Visual snow describes the appearance of flickering dots or “static” in the field of vision. It’s thought to be a problem with visual processing rather than a structural issue within the eyes. This can cause difficulties for patients when trying to report visual snow to their doctor, as standard eye examinations typically find no abnormalities in these patients.
The problem can be accompanied by other visual symptoms including palinopsia (afterimages), sensitivity to light (photophobia), flashes (photopsia), and floaters. Non-visual symptoms have also been reported including ringing in the ears (tinnitus), a feeling of depersonalization, and cognitive impairment. When there are other symptoms in addition to the visual snow itself, this is classified as visual snow syndrome.
There doesn’t appear to be a single cause of the condition, and in many cases there is no obvious explanation for its onset.
Visual snow and antidepressants
Our interest in the condition stems from receiving reports of visual snow syndrome linked to the use of SSRI and SNRI antidepressants. In many cases, the problem didn’t go away when the person stopped the medication, and in some cases their vision worsened upon stopping.
This appears to follow the same pattern as post-SSRI sexual dysfunction (PSSD) in that sexual side effects can remain after stopping an antidepressant, or sometimes only emerge when the medication is stopped. It also follows the pattern of tardive dyskinesia, a movement disorder linked to antipsychotics which can appear on treatment and remain afterwards, or only appear when the drug is stopped.
Ironically, patients with visual snow syndrome are sometimes given antidepressants in an attempt to help their condition – usually without success.
There were 11 reports of visual snow syndrome in our recently published paper: Development and persistence of patient-reported visual problems associated with serotonin reuptake inhibiting antidepressants. You can read the accompanying blog post here.
There is no suggestion that SSRIs or related medications are responsible for all cases of visual snow, but the data does suggest that these drugs can cause the condition in some patients.
At the time of writing our paper, we had 11 reports of visual snow syndrome linked to antidepressants. We now have 14 reports.
We are interested to hear from anyone with visual snow (or any vision problem) linked to the current use or previous use of an antidepressant. Please leave a comment below. You can also report your condition to us by completing a RxISK Report even if you aren’t interested in taking the report to your doctor.
Visual Snow Initiative
The Visual Snow Initiative (VSI) was founded by Sierra Domb, herself a sufferer of visual snow syndrome. The organisation works towards raising awareness, providing education, and carrying out research. They provide a lot of information about the condition on their website including diagnostic criteria and descriptions of the symptoms. The image at the top of this blog post is from their website.
We sent details of our published paper to the VSI, and they very kindly included it in their news section. They also informed us about a forthcoming announcement of a new treatment.
New treatment
The announcement was made at the Visual Snow Initiative Virtual Summit 2022. The video is available to watch at the end of this blog post.
The treatment was developed by Dr. Terry Tsang and Dr. Charles Shidlofsky, both based in the US. They had been working separately with patients who had visual snow syndrome and had both independently developed a method of treating the condition. They were put in contact with each other by the VSI and discovered that their treatment methods followed a similar approach. They began working together to refine the treatment and to run a study, the results of which are discussed in the video.
Patients undergo a set of specialized visual tests, and the treatment is tailored to each patient depending on the specifics of their condition. The treatment consists of a series of visual exercises that help to strengthen certain aspects of visual processing. Rather than go into too much detail here, it would be better for anyone with visual snow syndrome or anyone with an interest in these issues to watch the video.
We understand from the VSI that the treatment helps symptoms regardless of the origin of the condition. The study group apparently contained several participants that were on antidepressants, and their symptoms improved.
Following the announcement, we’ve had some contact with Dr. Shidlofsky. We’ll let you know if there is anything further to report.
Visual snow is interesting in its own right but also because of its possible connection to PSSD and antidepressant withdrawal.
Could the same mechanisms underpin all three and other sets of related problems?
Does this new visual snow treatment point to anything that could be done for people with PSSD or psychotropic drug dependence?
eileen says
I have visual snow due to SSRI withdrawal.
I’m 23, and I was stable on sertraline for just over two years, highest dose 50mg. It was prescribed after a period of anxiety due to burnout at university.
