Differential Diagnosis for a 72-Year-Old Female with Left Eye Flashes
Single Most Likely Diagnosis
- Posterior Vitreous Detachment (PVD): This condition is common in older adults and can cause flashes of light due to the vitreous gel pulling on the retina. Although the ophthalmologist noted no tears or holes, PVD itself can cause these symptoms without necessarily leading to a retinal detachment.
Other Likely Diagnoses
- Vitreous Syneresis: This is a condition where the vitreous gel in the eye liquefies and shrinks, which can cause flashes of light. It's a common age-related change that can occur without leading to more serious conditions like retinal detachment.
- Migraine: Ocular migraines can cause visual disturbances, including flashes of light. Although migraines are more common in younger populations, they can occur at any age.
- Ocular Ischemic Syndrome: This condition, caused by reduced blood flow to the eye, can lead to flashes of light among other symptoms. It's more common in older adults with vascular disease.
Do Not Miss Diagnoses
- Retinal Detachment: Despite the ophthalmologist's initial assessment, a retinal detachment could still be present and is a medical emergency. It requires prompt treatment to preserve vision.
- Giant Cell Arteritis: This condition can cause visual disturbances, including flashes of light, and is a medical emergency due to the risk of blindness if not promptly treated.
- Central Retinal Artery Occlusion: This is another emergency condition that can cause sudden visual loss and may be preceded by flashes of light.
Rare Diagnoses
- Choroidal Melanoma: Although rare, this type of eye cancer can cause visual disturbances, including flashes of light, especially if it involves the retina or vitreous.
- Vitreoretinal Lymphoma: A rare form of cancer that can affect the eye and cause a variety of symptoms, including flashes of light.
- Sarcoidosis: This autoimmune disease can affect the eyes in various ways, including causing flashes of light, though it's a less common presentation.