differential diagnosis

Last reviewed 09/2020

  • certain visual experiences do not correspond to any object in the external environmental
  • these may be grouped as
    • entopsias (floaters) (1)
      • these are visual perceptions that originate due to intrinsic structures of the eye (eg, vitreous cells shedding images on retina are perceived as floaters)
      • these images may be normal or pathologic
      • the precipitating structures can usually be identified on eye examination
    • photopsias (flashes) (1)
      • flashing lights thought to be stimulated by vitreous traction on the retina
      • may sometimes be considered a visual hallucunation
    • a variety of diseases cause flashes and floaters
      • these may be unilateral or bilateral
      • when unilateral , mainly due to disorders of the anterior visual pathway
    • acute posterior vitreous detachment is the most common cause of sudden-onset flashes and floaters
    • the differential diagnosis of floaters include (2)
      • retinal detachment
      • acute posterior vitreous detachment
      • proliferative diabetic retinopathy
      • trauma
      • uveitis
    • the differential diagnosis of flashes include (2)
      • posterior vitreous detachment
      • optic neuritis
      • migraine
      • hypotension
      • transient ischemic attack