I’m currently just over three months off sertraline. I was only taking 25mg, which I was told by multiple GPs was a ‘placebo/child’s dose’ and that I could stop taking it right away. I have since discovered that even at 25mg the brain will be significantly affected by abrupt removal of this drug, and for someone who is sensitive to psychoactive substances this has been disastrous – as evidenced by my ongoing withdrawal. A reinstatement attempt exacerbated negative symptoms (nausea, waking with feelings of panic and a racing heart, sleep paralysis, tingling pains all over my body, chest pain, facial numbness, nightmares, restlessness, feeling of doom, distorted perception as if having a bad ‘trip’ e.g. as if on psychedelics). Now the remaining symptoms which I struggle with are visual snow, light sensitivity, migraine headaches, fatigue, brain zaps (more like clicking sounds in my head) and derealisation. I also have PSSD, but sexual dysfunction was the reason I wanted to stop sertraline in the first place so i am unfortunately ‘used’ to it…
I think that there is similarity to my experience and people’s experiences of HPPD (hallucinogen persisting perception disorder) as both SSRIs and psychedelics such as LSD act serotonergically upon brain chemistry (as my understanding goes). In fact a lot of symptoms of HPPD align with symptoms experienced during SSRI withdrawal, in particular when it comes to visual snow.
Essentially, my nervous system has been drastically destabilised from SSRI use, to an extent which is shocking, and I have had a traumatic experience worse than any of the initial anxiety I was prescribed it for. The majority of doctors have no idea how to safely prescribe, supervise or deprescribe these drugs, which have the capacity to cause as much if not more harm as illegal drug use.
I do believe that my symptoms will improve with time, and that once a year has passed I will be in a much better place, I’m just white knuckling it until then and doing my best to find comfort in the small good things that I can. Peer support is saving me.
J.D says
Have you benefitted from the protocol Eileen?
Gonzalo says
My problems are very similar to yours, it was very hard for me to stop a “child dose” with paroxetine, have pssd, skin problems and visual snow which makes me crazy, it is hard to read to me right now
Meghan Cross says
I have had Vision Snow for 20 years now and it is not connected to any medication that I have identified. I was previously diagnosed with migraines due to the visual disturbance, but recently learned of the name “Vision Snow”. I am happy to provide any information that may help with research.
Anthony says
I am a 37 y/o male and positive I have developed visual snow after taking Bupropion XL 150mg for only 4 days. I see the multicolored dots in my entire field of vision, especially at night or in low light. I am discontinuing the drug in hopes that the condition will dissipate. However from what I have seen online it appears this will be permanent 🙁
I am happy to provide more information if contacted
Dr. David Healy says
Keep us posted if it persists – hopefully if only exposed for 4 days it might clear
David
A says
Thank you Dr. Healy. It has not gotten any better. I should clarify that I have ALL symptoms of visual snow syndrome as well, not just the visual snow. I submitted a RxISK report. Please let me know if I can help further with my story – this is extremely distressing and life-altering. I hope my story helps shed light on these horrible side effects and how the Rx can trigger Visual Snow Syndrome
Lucy says
I got visual snow when I started the SSRI ‘Escitalopram’. I was only on it for about a month and the symptoms have never gone away – it’s been 5 years now.
John says
I know Zoloft/sertraline caused my VSS, only on this medication for a couple of days! 👎
D says
Hello, first of all thank you for this page, because people with this syndrome are not taken seriously. I’m from Germany, if there are any mistakes in my English, I apologize, but I use a translator, so my English is probably understandable.
I was prescribed the antidepressant mirtazapine by a doctor in a psychiatric emergency room in late November 2016 due to depression from acne scars. I took mirtazapine until April 2017. Shortly after stopping (a few weeks or a month) I would then start noticing eye floaters when staring at a white wall and later these blue field entoptic phenomenon when looking at the sky outside. I am very sure that this antidepressant caused my vision problems because i took no other drug. However, I only have these two symptoms (eye floaters and these “sparks”, i.e. entoptic blue field phenomenon) and no eye flickering like with a television.
Unfortunately, doctors do not take this seriously and you are labeled as a hypochondriac, even though it is scientifically proven and documented. I’ve also asked hundreds of people around me (family, friends, classmates, etc.) and NO ONE knew or has these vision problems themselves. So it must be an abnormal pathology and not something that my ophthalmologist says everyone has. The symptoms, while not fatal, greatly impact quality of life. Last but not least, researchers had shown that there was no evidence that lower serotonin levels caused depression and I am deeply annoyed that I took this drug out of desperation at the time. I also found a case report reporting on a patient who developed Visual Snow Syndrome, however she was on citalopram and not mirtazapine (see source below).
What I am wondering is where is the location of the mechanism of origin of this syndrome, because in the scientific literature different potential pathomechanisms are described, e.g. B. autonomic dysregulation, disorder of the central nervous system, disorder of the retinal cells, disorder of the visual cortex, circulatory disorders of the vertebral artery due to craniomanibulary dysfunction.
