I Can See My Pulse In My Vision (Fatigue, Caffeine, Or Carotid-Cavernous Fistula?)

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Various changes in your environment or lifestyle could be responsible for pulsating vision. A sudden change can make your eye pulsate, such as fatigue, increased intake of caffeine, medication side effect, dry eyes, migraine, and so on. When one focuses and tries to live a healthy life, pulsation in the eyes won’t happen. But sometimes, it’s also caused by underlying medical conditions such as carotid-cavernous fistula. It can directly or indirectly affect your arteries and cause a pulsating eyeball. But both are treatable either through medication or surgery. Always talk to your health care provider for diagnosis and treatment, including your specific medical needs.

Our eyes are a gateway to this world, and if there’s even the slightest issue with them, we often feel like our world is falling apart.

While physical symptoms are easier to diagnose and start treatment for, it becomes difficult to pinpoint the issues for something that only you can feel like a pulsating eyeball.

The way it might be pulsating could be a sign of Carotid Cavernous Fistula (CCF), or other symptoms combined can change the diagnosis. But let’s look at the possible causes of having a pulsating vision. Maybe you’ll find a similarity with your current issue!

What is carotid cavernous fistula?

A carotid-cavernous fistula is an abnormal connection between the carotid artery and/or its branches and a large vein called the cavernous sinus. It’s a link between the artery in your neck and the network of veins at the back of your eye. 

The function of these veins at the back of your eyes is to transport blood from your face and brain back to your heart and are located in small spaces behind your eyes called cavernous sinuses. 

Due to an injury, a small tear might happen in one of the carotid arteries. If the tear occurs near the veins in the cavernous sinus, an abnormal channel may form between the artery and the network of the veins, through which blood may flow, called a fistula. 

A fistula can raise the pressure in your cavernous sinuses, which may compress the cranial nerves located around the cavernous sinuses. This compression can damage the nerve function, which controls your eye movements. 

These cranial nerves also allow you to experience sensations in parts of your face and head.

The increased pressure caused by the fistula can also affect the veins that drain your eye, and this can cause abnormal functions to take place in your vision, such as pulsating eyeball. 

Symptoms of carotid-cavernous fistula

CCF can be direct (high-flow) or spontaneous (indirect/low flow). Due to low blood flow, the symptoms are fewer and less serious in direct CCF.

With indirect CCF, the symptoms are many and need immediate attention, which includes:

  • A bulging eye
  • A pulsating eye
  • A red eye
  • Double vision
  • Loss of vision
  • An audible swish or buzz coming from the eye
  • Weak or missing eye movements
  • Pains in your face
  • Ringing in your ears
  • Headaches
  • Nosebleeds

Causes of carotid cavernous fistula

Direct CCFs are caused by major accidents which cause an injury that might lead to a tear and cause you to suffer. Causes might be an accident, a fight, falling down from somewhere, or even surgery. 

Indirect CCF, which is less threatening, often happens without warning since the cause isn’t due to an injury. Causes of this type of CCF include high blood pressure, hardened arteries, pregnancy, childbirth, or connective tissue disorders. 

Diagnosis and treatment of carotid-cavernous fistula

Your doctor will ask your routine questions, diagnose correctly based on your answers, and then start with tests. There might be scans of eyes, nearby blood vessels, and cavernous sinus with computed tomography, magnetic resonance imaging (MRI), or ultrasound. 

If the results show you’re suffering from CCF, you might need angiography to confirm the diagnosis. 

CCFs can either be treated by microvascular neurosurgical or endovascular techniques. 

Endovascular surgery involves inserting a narrow tube into an artery in your groin. The tube is then threaded up to the fistula. Once there, materials such as metal coils can be used to seal off the connection.

This is usually needed in direct CCF patients, and for indirect CCFs, it can most of the time solve spontaneously. 

Other treatments include:

  • Lubricating drugs can keep the eye from drying out and are best for when patients can close their eyes.
  • Drugs may also be used to lower the pressure in your eye.
  • The eyes can be closed with stitches and are done carefully on the surface as a last resort. The stitches are opened when the condition resolves itself.

