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 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 oft ...

/ retinal migraine) * migraine aura without headache * scintillating scotoma * retinal break or detachment * occipital lobe 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 al ...

(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 combinatio ...

) *

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 * 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 In materials science, liquefaction is a process that generates a liquid from a solid or a gas or that generates a non-liquid phase which behaves in accordance with fluid dynamics. It occurs both naturally and artificially. As an example of the ...

, 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 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 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 Optometry is a specialized health care profession that involves examining the eyes and related structures for defects or abnormalities. Optometrists are health care professionals who typically provide comprehensive primary eye care. In the Uni ...

ophthalmologist Ophthalmology ( ) is a surgery, 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. Followin ...

. 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.

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 Eyes are organs of the visual system. They provide living organisms with vision, the ability to receive and process visual detail, as well as enabling several photo response functions that are independent of vision. Eyes detect light and conv ...

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

. 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 Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pat ...

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 Migraine (, ) is a common neurological disorder characterized by recurrent headaches. Typically, the associated headache affects one side of the head, is pulsating in nature, may be moderate to severe in intensity, and could last from a few hou ...

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 Multiple (cerebral) sclerosis (MS), also known as encephalomyelitis disseminata or disseminated sclerosis, is the most common demyelinating disease, in which the insulating covers of nerve cells in the brain and spinal cord are damaged. This d ...

(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 Ischemia or ischaemia is a restriction in blood supply to any tissue, muscle group, or organ of the body, causing a shortage of oxygen that is needed for cellular metabolism (to keep tissue alive). Ischemia is generally caused by problems wi ...

, 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 A stroke is a medical condition in which poor blood flow to the brain causes cell death. There are two main types of stroke: ischemic, due to lack of blood flow, and hemorrhagic, due to bleeding. Both cause parts of the brain to stop functionin ...

) 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 *

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

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 al ...

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 Signs and symptoms are the observed or detectable signs, and experienced symptoms of an illness, injury, or condition. A sign for example may be a higher or lower temperature than normal, raised or lowered blood pressure or an abnormality showin ...

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