Photopsia

Photopsia is the presence of perceived flashes of light in the field of vision. It is most commonly associated with: 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 are the most common causes of photopsia, cause 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), 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 concerning 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 (5–7 per 1 million people will be affected, typically fair-skinned, blue-eyed northern Europeans). Photopsia should be investigated immediately. 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 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. 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.