Differential Diagnosis for Flashing Dots in Peripheral Vision
Single Most Likely Diagnosis
- Ocular Migraine: This condition is characterized by transient visual symptoms, including flashing dots or lights, which can occur in the peripheral vision and resolve spontaneously. The symptoms are often benign and related to migraine activity without headache.
Other Likely Diagnoses
- Vitreous Detachment: As people age, the vitreous gel in the eye can shrink and pull away from the retina, causing flashes of light in the peripheral vision. These symptoms can resolve on their own but may also indicate a need for further evaluation to rule out retinal tears or detachment.
- Posterior Vitreous Detachment (PVD): Similar to vitreous detachment, PVD can cause sudden onset of flashing lights due to the vitreous gel pulling on the retina. Most cases are benign and resolve without intervention.
- Dry Eye Syndrome: Although less common, severe dry eye can cause visual disturbances, including flashing dots, due to irritation and inflammation of the ocular surface.
Do Not Miss Diagnoses
- Retinal Detachment: A medical emergency where the retina separates from the back of the eye. Flashing lights in the peripheral vision can be an early symptom, along with floaters and a curtain or shadow descending over the field of vision. Prompt treatment is necessary to preserve vision.
- Retinal Tear: Similar to retinal detachment, a retinal tear can cause flashing lights and requires immediate medical attention to prevent progression to detachment.
- Stroke or Transient Ischemic Attack (TIA): Although less common, visual disturbances, including flashing lights, can be a symptom of a stroke or TIA, especially if accompanied by other neurological symptoms.
Rare Diagnoses
- Ocular Lyme Disease: In rare cases, Lyme disease can cause a variety of ocular symptoms, including visual disturbances such as flashing lights, though this would typically be accompanied by other systemic symptoms of Lyme disease.
- Sarcoidosis: This autoimmune disease can affect the eyes in various ways, including causing uveitis, which might lead to visual symptoms like flashing dots. However, it would usually be part of a broader systemic disease presentation.
- Multiple Sclerosis: Optic neuritis, a condition associated with multiple sclerosis, can cause visual disturbances, including flashing lights, but this would typically be accompanied by other neurological symptoms and signs of optic nerve inflammation.