroid, a thyroid medication, but it didn’t help. I still felt bad so I kept pursuing information on the web about thyroid issues.
I found Dr. Kharrazian’s book “Why Do I still Have Thyroid Symptoms? When My Lab Tests Are Normal”. Through that book I found Dr. Flannery’s information and I called to make an appointment. I was skeptical at first, having a doctor that was in California while I was in Michigan, but I needed the help. Dr. Flannery listened to me, was very understanding, and assured me that I wasn‘t “loosing my mind”, even though I felt like I was. He wanted a thorough health history from me, which no other doctor had asked for up to this point. After we went through my health history he ordered some tests to help figure out what was really going on with me.
The test results were devastating to me. I found out that my body was attacking itself, and at least twenty-one tissues in my body were being attacked by my immune system. I learned that I was dealing with some intestinal parasites, low blood sugar, low vitamin D. and many other abnormal lab markers. I also found out that I was never going to be able to eat certain foods again because they caused my immune system to react leading to further tissue damage. Dairy, coffee, grains, corn, egg, and rice were among the foods I could never eat again. I cried for several days. I realized that what I was dealing with was much more than just Hashimoto’s. Dr. Flannery told me that it was good that we have that information because now I could start working towards healing myself, and that’s just what I did. I had to look at all the positives about this new life style change.
I had to look at what I could eat and started making healthy and tasty meals. Dr. Vera Flannery made a twenty-eight day meal plan that has fantastic recipes. I began following Dr. Flannery’s advise and I began eating every two hours and started taking the supplements that he recommended. It wasn’t long before the symptoms started going away. I didn’t feel like I was going to pass out. The brain fog, blurred vision, and tremors went away. I now have energy and I am not abnormally tired. I lost a lot of weight and have kept it there. No more yo-yo weight gain and loss. This is the first summer in a long time that I have been able to do yard projects. I am not sick all the time anymore. I feel like I have a life again.
I am not going to tell you that it hasn’t been tough making this diet change and I am going to have to be on supplements for a while because I have been so sick for so long, but I feel great! I want to thank you Dr. Mark and Dr. Vera Flannery for dedicating your life to helping people, because you have changed my life and I am so grateful!
Terri H., Kalamazoo, MI
Common causes of dizziness
The most common causes of dizziness are outlined below.
- Labyrinthitis – an inner ear infection that affects your hearing and balance, and can lead to a severe form of dizziness called vertigo.
- Migraine – dizziness may come on before or after the headache, or even without the headache.
- Stress or anxiety – particularly if you tend to hyperventilate (breathe abnormally quickly when resting).
- Low blood sugar level (hypoglycaemia) – which is usually seen in people with diabetes.
- Postural hypotension – a sudden fall in blood pressure when you suddenly sit or stand up, which goes away after lying down. This is more common in older people.
- Dehydration or heat exhaustion – dehydration could be due to not drinking enough during exercise, or illness that causes vomiting, diarrhoea or fever.
- Vertebrobasilar insufficiency – decreased blood flow in the back of the brain, which may be caused by the blood vessels that lead to the brain from the heart being blocked (known as atherosclerosis).
Less common causes of dizziness
Less common causes of dizziness include:
- having a severe illness or condition that affects the whole body
- using recreational drugs or consuming excessive amounts of alcohol (either binge drinking or long-term alcohol misuse)
- certain types of prescription medicine – such as antidepressants or blood pressure medication
- having a heart rhythm problem – such as atrial fibrillation (a fast, irregular heartbeat)
- carbon monoxide poisoning
Headache • fatigue • blurred vision • Dx?
One month after moving into her mother’s apartment, a 27-year-old woman sought care at our clinic for fatigue, headache, blurred vision, nausea, and morning vomiting. She had weakness and difficulty sleeping, but denied any fever, rashes, neck stiffness, recent travel, trauma, or tobacco or illicit drug use. She did, however, have a 6-year history of migraines. Her physical exam was normal. She was sent home with a prescription for tramadol 50 mg bid for her headaches.
The patient subsequently went to the emergency department 3 times for the same complaints; none of the treatments she received there (mostly acetaminophen with codeine) relieved her symptoms. Three weeks later she returned to our clinic. She was distressed that the symptoms hadn’t gone away, and noted that her family was now experiencing similar symptoms.
