Flashes and floaters diagnostic signs

✍️ DD of Flashes only

☝️ Retinal traction ( true flashes)

• Vitreoretinal traction

• PDR

• Sickle cell retinopathy

• ROP

☝️ Pseudo flashes

 Ocular causes of pseudo Flashes 

• Photophobia
discomfort commonly associated with anterior segment inflammation or retinal hypersensitivity.

• Glare
dazzle commonly associated with media opacities.

• Haloes
ring effect associated with corneal oedema and some media opacities.

 CNS causes of pseudo Flashes 

• Papilloedema 
transient, associated with straining or change in posture.

• Migraine
classic enlarging zigzag fortification spectra moving central to peripheral, usually followed by headache.

• Occipital lobe lesions (tumours, AVMs)
coloured shapes or blobs( visual hallucinations ). 

• Other visual hallucinations
bilateral severe visual loss may result in more complex visual hallucinations (Charles Bonnet syndrome).

✍️ DD of Floaters only

• PVD
partial/complete Weiss ring overlying the optic disc ± visible posterior vitreous face.

• Vitreous condensations
degenerative changes within the vitreous lead to translucent opacities.

• Vitreous haemorrhage
red cells in the vitreous, varies from minor bleed (spots) in vision, fundus easily visualized) to severe (severe drop of VA, no fundal view), may be followed by synchysis scintillans (golden particles which settle with gravity).

• Vitritis
white cells in the vitreous, may be bilateral and associated with features of intermediate or posterior uveitis.

• Asteroid hyalosis
small yellow-white particles that move with the vitreous (rather than settling with gravity), usually innocuous.

• Amyloidosis
sheet-like opacities, usually bilateral most commonly seen with familial systemic amyloidosis.

• Tumours (choroidal melanoma, lymphoma)
vitritis of inflammatory or tumour cells may be seen.

✍️ DD of Flashes and floaters

• PVD
partial or complete Weiss ring overlying the optic disc ± visible posterior vitreous face.

• Retinal tear
usually u-shaped tear and pigment in the vitreous; may be associated with vitreous haemorrhage or retinal detachment.

• Retinal detachment
usually rhegmatogenous (associated with a tear) resulting in elevated retina with SRF.

• Tumours
visual phenomena include slow-moving ball of light  and floaters 2ry to tumour cells and inflammation associated with a choroidal or retinal mass.

Flashes and floaters diagnostic signs powerpoint presentation :

Floaters : Evaluation and Management with FOV

This was the presentation used during my webinar on Floaters: Evaluation and Treatment given in the winter of 2013. Floaters are anything that moves “to and fro” in your vision with eye movement. While they can decrease vision, proper treatment and evaluation is elusive. Vitrectomy surgery, or FOV, is the only way to safely remove any floaters from the eye. Vitrectomy (floater only vitrectomy/FOV) is as safe or safer than cataract surgery.

Flashes and floaters diagnostic signs Videos :

Flashes & Floaters – A Sign of Retinal Detachment

Flashes and floaters diagnostic signs