Decreased performance 1900XTX

Hi guys. I noticed in the last few days that I am getting far less performance from my card. I play LoTRO and I had to drop down to medium settings because it was getting such bad frame rates. The game really isnt all that graphically intensive, and I have been playing it on high settings for about a year. I keep my case clean and just cleaned it again a few days ago. I checked all the cables and updated all the drivers.

I also notice some screen flicker out of the game. While I was typing an email yesterday, the screen would flicker to black and back, almost as if someone was flipping a lightswitch. Very strange.

Any ideas what this could be?