Most of these patients have a known migraine history. 3 The aura may not be accompanied nor followed by a headache of any sort within 60 minutes, representing an acephalgic migraine. Each symptom lasts no longer than one hour and is completely reversible. Patients often describe “a camera flash at the side of my vision.” Migraine with typical aura is defined as gradual development of positive and negative visual and/or sensory and/or speech/language symptoms, but no motor weakness. Further, the flashing lights seen with PVD are rapid, peripheral, and short-lived. This phenomenon is bilateral and involves the sensation of coloured lights, as opposed to monocular flashing lights seen in retinal pathology and white lights seen in PVD. On history, patients describe a pattern of lights, jagged lines, or colours “marching” through the visual field, sometimes surrounding a central area of visual field loss. The most common mimicker of PVD is visual aura with or without a migraine.

Data that answers these questions or gaps What this article will not do: a comprehensive migraine review… perhaps another TCMP article. What this article will do: help you decode flashing lights. The objective of this article is to outline clinical features that differentiate these diagnoses and aid the primary care physician in determining the urgency of ophthalmologic assessment. 2 Other conditions, such as acephalgic migraine, can also present with flashing lights. These are less common, with a 0.1% lifetime risk of developing a retinal detachment, but a threat to vision and must be ruled out. 1 However, the differential diagnosis also includes concerning retinal pathology, such as a retinal tear or detachment. Most often, this represents a posterior vitreous detachment (PVD), an age-related condition with a prevalence that increases from 24% in adults aged 50 to 59 to 87% among those aged 80 to 89 years. The acute onset of monocular flashes and/or floaters is a common presentation to primary care providers. O’Donnell ( biography and disclosures) What care gaps or frequently asked questions I have noticed Lauren Hughes ( biography, no disclosures) and Dr.

Lattice degeneration flashes