Symptoms of HPPD

Andrew aka SPAWNmaster [subject #99], The Pentagon..., 2006. "The streaks across my field of vision are very much like those threads of multicolor light... although more 'neon' colored in real life." © 2006 SPAWNmaster [more]

In addition to visual disturbances (30 subjects) comprising visual hallucinations (28 subjects), visual illusions (23 subjects) and visual loss (4 subjects), the responses of the 30 participants in Sofia Greene's internet survey who were diagnosed as having HPPD documented a variety of non-visual symptoms (19 subjects) including depersonalisation (11 subjects), derealisation (9 subjects), tinnitus (6 subjects), cognitive problems (5 subjects), somatosensory symptoms (4 subjects), fatigue (3 subjects), paracusis (2 subjects), vertigo (2 subjects), déjà vu (2 subjects), minor balance problems (1 subject), musical palinacusis (1 subject) and auditory hallucinations of hearing "people calling my name" (1 subject), respectively. The often-heard notion that HPPD is a purely visual disorder (derived from the fact that all examples of phenomena quoted in the DSM-IV criteria are visual disturbances) is clearly contradicted by this finding.

ihatethesymptoms [subject #245], Visual snow, 2007. © 2007 ihatethesymptoms [more]

As the most frequent symptom, persistent visual hallucinations of random form dimension (Siegel and Jarvik, 1975) were encountered in 27 HPPD subjects. These were described as visual snow (20 subjects), static (12 subjects), floaters (9 subjects), dots (5 subjects), flashes (4 subjects), light (4 subjects), sparkles (3 subjects), flickering (2 subjects), grainy vision (2 subjects), particles (2 subjects), pulses (2 subjects), specs (2 subjects) or as blizzard, blobs, bubbles, globs in air, heat-wave like things, mouches volantes, points, weird shapes or a "big worm thing" by each 1 subject. According to one subject (#371), "It's like a veil of points of different colours that seems to be staying between you and the background."

One subject (#434) reported a visual hallucination of "this big worm thing that has many dark circles inside it floating around not moving and many little bubbles with black dots in it and when searching for many different bacteria pictures under a microscope to try to find something that looked like what I see I found on this site a picture on the right of exactly what I see and this site is about candida and the picture the long worm like structure and many little bubles with black dots in it is exactly what I see". On the basis of this phenomenal similarity, he became convinced to suffer from candida in the eye. [more]

ihatethesymptoms [subject #245], Red line across vision, 2007. "A line across my vision mainly in the dark... reddish color, went away for a while, then back, then away (a bit)... " © 2007 ihatethesymptoms [more]

Persistent visual hallucinations of line form dimension were mentioned by 3 HPPD subjects (see figure above), persistent visual hallucinations of curve or web form dimension by each 2 HPPD subjects and persistent visual hallucinations of lattice or kaleidoscope form dimension by each 1 HPPD subject.

ihatethesymptoms [subject #245], Visual perseveration, 2007. "When I get trails I have the cell phone moving, plus a second strong image of the cell phone light chasing behind the real one, the faster I move the phone, the longer the gap between them. I also have a ghostly trail covering the whole journey of the light, it will stay there a long time, longer if I don't try and blink it away." © 2007 ihatethesymptoms [more]

Persistent visual perseveration was reported by 18 HPPD subjects, including positive afterimages (12 subjects), negative afterimages (9 subjects), trails (9 subjects) and palinopsia (1 subject). One subject (#245) experienced a variety of visual perseveration amalgamating the features of trails and diplopia, as shown in the illustration above. Less frequently encountered visual illusions included autokinesis (8 subjects), corona phenomenon (4 subjects), metamorphopsia (4 subjects), diplopia (3 subjects), polyopia (2 subjects), macropsia (1 subject) and micropsia (1 subject), respectively.

Persistent hypersensitivity to light was experienced by 10 HPPD subjects.

Persistent depersonalisation was recorded by 11 HPPD subjects and persistent derealisation by 9 HPPD subjects. These are considered the most embarrassing symptoms and often lead to anxiety, depression, and even contemplating suicide (see here).

ihatethesymptoms [subject #245], Increased halos and starbursts, 2007. © 2007 ihatethesymptoms [more]

Increased starbursts and increased halos around lights were experienced by each 5 HPPD subjects, respectively.

ihatethesymptoms [subject #245], Varieties of central scotomas, 2007. © 2007 ihatethesymptoms [more]

Persistent visual loss was reported by 4 HPPD subjects, including 3 subjects with a complaint of blurry vision and one subject with a variety of presentations of a central scotoma as shown in the sufferer's above series of illustrations.

