Differential Diagnosis for Repeated Flashes and Streaks of Light in Peripheral Vision
Single Most Likely Diagnosis
- Migraine with aura: This condition is characterized by visual disturbances, including flashes and streaks of light, often in the peripheral vision, preceding or accompanying a migraine headache. The symptoms described are classic for a migraine aura.
Other Likely Diagnoses
- Ocular migraine: Similar to migraine with aura, but without the headache. The visual symptoms can be identical and are thought to be related to migraine pathology but without the pain component.
- Posterior vitreous detachment (PVD): As people age, the vitreous gel in the eye can shrink and pull away from the retina, causing flashes of light. This is a common condition, especially in people over 40.
- Vitreous detachment with retinal tear: A more serious condition where the vitreous detachment causes a tear in the retina, leading to flashes of light and potentially severe vision loss if not treated promptly.
Do Not Miss Diagnoses
- Retinal detachment: A medical emergency where the retina separates from the back of the eye, causing sudden flashes of light, floaters, and vision loss. Prompt treatment is necessary to preserve vision.
- Central retinal vein occlusion: A blockage of the main vein of the retina, which can cause sudden vision loss and may be preceded by flashes of light.
- Temporal arteritis (Giant Cell Arteritis): An inflammation of the blood vessels, particularly those in the head, which can cause visual disturbances, including flashes of light, and potentially lead to blindness if not treated.
Rare Diagnoses
- Occipital lobe seizures: Rarely, seizures originating in the occipital lobe of the brain can cause visual hallucinations, including flashes of light.
- Lympoma or other intracranial tumors: In rare cases, tumors in the brain can cause visual disturbances due to pressure on the visual pathways.
- Malignant hypertension: Severe high blood pressure can cause visual symptoms, including flashes of light, due to the effect on the blood vessels in the eye and brain.