It will probably take another 100 years for research to figure it out, and then the treatment will likely cause side effects of its own. I hate psychotropic drugs and will now only use naturopathic treatments that do not cause irreversible damage. I’m so frustrated because the side effect won’t go away even naturopathic medicine won’t make the side effect go away.
Sources:
https://neuronresearch.net/vision/clinical/snowyvision.htm#a4
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7803695/
https://pubmed.ncbi.nlm.nih.gov/34633444/#:~:text=Visual%20snow%20syndrome%20is%20a,neural%20responses%20to%20visual%20input
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8521005/
https://vestibular.org/visual-snow-syndrome/
https://www.frontiersin.org/articles/10.3389/fneur.2021.703006/full
https://academic.oup.com/braincomms/article/4/4/fcac164/6614740
https://www.frontiersin.org/articles/10.3389/fopht.2022.758963/full
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8886039/
https://thejcn.com/DOIx.php?id=10.3988/jcn.2020.16.4.646
F says
Can I contact you somehow? On Reddit or something? I have the same issue and same cause.
Jason Perrone says
I have had visual snow syndrome my entire life, at least that I can remember. I am currently 51 years old. I remember as a little boy looking at the stars with my dad asking him what all the other dots were. Back then it was only visible at night. Today it is so bad that it’s hard to do a full day of work. My static is so out of control that at night in a light blacked out room with my eyes closed it seems like the sun is out. It’s becoming impossible to look at a computer screen. I do everything I can, I wear FL 41 tinted lenses, I bought an expensive computer monitor designed for eye care, my diet is centered around my eyes, I have an app on my computer that forces me to take eye breaks, you name it, but I realize that this is not an optical thing, it’s a brain thing. (although my ophthalmologist has recently detected a thinning of my optic nerves so that’s concerning).
I have severe static, floaters, flashes, after images, extreme photosensitivity, tinnitus, all of the classic symptoms. I have a feeling it might have started when I was very young and my brother smashed me in the back of the head with a rock the size of a cantaloupe causing me to lose consciousness for a few seconds. Since then at various times in my life I have been on Wellbutrin, Zoloft, Haldol, and some other psychological drugs. The Wellbutrin left me with tardic dyskinesia. It’s possible that each drug has made it worse and worse and at this point I do feel like at some point my vision with be completely off the air.
I live in NY and I don’t have access to any doctors who even know what I am talking about so I don’t see how I can benefit from Tsang and Shidlofsky’s program. Pretty much hopeless after 51 years of this.
H says
I have developed visual snow syndrome after increasing my dosage of Bupropion from 150 to 300mg. I have since completely come off the medication and all the symptoms persist. It has been over a month
Lena says
I have visual snow, and don’t know the cause. I was on sertraline, between 150 and 200 mg for about 3 years. When I first started taking it I developed tinnitus, and while I can’t pinpoint when the visual snow started, it seemed to worsen when I stopped taking the medication. I’ve been off of it for about 3 months now and the vision problem hasn’t improved.
Dr. David Healy says
Lena
Yes these visual problems can get worse after stopping – and in fact can often only appear after stopping. At the moment we don’t know how long the problem can persist but if you find something that helps or can keep us updated on what happens to you this would be great information to get
David
Jemma says
I am a 35 year old female and I developed visual snow in 2016 after a period of extreme stress.
Since then I have continued to have all the common symptoms – static-like vision, shimmering vision in peripherals, tinnitus, afterimages and palinopsia etc. I have had every test under the sun and was eventually diagnosed with VS from my neuro.
However, I also suffer from a symptom that not many others with VS seem to – I have tens of permanent tiny blind spots scattered throughout my vision in both eyes. They are all in different locations to the other eye so don’t seem neurological yet my retinologist sees nothing wrong with my eyes. I wonder if this is something you may have found with other reports?
And worryingly (I did not know the potential effect of SSRIs on VS beforehand), I have recently began taking Sertraline! BUT, just to be different, I feel like my VS symptoms seem to have actually improved slightly with treatment. Not sure if this could potentially help in any way?
Mike says
Palinopsia went from tolerable to severe due to Zoloft. This needs to be reported more.
Matthew Howard says
Mine developed in college in 2005 during a period of high stress while taking adderall during finals
Sandy says
I developed visual snow after 2 months on mirtazapine, and then a period of severe stress. I read that mirtazapine can cause or worsen VSS so tapered off. Once it was out of my system, the symptoms intensified. I’ve noticed some things make it worse. Mainly the palinopsia which is hard to live with:
– poor sleep
– caffeine
– stress
– heavy screen time
– alcohol
– high sugar and salt
– pms and period
Exercise and healthy diet noticeably improved my symptoms.
