Photopsia is a perception of light (flash, spark, etc) that is not associated with incident light to the eye.
Possible causes of photopsia:
(1) retinal detachment
(2) migraine
(3) flick phosphene
(4) postural hypotension
(5) choroidal tumor
(6) disorder of the optic nerve (may be demyelinating)
(7) transient ischemic attack (TIA)
where:
• A peripheral retinal break can be missed by direct ophthalmoscopy.
• A phosphene is a visual sensation that occurs with the eyes closed and in the absence of light. A flick phosgene is associated with a quick eye motion.
The evaluation requires consideration of each condition. The workup should not stop once a single explanation is identified since multiple problems can exist.
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