The distribution of visual symptoms of HPPD encountered in the present sample of 30 subjects with a diagnosis of HPPD matches that from the sample of 70 LSD users who participated in the classical study of Abraham (1983) in that geometric visual hallucinations, positive and negative afterimages, trailing phenomena, halos around objects (corona phenomenon) and difficulty reading are recorded with similar frequencies in both studies. Other visual phenomena were reported considerably less frequently by the subjects from the present study than by Abraham's subjects, which can be attributed to the fact that the present internet-based study used a shorter and less structured questionnaire to elicit reports of visual symptoms than the study of Abraham (1983) that employed (in the second phase of the study) an 83-item-questionnaire to obtain information falling into several categories including the phenomenology of visual disturbances and other flashback symptoms. These visual phenomena include perceptions in peripheral field ("my field of vision is very wide if that makes any sense... Like I can see more, as if I have a 'wide screen' sort of perception" [subject #99]; "It's hard to tell exactly what's real, as I am bombarded with flashes, sparkles, and anomalies, particularly on the periphery of my vision" [subject #199]; "flickering in periphery of vision" [subject #404]), flashes of colour ("color patterns" [subject #89]; "'neon' colored ... streaks across my field of vision" [subject #99]; "strange colors in weird shapes... that weird, purplish/red shifting color blob" [subject #190]; "color outbursts" [subject #191]; "flashes of coloured light" [subject #245]; "a coloured dot" [subject #260]; "coloured lights" [subject #490]), intensified colour ("extreme... color sensitivity" [subject #103]; "stronger colours (especially neon)" [subject #437]), imagistic pseudohallucinations ("Sometimes... I can see things inside the colors. What I think in my mind I'll see in the red and purple static, like looking at an ink blot test" [subject #89]), macropsia [subject #490] and micropsia [subject #490], geometric phosphenes ("I have much activity in my vision when I close my eyes; orange light dispersed with dark and yellowish moving colours. I first started seeing orange specs dispersed in the black, and now the yellowish (more phosphenes it seems)" [subject #32]; "At night, with my eyes closed I could see bright colors moving back and forth" [subject #101]; "big fireworks of pulsing colours when my eyes were closed... the closed eye visuals took my mind off it" [subject #245]; "Closed eye visuals - mainly a green light pulsing inwards to a detailed image, almost like a picture, turns a blue kind of colour. Nothing in particular, each time different. Not all the time" [subject #245]; "NOW THIS... what's this about..... ok so close my eyes sometimes, I get green light spreading from the outside of my closed eyes to the centre in pulses, getting smaller, then closing up into a detailed image in dark blue (?) sometimes looks like my iris (is that what's is called - round me pupil) but it's small. Who knows. Slow as well, say 10 secs per pulse" [subject #245]), pareidolia ("fractals and certain 'patterned' images that appear when looking at the walls, or floors or any materials that have some sort of points... from which my mind can make patterns" [subject #99]) and color confusions ("Everything white has a light neon green or red tint to it" [subject #245]).

References

Abraham HD. Visual phenomenology of the LSD flashback. Arch Gen Psychiatry 1983; 40: 884-889. [PDF]
American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-IV. 4th ed. American Psychiatric Association, Washington, DC 1994.
Asher H. "Trailing" phenomenon--a long-lasting LSD side effect. Am J Psychiatry 1971; 127: 1233-1234.
Asher H. "Trailing" phenomenon--a long lasting side effect of LSD. J Tenn Med Assoc 1971; 64: 681-682.
Kaminer Y, Hrecznyj B. Lysergic acid diethylamide-induced chronic visual disturbances in an adolescent. J Nerv Ment Dis 1991; 179: 173-174.
Kawasaki A, Purvin V. Persistent palinopsia following ingestion of lysergic acid diethylamide (LSD). Arch Ophthalmol 1996; 114: 47-50.
Levi L, Miller NR. Visual illusions associated with previous drug abuse. J Clin Neuroophthalmol 1990; 10: 103-110.
Medford N, Baker D, Hunter E, Sierra M, Lawrence E, Phillips ML, David AS. Chronic depersonalization following illicit drug use: a controlled analysis of 40 cases. Addiction 2003; 98: 1731-1736.
Siegel RK, Jarvik M. Drug-induced hallucinations in animals and man. In: Siegel R, West L (eds) Hallucinations: Behavior, experience, and theory. John Wiley and Sons, New York, NY 1975, 81-161.
Sunness JS. Persistent afterimages (palinopsia) and photophobia in a patient with a history of LSD use. Retina 2004; 24: 805.
Woody GE. Hallucinogens and afterimages. Am J Psychiatry 1971; 128: 367.

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