Photopsia

Causes

Several conditions affecting the eyes can cause photopsia to occur. The underlying condition must be identified and treated to resolve the symptoms.

Peripheral (posterior) vitreous detachment

Peripheral (posterior) vitreous detachment occurs when the gel around the eye separates from the retina. This can naturally occur with age. However, if it occurs too rapidly, it can cause photopsia which manifests in flashes and floaters in the vision. Typically, the flashes and floaters go away in a few months.

Retinal detachment

The retina lines the inside of the eye. It is light-sensitive and communicates visual messages to the brain. If the retina detaches, it moves and shifts from its normal position. This can cause photopsia, but can also cause permanent vision loss. Medical attention is needed to prevent vision loss. Procedures may include laser treatment, freezing, or surgery.

Age-related macular degeneration

Age-related macular degeneration (AMD) is a common eye condition among people aged 50 and older. The macula is a part of the eye that helps you see sharply straight ahead. With AMD, the macula slowly deteriorates which can cause photopsia.

Ocular (retinal) migraine / Migraine aura

Migraines are a type of recurring headache. Migraines typically cause severe pain in the head, but can also cause visual changes known as auras. Migraines can also cause visual snow.

Optic neuritis

Optic neuritis is an inflammation that damages the optic nerve. It's linked to multiple sclerosis (MS). Along with flickering or flashing with eye movement, symptoms include pain, loss of colour perception, and vision loss.

Occipital lobe infarction (stroke) or ischemia

The occipital lobe is one of four lobes in the brain. It controls the ability to see things. Impaired blood flow to the cells of the occipital lobe (ischemia, for example as caused by a TIA or Vertebrobasilar insufficiency) will lead to temporary visual problems; if the poor blood flow is sustained it will lead to cell death (infarction, for example as caused by a stroke) which may cause persistent visual problems.

The main symptoms associated with an occipital lobe infarction involve changes to vision such as:

• blurry vision
• blindness, which may affect part of vision only
• hallucinations, such as flashing lights (photopsia): usually only in the context of blindness

Sensory deprivation (Ophthalmopathic hallucinations)

Sensory deprivation or ophthalmopathic hallucination are hallucinations that appear in the field of vision.

Appearance

Photopsias is defined as an effect on the vision that causes appearances of anomalies in the vision. Photopsias usually appear as:

• flickering lights
• shimmering lights
• floating shapes
• moving dots
• snow or static

Photopsias are not generally a condition on their own, but a symptom of another condition.

References

• Engmann, Birk (2008). "Phosphenes and photopsias – ischaemic origin or sensorial deprivation? – Case history." Z. Neuropsychol. 19(1): 7–13.
• Chu, David S. (MD) (2001). Ocular Immunology and Uveitis Foundation. https://web.archive.org/web/20160304061225/http://www.uveitis.org/docs/dm/punctate_inner_choroiditis.pdf
• Sihota, Ramanjit. Tandon, Radhika.(2011). Parsons' Disease of the Eye. 2011. Edition 21st. pp. 90–91.

References

1. "Photopsia: Is It Dangerous? (How to Treat It) - Nvision".
2. "The woman who saw the light".
3. "Retinal detachment - Symptoms and causes - Mayo Clinic".
4. "Photopsias". [[University of Iowa Carver College of Medicine]].
5. "Punctate inner choroidopathy {{!}} Genetic and Rare Diseases Information Center (GARD) – an NCATS Program".