Rainbow halos, starbusts, visual distortion

[LJM]

Hello. I would just like some reassurance. I have hashimoto's thyroiditis and am 55 years old. About 8 months ago my vision began to change. First I noticed that there was distortion of lights. They started out appearing as large circles in only one eye, then they turned into stars with many points. My other eye became involved after a few months too. Then the starbursting started with glare. My eyes were dry at this time, but I did not connect the two things. I went to an optometrist who did a thourogh exam, though she did not ask me about dry eye or test me for it and told me that it was simply astigmatism and she wanted to give me a stronger prescription. I never filled that prescription as we moved shortly thereafter. Meanwhile my eyes continued to change. In the last few months I have started to see halos around lights that are rainbow colored. At first I thought that I must be in early stage for cataracts as my father had that. So today, finally I got up the nerve to go to a second optometrist (when I tried to book an ophthamologist they told me to go there first). I just got back. She spent so long with me and did so many tests. My optic nerve was fine, my macular was fine. The only thing other than the astigmatism that she found was dry eyes. I asked her if dry eyes can cause rainbow halos around lights. She told me that she sees alot of people and that some of them tell her they see rainbow halos but that there is nothing wrong with their eyes. She said that some of them see these things as a religious experience.
I was so glad she found the dry eye as I did suspect that since it is hard to open my eyes in the mornings and she give me drops for the day and ointment for the night. She was very very nice. She told me that they can put a special coating on the glasses that stop the glare.
The reason I am writing is that I still am not convinced that these rainbow colored halos are part of dry eye?? I thought maybe that a specialist in some area might find something else.
Is it possible to have rainblow colored halos that are not glaucoma or corneal dystrophy or cataracts? I would appreciate it if some of you experts would help out here. Thanks for listening. LJM

[poppy]

Rainbow coloured lights are NOT part of dry eye, any doctor who tells you that is just making stuff up to get rid of you because they can't figure out what's wrong. And the stuff about thinking of it as a religous experience I personally would have found highly offensive.

Halos + starbursts are possible to be caused by dry eye and/or it's complications. eg Inflammation/swelling of cornea, damage to ocular surface, unstable tear film that affects vision, and so on. I have tried on glasses in the optometrist's office that are anti-glare and supposed to help with these things, but it didn't make any difference for me, so I suggest you ask to try them on before spending any money on them. Do you have corneal inflammation or damage? What clinical signs of dry eye did the optometrist find? Did she do a schirmer test or put dye in your eyes to test your tear break up time? If your corneas are fine, and your dry eye is clinically mild, it is much less likely that your halos and starbursts are from dry eye.

There was a member here a while back who had rainbow coloured lights and she turned out to have glaucoma. Again, if you clearly see rainbow coloured lights as opposed to just halos, there is no way that's from dry eye. I have read that when examing misdiagnosis/medical errors, a major cause is that when a doc finds "something" wrong with the body part the patient is complaining about, they simply STOP LOOKING for another problem even if the problem does not fit with the symptoms. I have found this happens a lot with doctors. I would suggest you push to see an opthalmologist and ask for a dilated eye exam in case the optometrist has missed something. I assume the optom. already did a visual field test and IOP test? Don't mention dry eyes to the opthalmologist if/when you see them - focus on the issue of the rainbow lights alone - don't let the opthalmologist try to write off your problem as dry eye.

Edit: I've just noticed your from Australia. Definitely do NOT mention your dry eye to the opthalmologist if you see one RE the rainbow lights. Most eye docs in OZ loathe dry eye patients. Talking about this will just make your appointment go badly. Only talk about dry eye with an opthalmologist in Australia if you know that they are a dry eye friendly doctor. I'll also add that optometrists in Australia are different to those in the US (where most people on this forum are from), optometrists in OZ have basically zero rights to prescribe meds and seemingly, must have less training so I wouldn't trust them to be able to definitely rule out a problem.

[Rebecca Petris]

Hi LJM and welcome.

I'm glad you got such a thorough exam to rule out 'back-of-the-eye' causes for what you're seeing. That would be a relief. Also glad also she's at least started you on the road to addressing the dry eye. I would encourage you to read up here in much more detail about what dry eye is, including the difference between evaporative type and aqueous deficient type, which will help you to ask more specific questions in these exams and also help you with getting more appropriate treatment. It's tempting for doctors to just throw drops and ointments at dry eye patients without really pinning it down in more detail. While this doctor may have been thorough in general tests, I don't see anything that suggests she was very thorough in tests specific to dry eye. Eyes sticking shut in the morning means something is going on that needs to be investigated in more detail, for sure, whether it's blepharitis, poor eyelid closure or something else.

