| Photopsia | |
|---|---|
 | |
| This is an approximation of the zig-zag visual of a scintillating scotoma as a migraine aura. It moves and vibrates, expanding and slowly fading away over the course of about 20 minutes. | |
| Specialty | Ophthalmology, Neurology |
| Symptoms | Flickering lights or flashes in the field of vision, along with pain, loss of colour perception, and eventual vision loss are also part of the damage to the optic nerve during optic neuritis[1] |
| Usual onset | During pregnancy |
| Duration | Migraine with aura, which includes photopsia 39% of the time, typically lasts 10 to 20 minutes and often is followed by a headache.[2] |
| Causes | Peripheral (Posterior) vitreous detachment, retinal detachment, age-related macular degeneration, ocular (retinal) migraine / migraine aura, vertebrobasilar insufficiency, optic neuritis, occipital lobe infarction (similar to occipital stroke), sensory deprivation (ophthalmopathic hallucinations) |
| Risk factors | Above age 50 (risk of retinal detachment)[3] |
| Treatment | In most cases, photopsia is a symptom of a preexisting condition. The underlying condition must be identified and treated to resolve the symptoms. |
Photopsia is the presence of perceived flashes of light in the field of vision.
It is most commonly associated with:[4]
- posterior vitreous detachment
- migraine aura (ocular migraine / retinal migraine)
- migraine aura without headache
- scintillating scotoma
- retinal break or detachment
- occipital lobe infarction (similar to occipital stroke)
- sensory deprivation (ophthalmopathic hallucinations)
- age-related macular degeneration
- vertebrobasilar insufficiency
- optic neuritis
- visual snow syndrome
Vitreous shrinkage or liquefaction, which is the most common cause of photopsia, causes a pull in vitreoretinal attachments, irritating the retina and causing it to discharge electrical impulses. These impulses are interpreted by the brain as flashes.
This condition has also been identified as a common initial symptom of punctate inner choroiditis (PIC),[5] a rare retinal autoimmune disease believed to be caused by the immune system mistakenly attacking and destroying the retina. During pregnancy, new-onset photopsia is a concern for severe preeclampsia.
Photopsia can present as retinal detachment when examined by an optometrist or ophthalmologist. However, it can also be a sign of uveal melanoma. This condition is extremely rare (affecting 5–7 per 1 million people, typically fair-skinned, blue-eyed northern Europeans). Photopsia should be investigated immediately.
- ^ "Photopsia: Is It Dangerous? (How to Treat It) - Nvision". Nvision. Retrieved 30 August 2019.
- ^ "The woman who saw the light". MDedge Psychiatry. Retrieved 31 August 2019.
- ^ "Retinal detachment - Symptoms and causes - Mayo Clinic". Mayo Clinic. Retrieved 30 August 2019.
- ^ Morrow, Nicole C.; Chung, Anthony T.; Wall, Michael. "Photopsias". EyeRounds.org. University of Iowa Carver College of Medicine. Retrieved 20 June 2020.
- ^ "Punctate inner choroidopathy | Genetic and Rare Diseases Information Center (GARD) – an NCATS Program". rarediseases.info.nih.gov. Retrieved 2019-08-28.