A proper diagnosis is needed when feeling something in the eye with no other symptoms that can help you find the underlying issues. Sometimes things are quite interrelated, so there might be other related issues to this pulsating vision of yours.

Other possible causes for pulsating eye

A man has sitting down with his hand on his left eye, which is pulsating and causing him pain

It isn’t easy to describe this feeling of a pulsating eye. But most people describe it as a feeling of pulse in your eyes, like sometimes you feel it in your calves when you’ve walked too much or played sports for long. 

It can also be confused with a gentle tug in the eye or eyelid. Sometimes this pulsating vision could be because of a slight feeling or an irregular routine of yours and other times caused by another underlying health condition.

Some causes include:

  • Eye irritation
  • Strain
  • Corneal abrasion
  • Environmental disturbances such as wind, light, sun, or pollution
  • Fatigue or lack of sleep
  • Physical exertion or stress
  • Use of alcohol, tobacco, or caffeine
  • Dry eyes
  • Medication side effects
  • Light sensitivity
  • Uveitis, or swelling of the middle layer of your eye
  • Blepharitis, or inflammation of your eyelid
  • Conjunctivitis, or pink eye
  • Migraine episodes

Mostly these are experienced when one is not following a healthy routine, including a balanced diet. So, make sure you drink less caffeine, get adequate sleep, keep your eye lubricated if they remain dry by using drops, and apply a warm compress when feeling an unusual pulsation.

High blood pressure, also known as hypertension, can cause retinopathy or damage to the eye’s main blood supply. This can lead to bleeding in the eye, blurred vision, swelling, blood clots, damage to the nerve, or even a stroke in the retina with complete loss of vision. 

If the pulsating eye keeps bothering you and the frequency increases, it’s best to get professional advice and help from a doctor rather than self-treatment. You never know if you might end up elevating the issue even further.

FAQs

Why do my eyeballs pulse?

Your eyeballs can pulse for various reasons. There might be issues with your environment or lifestyle, such as fatigue, stress, or increased caffeine intake, which can be treated once you start making healthier choices. 

Other factors could include underlying health issues causing this problem. It can be anything from an injury to the eye, an infection, and so on. If the issue is increasing in intensity, it’s best to see a doctor and get a proper diagnosis. 

Why does my vision blurry with my heartbeat?

When your heart isn’t pumping correctly, blood isn’t getting to the parts of your body that need it, such as your brain. That’s why you might feel dizzy, faint, or even have blurry vision during an atrial flutter episode. 

Atrial flutter happens when the atria start beating faster, and the ventricles can’t keep up. The heart rate during episodes of atrial fibrillation may reach over 150 a minute. Lightheadedness, shortness of breath, and heart palpitations are some obvious signs, along with increased heart rate.

Can you feel your pulse in your left eyelid?

It’s more like a twitch where a person feels a gentle tug in their eyes or eyelids. Usually, it’s gentle, but it can be a bit stronger too if the condition worsens.

Also known as an eyelid twitch, or myokymia is a repetitive, involuntary spasm of the eyelid muscles. A twitch usually occurs in the upper lid, but it can occur in the upper and lower lids. 

To summarise

There’s nothing wrong with feeling your pulse in your eyes once in a while because it can happen due to lifestyle and environmental changes.

If it’s only limited to a few times you’ve felt this, then you need not worry about it. But if the issue persists and the intensity of pulsating increases, there might be an underlying issue responsible for it. 

A carotid-cavernous fistula is a medical issue where damage to the nerves directly or indirectly can cause pulsating effects, amongst other symptoms. With treatment, symptoms usually go away within hours or days. Those with direct CCF might not recover entirely but get better significantly. But indirect CCF might reoccur. 

Whatever issues you’re facing can only be felt by you and properly diagnosed by a doctor.

When it comes to such feeling or seeing something only you can, it’s best to seek professional medical advice, for they have had years of knowledge and experience regarding all the symptoms you’re feeling. 

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Saumya Malik is an ardent follower of everything good for the health and wellness of body and mind. She's passionate about providing effective solutions to general health and mental well-being issues and wants to help people achieve the same. When not writing, you can find her curled up with a good book in a corner or cooking as a form of good mental therapy.
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