As to visual effects from dry eye: Dry eye causes increased "higher order aberrations" which can mean some strange visual phenomena. Whether that could include the things you're describing specifically, I don't know (and frankly most doctors probably won't - even specialists don't have time to read ALL the studies on these things, let alone mainstream eye doctors). Might take some prowling around PubMed to figure that out.

So, did you never fill that astigmatism prescription? Did the new doctor find any astigmatism?

[kitty]

I hope your eye doctor checked your intra ocular pressure. I saw rainbow halos, crazy distortions around lights and had morning nausea and aching eyes. It turned out to be Glaucoma. My eye specialist said rainbow halos are caused by one of two things: corneal edema or glaucoma. Get another opinion to be sure. Neither one is something to take lightly.

[LJM]

Dear Poppy, thank you for all of the advice, it really is appreciated. I also want to thank Rebecca and Kitty. Thank you for taking the time to advise me as I see that all of you have a great deal of knowledge about all of this.
As far as all the tests that you are asking me about, I feel very inadequate regarding it all. I know that she tested the back of my eye and showed me the films saying the macular and optic nerve were fine. She also looked in my eyes and used some very very bright light to look at them both. She also had me look at some kind of picture or scenery (all of these were machines that you lean forward and look into), she also did something where she blew air into my eyes. Finally she put some dye or something into my eyes and told me that they were dry. I wish I could tell you with more expertise what she did and I did not know to ask about things. I mainly told her about my symptoms. She also did an eye exam and wrote a new glasses prescription. I am due to see her in 2 weeks again.
I was concerned enough to ask my GP to write a referral to an ophthamologist for me, which she did today. I will call and book tomorrow. I would not have pushed this without all of your advice, unless of course my eyes get worse. I hope that he will shed some light on this situation. I have had some rude doctors in the past and some very nice ones but one thing stands out to me about the illnesses that I have is that most of them took years and years to find the answer to. I think that going from doctor to doctor is exhausting and when you have symptoms that they can not find the answers to you start to feel crazy. On the other hand, you can not just let your health go.
I did not even ask about the inter ocular pressure..how do they do that? Sorry but I am really new at all of this and just haven't got a clue. Thank you again for your help, it is so great to have encouragement when you are in this situation. LJM PS Kitty so sorry about the diagnosis, but so glad that they found what was wrong with you when they did.

[LJM]

Kitty can you have corneal edema with dry eye? edema sounds like swelling/moisture doesn't it? How does that work? LJM

[robster]

The test they did when they blew air into your eye is to check the eye pressure. The scenery you were looking at did it come into focus when looking at it? if so then they were measuring your prescription.

[LJM]

Hello everyone, I know it has been a while. It has taken all this time to finally see the opthamologist. I saw him today. My rainbows around lights have continued all this time, the dry eyes and starbursts etc etc. This time they dialated my eyes. After listening to my symptoms and checking my eyes, he basically told me that my eyes are very healthy. He said that they are dry and maybe dialated a bit more than normal and that is causing the rainbows around the lights in the morning. He told me that this (dry eye) is a common finding and that I can use drops when it bothers me and if driving at night is difficult that I can avoid it.
I tried to follow the advice of Poppy who told me to stick to the rainbow light issue and not talk too much about the dry eye. I guess I thought there was a possibility that there was some form of edema in the eyes since one user here mentioned that glaucoma and corneal edema are the only causes of rainbows. He told me that I did not have eye disease, just dryness from aging. I did not know exactly how to take it. I determined to have a good attitude as it is possible that I am overreacting to the symptoms, after all they have only affected my vision to a certain degree, some people on these boards are really suffering. I am going to a rheumatologist next month as I do have hashimoto's disease and sore joints, dry eyes and some mild dry mouth. After the adventure today I wonder if I am wasting my time. I remember once going to a doctor about my eczema on my legs and he just told me it was aging related drying out, that was over 10 years ago. It makes you feel like you are sort of overreacting or something, yet, I could not understand about the rainbows. Maybe there really are people who see rainbows and don't have eye disease. The medical merry go round is a test of patience. I hope I passed today. I guess that some of you have been through this too. Well after the next specialist, I want to pull out of the medical option for as long as possible. Thanks again for your help everyone, it was great getting support from people who know what it is like. LJM

[Rebecca Petris]

LJM,

I've moved this thread back up to Patients & Pros in case any doctors are reading who would give their input. We are not best equipped here however to address any vision questions that are not related to dry eye (and while yours may be, they also may not be). I would encourage you to look for some other online resources on vision issues.

