Differential Diagnosis for Visual Disturbances
The patient presents with a flashing light in the upper left corner of their vision, accompanied by mild visual disturbances. The following differential diagnoses are considered:
- Single most likely diagnosis
- Migraine with aura: This condition is characterized by visual disturbances, such as flashing lights, that can occur before or during a migraine headache. The symptoms described by the patient are consistent with a migraine aura.
- Other Likely diagnoses
- Ocular migraine: Similar to migraine with aura, but without the headache. The visual disturbances can be unilateral and may include flashing lights.
- Dry eye syndrome: Although less likely to cause flashing lights, severe dry eye can lead to visual disturbances and may be accompanied by other symptoms like eye irritation or blurred vision.
- Refractive errors: Uncorrected or under-corrected refractive errors, such as myopia, hyperopia, or astigmatism, can cause visual disturbances, including flashes of light, especially if the error is significant.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Retinal detachment: A medical emergency that can cause sudden flashes of light, especially if the detachment is in the peripheral retina. Prompt diagnosis and treatment are crucial to prevent permanent vision loss.
- Temporal arteritis: An inflammatory condition that can cause visual disturbances, including flashing lights, and may lead to blindness if not treated promptly.
- Stroke or transient ischemic attack (TIA): Although less common, a stroke or TIA can cause sudden visual disturbances, including flashing lights, and requires immediate medical attention.
- Rare diagnoses
- Occipital lobe seizures: Rare seizures that can cause visual disturbances, including flashing lights, and may be accompanied by other neurological symptoms.
- Vitreous detachment: A condition where the vitreous gel separates from the retina, which can cause flashing lights and floaters. Although usually benign, it can be a sign of an underlying retinal tear or detachment.
- Choroidal melanoma: A rare type of eye cancer that can cause visual disturbances, including flashing lights, although this is not a common presenting symptom.