Her temperature was 98.1°F (36.7°C), blood pressure was 131/88 mm Hg, pulse was 85 beats/min, and respiratory rate was 18 breaths/min. Physical and neurologic exams were normal.
Although most of the patient’s lab test results were within normal ranges, her carboxyhemoglobin (COHb) level was 4.2%. COHb levels of >2% to 3% in nonsmokers or >9% to 10% in smokers suggest carbon monoxide (CO) poisoning.1,2 Based on this finding and our patient’s symptoms, we diagnosed unintentional CO poisoning. We recommended that she and her mother vacate the apartment and have it inspected.
CO is the leading cause of poisoning mortality in the United States, and causes half of all fatal poisonings worldwide.1,3,4 It is a colorless, odorless, and tasteless gas that is produced by the incomplete combustion of carbon-based products, such as coal or gas.5,6 Exposure can occur from car exhaust fumes, faulty room heaters, and other sources (TABLE 1).6 The incidence of CO poisoning is higher during the winter months and after natural disasters. Individuals who have a lowered oxygen capacity, such as older adults, pregnant women (and their fetuses), infants, and patients with anemia, cardiovascular disease, or cerebrovascular disease, are more susceptible to CO poisoning.5,6
COHb, a stable complex of CO that forms in red blood cells when CO is inhaled, impairs oxygen delivery and peripheral utilization, resulting in cellular hypoxia.1 Signs and symptoms of CO poisoning are nonspecific and require a high degree of clinical suspicion for early diagnosis and treatment. Although cherry-red lips, peripheral cyanosis, and retinal hemorrhages are often described as “classic” symptoms of CO poisoning, these are rarely seen.6 The most common symptoms are actually headache (90%), dizziness (82%), and weakness (53%).7 Other symptoms include nausea, vomiting, confusion, visual disturbances, loss of consciousness, angina, seizure, and fatigue.6,7 Symptoms of chronic CO poisoning may differ from those of acute poisoning and can include chronic fatigue, neuropathy, and memory deficit.8
The differential diagnosis for CO poisoning includes flu-like syndrome/influenza/other viral illnesses, migraine or tension headaches, depression, transient ischemic attack, encephalitis, coronary artery disease, gastroenteritis or food poisoning, seizures, and dysrhythmias.1,4 Lab testing for COHb can help narrow the diagnosis. CO poisoning can be classified as mild, moderate, or severe based on COHb levels and the patient’s signs and symptoms (TABLE 2).6 However, COHb level is a poor predictor of clinical presentation and should not be used to dictate management.2,7
Oxygen therapy is the recommended treatment
Early treatment with supplemental oxygen is recommended to reduce the length of time red blood cells are exposed to CO.1 A COHb level >25% is the criterion for hyperbaric oxygen therapy.1,3 Patients should receive treatment until their symptoms become less intense.
Delayed neuropsychiatric sequelae (DNS) can occur in up to one-third of patients with acute CO poisoning more than a month after apparent recovery.1,6,9 DNS symptoms include cognitive changes, emotional lability, visual disturbances, disorientation, depression, dementia, psychotic behavior, parkinsonism, amnesia, and incontinence.1,6,9 Approximately 50% to 75% of patients with DNS recover spontaneously within a year with symptomatic treatment.1,6,9
After recommending that our patient (and her mother) leave the apartment and have it inspected, we later learned that the fire department was unable to determine the source of the CO. A CO detector was installed and our patient was advised to keep the windows in the apartment open to allow for adequate oxygen flow. One month later she returned to our clinic and reported that her symptoms resolved; serum COHb was negative upon repeat lab tests.
Patients who present with headaches, dizziness and/or fatigue should be evaluated for CO poisoning. The patient’s environmental history should be reviewed carefully, especially because CO poisoning is more common during the winter months. Oxygen therapy is the mainstay of treatment. Up to one-third of patients with acute poisoning may develop delayed neuropsychiatric sequelae, including cognitive changes, emotional lability, visual disturbances, disorientation, and depression, that may resolve within one year.