Can photopsia (flashing dots) be a benign condition?

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From the Guidelines

Yes, photopsia (flashing dots) can be a benign condition, often caused by age-related changes in the vitreous gel inside the eye, which can cast shadows on the retina as it moves, as noted in the study by 1.

Causes of Photopsia

The causes of photopsia can be varied, including:

  • Age-related changes in the vitreous gel
  • Stress, fatigue, or migraine auras
  • Vitreomacular adhesion, the attachment of the posterior cortical vitreous to the neurosensory retina, which may represent the normal evolution of a posterior vitreous detachment (PVD) 1
  • Epiretinal membranes, which can lead to macular traction and similar visual symptoms 1

Concerning Symptoms

However, certain symptoms can indicate a more serious condition, such as:

  • Sudden onset of numerous flashing lights
  • Vision loss
  • Curtain-like shadow
  • Many new floaters
  • Eye pain
  • Severe headache
  • Flashes that persist for hours

Evaluation and Risk Factors

If you're unsure about flashing dots in your vision, it's best to consult an eye care professional for proper evaluation, especially if you have risk factors like:

  • High myopia
  • Previous eye surgery
  • Eye trauma
  • History of ocular trauma or abnormalities of the anterior segment, such as corneal ectasia, corneal dystrophies, or peripheral anterior synechiae 1
  • Conditions that increase the risk of open-angle glaucoma (OAG) or angle-closure glaucoma, such as exfoliation syndrome and pigment dispersion syndrome 1

Importance of Medical Evaluation

A comprehensive adult medical eye evaluation, as outlined in the study by 1, can help identify signs of systemic diseases or other serious medical conditions, and is essential for individuals with risk factors or concerning symptoms.

From the Research

Photopsia as a Benign Condition

  • Photopsia, or flashing dots, can be a symptom of various conditions, including Charles Bonnet syndrome (CBS) 2, 3, 4 and visual snow syndrome 5.
  • In the context of CBS, visual hallucinations, including photopsia, are typically benign and occur in patients with visual loss due to age-related macular degeneration (AMD), cataracts, and other ocular diseases 2, 3.
  • However, photopsia can also be a symptom of more serious conditions, such as sporadic Creutzfeldt-Jakob Disease 5, and can provoke seizures in individuals with photosensitive epilepsy 6.
  • The visual snow syndrome, which includes photopsia as a symptom, is typically considered benign, but careful diagnosis and exclusion of underlying pathology are essential 5.

Key Factors and Associations

  • Poor visual acuity is a significant risk factor for the development of CBS and associated visual hallucinations, including photopsia 3.
  • The prevalence of CBS in late AMD is high, and the majority of patients experience benign visual hallucinations, including photopsia 3.
  • In contrast, photopsia can be a symptom of photosensitive seizures, which can be provoked by visual stimulation, including light flashes and patterns 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Charles Bonnet syndrome.

Vojnosanitetski pregled, 2016

Research

The Charles Bonnet syndrome: a review of recent research.

Current opinion in ophthalmology, 2006

Research

Visual snow: Not so benign.

Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia, 2019

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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