Dr. David Healy says
S
This is fascinating – can you submit a rxisk report about it
David
Tyler says
I’ve had VSS for about 17 years. Age is 31 now. All the symptoms and just started taking sertraline and Amitryptiline and I wake up at night panicking. While vision field is moving and all the dots turned colourful. Interesting what the meds can do to the brain. Feel like I need something to suppress the hyperactivity. Hit my head a lot growing up playing sports. It just developed in grade 7. I hit my right ear off the ground snowboarding and it bled for a few days. There was the SARS outbreak so attempts to get me into see a doctor failed.
Will continue to take these meds if symptoms don’t improve I’ll wean off them and try something else. Maybe another anti-seizure drug
Christine says
I was finally diagnosed with VSS a couple of years ago and have had it for 30 years approx. Mine is not due to medications. I also have horrible tinnitus and memory loss along with depression, anxiety, and depersonalization. I am still working full time and taking care of everything on my own which is incredibly difficult. Any test studies coming up, please let me know. I will gladly sign up.
Amitabh Varma says
I got PPPD & VSS from SSRI. Is there anything that helps? How can we access this protocol?
Brittany says
Hi folks, I figured it might be helpful for me to post my journey with this in case anyone reading this is distraught and doesn’t know what to do. I was prescribed the smallest dose of Viibryd several months ago which I cut into quarters and only took 1/4 of the pill per day. I took it for one week total. Within 2-3 days of taking the medication, I noticed my vision completely change. It became blurry, I was seeing millions of dots everywhere, and I had horrible after images and sensitivity to light. This did not go away after stopping the medication, but instead worsened. I went to every specialist you can imagine–ophthalmologists, neuro-ophthalmologists, optometrists, neurologists, you name it. I was ultimately diagnosed with Visual Snow Syndrome that was brought on by the medication. These medications are DANGEROUS–stay away for good and never go back. Now months later, I am doing a lot better although not cured (there is no cure for VSS). I have done several months of vision therapy at two separate places: 1) Performance Vision Therapy in Los Angeles, and 2) Dr. Terry Tsang Optometry in Irvine, CA. There is a long list of doctors on the Visual Snow Initiative website–GO TO THEM. See someone who does vision therapy and tinted lenses and knows how to handle this. It will help as it helped me quite a bit and has given me my life back. I can still work although with challenges looking at screens all day, but several months ago I wasn’t sure I would ever be able to work again. If you tackle this aggressively and go to the right doctors (and spend whatever money you have to), you can beat it. I wanted to make sure to follow up because I was sobbing in tears and so lost when I first came to this discussion board. Hopefully this helps someone who’s now in my same shoes. Oh and STAY AWAY from big pharma–I am no longer taking a single prescription medication after this horrible experience. I hope this post saves someone out there!!
chris says
Was put on Lexapro 10mg for 2 weeks, told Dr. i had too many headaches and poor sleep and did not like the medication. They switched to 75mg of sertraline. visual snow developed two weeks in. Discontinued medications and VS has gotten worse at the >90 day mark. Never had any VS symptoms before starting either SSRI.
W. says
Hello,
I have VSS now for almost 3 months.
One year ago I got pulsatile tinnitus and bilateral somatic tinnitus. The VSS started in week 19/20 of my pregnancy. It started fast with static, blue field phenomenon and night blindness. Then gradually the rest came: severe palinopsia, tremors, vertigo, sensitivity to light, and headaches.
I feel like being punished for something. I’ll see my baby for the first time with static. I cannot sit outside or do my job. The doctor said I’ll get used to it, nothing to worry about..
I have no history with any medication or migraines or anxiety. I do now. VSS has destroyed my vision and my vision of how I wanted to live my life, my family life, career, marriage.
W.
Francesca Sharpe says
Hi,
I was prescribed sertraline in April 2020. I was titrated up to 150 mg on 20th May 2020. 1 week later (29th May 2020) I scheduled an emergency appointment with my optician because I have developed floaters and beams of light that move in irregular patterns all across my visual field. I also attended Moorfields eye hospital emergency department that week. On June 2nd, I began to be titrated off sertraline but the visual problem is persisted. A year later, after many investigations, I had an appointment with a neuro-ophthalmologist who informed me it was an issue with the visual cortex of the brain and not a problem with my eye. I then realised it was probably due to my antidepressant.