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The following tutorial discusses the various sources of photopsia: vitreoretinal traction, ocular migraines, age-related macular degeneration, diabetes, cerebral blood flow, visual hallucinations, cancer associated retinopathy, entoptic phenomenon, phosphenes, and lens associated dysphotopsias.
Ocular Migraine Phenomena Photopsia (18 sec) This is an artist's rendering of photopsia. The video was created for UIHC Department of Ophthalmology and Visual Sciences by Juan Carlos Nieto, Thomas A. Weingeist, PhD, MD, and Michael Abramoff, MD, PhD.
A 25-year-old male presented with 3 days of painless scotoma and photopsia in the left eye. Amsler grid testing revealed an enlarged blindspot. Fundus examination showed multiple subretintal white spots. Fluorescein angiography showed classic punctate hyperfluorescence in a wreath-like pattern in the left eye (photo at bottom of page).
A subconjunctival hemorrhage occurs due to ruptured blood vessels in the conjunctiva. The blood accumulates between the sclera and the conjunctiva and appears as a red spot on the white of the eye.
Contributor: Jesse Vislisel, MD Photographer: Antoinette Venckus, CRA; Stefani Karakas, CRA. Purtscher retinopathy is the appearance of cotton wool spots, hemorrhages, and retinal edema located predominantly around the optic disc.
Figure 9-1. Acute angle closure glaucoma. Left: In an eye with a normal configuration of the anterior segment, the angle between the iris and cornea is wide open (approximately 40˚).
Discussion. MEWDS (Multiple Evanescent White Dot Syndrome) is a rare, unilateral, self-limiting inflammatory disease that afflicts young women more than men in a 4:1 ratio.
Retinal detachment is an important cause of decreased visual acuity and blindness. It is one of the most common ocular emergencies today, most frequently affecting the middle aged and elderly.
Epidemiology and Pathophysiology. Occurs in three out of 100,000 patients on topiramate; Involves choroidal swelling that increases retrolenticular pressure to push the lens-iris diaphragm anteriorly
Photopsia (16%) Eye pain (7%) Scotomas (3%) TREATMENT . Key to effective treatment is the improvement of the immune status of the patient, especially institution of multidrug anti-HIV therapy for the HIV+ patient (protease inhibitors plus nucleoside analogues) Small peripheral lesions may be observed without other treatment