It sounds like there are three clues so far any one or more of which might actually be involved (and I'm really only thinking of the starbursting issue because personally I don't know anything about the rainbow effect or what could cause it): 1) astigmatism, 2) dry eye, 3) Large pupils?? Did you always have large pupils, or is something causing them to dilate more than normal? Also 4) possibility of corneal edema.

Are your visual symptoms all the time, or are they primarily indoors, or in low light situations, etc? Do they go away in brightly lit conditions?

[LJM]

Dear Rebecca, I have never been aware of having dialated eyes and think he guessed at that since my rainbows were showing up strongly around his office light and I told him and he assumed that was from the dilation. How could he know if I have dialated eyes in the mornings without seeing my eyes? Yes I have astigmatism and dry eye diagnosis.
My symptoms with the rainbows are stronger in the mornings, and the starbursts, and light distortion is constant. There are halos around lights and a lot of starbursts from street lights and headlights at night and it greatly affects my driving. I do notice some decreased vision a kind of haziness mainly in the first part of the day. How could a doctor not see edema in my corneas ? Well thank you so much everyone for trying to help with this. He told me I could come back to him if I got a lot worse and said that it was a common finding? I am not sure of any of this as I hear different things from different people and read different things on the net. LJM

[Rebecca Petris]

Dear Rebecca, I have never been aware of having dialated eyes and think he guessed at that since my rainbows were showing up strongly around his office light and I told him and he assumed that was from the dilation. How could he know if I have dialated eyes in the mornings without seeing my eyes? Yes I have astigmatism and dry eye diagnosis.

What I was talking about was not dilated eyes (that term I think is normally used when there's an artificial cause for example the drops they use for an exam)... Here's what I meant: Everyone's pupils naturally get larger when there is less light and smaller when there is more. But some people's pupils get much larger than others in dim light (average for adults is nearly 7mm, but some people have 8mm or 9mm)... and some people's pupils might be larger than normal even in strong light for some reason. I just thought it was a possible area to investigate. There is a device called a pupillometer which they can use to measure you in different light settings (all ophthalmology offices that do LASIK have one... though a lot of them aren't very good at using it, they have to gradually adapt you to low light to get an accurate reading). Might be something to ask for at another exam. Or I might be barking up the wrong tree. Just a thought.

[spmcc]

I could be wrong - but is this called mydriasis? You could check out some old posts by MikefromsouthNZ e.g., http://www.dryeyezone.com/talk/showt...ight=mydriasis

[robinc]

Has anyone mentioned Fuchs' Dystrophy to you. I have been seeing halos around bright lights at night for years and more recently during the day. Starbursts from oncoming vehicles have made driving at night almost impossible. There was a cloudiness to my vision that was not corrected with a new prescription. I thought when a a cataract was diagnosed in my left eye and surgery recommended that my problems were over. Not so. While my vision was sharper, the cloudiness was worse. I went back to the ophthalmologist who had another look and told me I had Fuchs' Dystrophy. Do a web search and see if the symptoms match yours.

LJM,

I've moved this thread back up to Patients & Pros in case any doctors are reading who would give their input. We are not best equipped here however to address any vision questions that are not related to dry eye (and while yours may be, they also may not be). I would encourage you to look for some other online resources on vision issues.

It sounds like there are three clues so far any one or more of which might actually be involved (and I'm really only thinking of the starbursting issue because personally I don't know anything about the rainbow effect or what could cause it): 1) astigmatism, 2) dry eye, 3) Large pupils?? Did you always have large pupils, or is something causing them to dilate more than normal? Also 4) possibility of corneal edema.

Are your visual symptoms all the time, or are they primarily indoors, or in low light situations, etc? Do they go away in brightly lit conditions?

[spmcc]

I went back to the ophthalmologist who had another look and told me I had Fuchs' Dystrophy. Do a web search and see if the symptoms match yours.

Hi robinc,

What did your doctor say to do to treat Fuchs'?

Thanks.

[Guest]

Hello! I know this was posted 8 years ago but here goes nothing; don't know if anyone is active here still.

I am 20 years old and I see extreme halos in both of my eyes, I have floaters and retinitis pigmentosa runs in my family.

However, my retina was checked twice and is fine, my IOP is good and I also did a head MRI. All is clear. A 2nd doctor told me other than some excessive tears my eyes were fine and that he can't explain the rainbow halos. Bummer. He told me to check my heart and it is also fine.

Here is what has startled me, though.
You wrote right off the bat that you have Hashimotos. I've recently been on an ultrasound and the doctor told me she is sure it is Hashimotos, but I need to do some blood test to confirm.

Could the thyroid be the cause of all this as it CAN affect the eyes?

all the best.