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 An aura is a perceptual disturbance experienced by some with epilepsy or migraine. An epileptic aura is a seizure. Epileptic and migraine auras are due to the involvement of specific areas of the brain, which are those that determine the symptom ...

( ocular migraine /

retinal migraine Retinal migraine is a retinal disease often accompanied by migraine headache and typically affects only one eye. It is caused by ischaemia or vascular spasm in or behind the affected eye. The terms "retinal migraine" and "ocular migraine" are of ...

) * migraine aura without headache *

scintillating scotoma Scintillating scotoma is a common visual aura that was first described by 19th-century physician Hubert Airy (1838–1903). Originating from the brain, it may precede a migraine headache, but can also occur acephalgically (without headache), a ...

* retinal break or detachment *

occipital lobe The occipital lobe is one of the four major lobes of the cerebral cortex in the brain of mammals. The name derives from its position at the back of the head, from the Latin ''ob'', "behind", and ''caput'', "head". The occipital lobe is the vi ...

infarction (similar to occipital stroke) *

sensory deprivation Sensory deprivation or perceptual isolation is the deliberate reduction or removal of stimuli from one or more of the senses. Simple devices such as blindfolds or hoods and earmuffs can cut off sight and hearing, while more complex devices can ...

(ophthalmopathic

hallucinations A hallucination is a perception in the absence of an external stimulus that has the qualities of a real perception. Hallucinations are vivid, substantial, and are perceived to be located in external objective space. Hallucination is a combinati ...

) *

age-related macular degeneration Macular degeneration, also known as age-related macular degeneration (AMD or ARMD), is a medical condition which may result in blurred or no vision in the center of the visual field. Early on there are often no symptoms. Over time, however, som ...

vertebrobasilar insufficiency Vertebrobasilar insufficiency (VBI) describes a temporary set of symptoms due to decreased blood flow (ischemia) in the posterior circulation of the brain. The posterior circulation supplies the medulla, pons, midbrain, cerebellum and (in 70-8 ...

* optic neuritis *

visual snow syndrome Visual snow syndrome (VSS) is an uncommon neurological condition in which the primary symptom is that affected individuals see persistent flickering white, black, transparent, or coloured dots across the whole visual field. Other common symptom ...

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 Punctate inner choroiditis (PIC) is an inflammatory choroiditis which occurs mainly in young women. Symptoms include blurred vision and scotomata. Yellow lesions are mainly present in the posterior pole and are between 100 and 300 micrometres in ...

( PIC), a rare retinal

autoimmune In immunology, autoimmunity is the system of immune responses of an organism against its own healthy cells, tissues and other normal body constituents. Any disease resulting from this type of immune response is termed an "autoimmune disease". ...

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 Pre-eclampsia is a disorder of pregnancy characterized by the onset of high blood pressure and often a significant amount of protein in the urine. When it arises, the condition begins after 20 weeks of pregnancy. In severe cases of the disease ...

. Photopsia can present as

retinal detachment Retinal detachment is a disorder of the eye in which the retina peels away from its underlying layer of support tissue. Initial detachment may be localized, but without rapid treatment the entire retina may detach, leading to vision loss and blin ...

when examined by an optometrist or

ophthalmologist Ophthalmology ( ) is a surgical subspecialty within medicine that deals with the diagnosis and treatment of eye disorders. An ophthalmologist is a physician who undergoes subspecialty training in medical and surgical eye care. Following a medic ...

. However, it can also be a sign of

uveal melanoma Uveal melanoma is a type of eye cancer in the uvea of the eye. It is traditionally classed as originating in the iris, choroid, and ciliary body, but can also be divided into class I (low metastatic risk) and class II (high metastatic risk). Symp ...

. 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.

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 Floaters or eye floaters are sometimes visible deposits (e.g., the shadows of tiny structures of protein or other cell debris projected onto the retina) within the eye's vitreous humour ("the vitreous"), which is normally transparent, or between ...

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 Visual impairment, also known as vision impairment, is a medical definition primarily measured based on an individual's better eye visual acuity; in the absence of treatment such as correctable eyewear, assistive devices, and medical treatment� ...

. 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 The macula (/ˈmakjʊlə/) or macula lutea is an oval-shaped pigmented area in the center of the retina of the human eye and in other animals. The macula in humans has a diameter of around and is subdivided into the umbo, foveola, foveal avas ...

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 In neuroanatomy, the optic nerve, also known as the second cranial nerve, cranial nerve II, or simply CN II, is a paired cranial nerve that transmits visual information from the retina to the brain. In humans, the optic nerve is derived from ...

. It’s linked to multiple sclerosis (MS). Along with flickering or flashing with

eye movement Eye movement includes the voluntary or involuntary movement of the eyes. Eye movements are used by a number of organisms (e.g. primates, rodents, flies, birds, fish, cats, crabs, octopus) to fixate, inspect and track visual objects of intere ...

, symptoms include pain, loss of colour perception, and

Occipital lobe infarction (stroke) or ischemia

The

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 TIA or Tia may refer to: Aviation * Tampa International Airport, US, IATA code TPA * Texas International Airlines, US, ICAO code * Tirana International Airport Nënë Tereza, Albania, IATA code * Trans International Airlines, former U.S. airl ...

Vertebrobasilar insufficiency Vertebrobasilar insufficiency (VBI) describes a temporary set of symptoms due to decreased blood flow (ischemia) in the posterior circulation of the brain. The posterior circulation supplies the medulla, pons, midbrain, cerebellum and (in 70-8 ...

) will lead to temporary visual problems; if the poor blood flow is sustained it will lead to

cell death Cell death is the event of a biological cell ceasing to carry out its functions. This may be the result of the natural process of old cells dying and being replaced by new ones, as in programmed cell death, or may result from factors such as dis ...

( 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 Blurred vision is an ocular symptom where vision becomes less precise and there is added difficulty to resolve fine details. Temporary blurred vision may involve dry eyes, eye infections, alcohol poisoning, hypoglycemia, or low blood pressure. ...

blindness Visual impairment, also known as vision impairment, is a medical definition primarily measured based on an individual's better eye visual acuity; in the absence of treatment such as correctable eyewear, assistive devices, and medical treatment� ...

, which may affect part of vision only *

, such as flashing lights (photopsia): usually only in the context of

Sensory deprivation (Ophthalmopathic hallucinations)

Sensory deprivation Sensory deprivation or perceptual isolation is the deliberate reduction or removal of stimuli from one or more of the senses. Simple devices such as blindfolds or hoods and earmuffs can cut off sight and hearing, while more complex devices can ...

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. {{ISBN, 978-81-312-2554-7 Eye diseases Medical signs Migraine Hallucinations