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Year : 1982  |  Volume : 30  |  Issue : 2  |  Page : 91-93

Photopsia-due to retinal disease

A.M.U. Institute of Ophthalmology, J.N. Medical College, Aligarh, India

Correspondence Address:
Manoj Shukla
A.M.U. Institute of Ophthalmology, J.N. Medical College, Aligarh
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Source of Support: None, Conflict of Interest: None

PMID: 7141600

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How to cite this article:
Shukla M, Ahuja O P. Photopsia-due to retinal disease. Indian J Ophthalmol 1982;30:91-3

How to cite this URL:
Shukla M, Ahuja O P. Photopsia-due to retinal disease. Indian J Ophthalmol [serial online] 1982 [cited 2021 Jun 24];30:91-3. Available from: https://www.ijo.in/text.asp?1982/30/2/91/28085

Table 1

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Photopsia or light flashes is a common symptom of patients with retinal disease. In this report recognition of symptom as a due to retinal disease has been emphasised and our findings in ICO patients complaining of light flashes, excluding eyes with rhegmatogenous retinal detachment are reported.

  Materials and methods Top

100 patients complaining of light flashes or lightening streak in one or both eyes were examined to detect a demonstrable vitreo-reti­nal pathology. Out of these patients 61 were males and 39 females. Myopia of varying degree (-1.50 DSph to -14 DSph) was present in 50 subjects.

After a complete ophthalmological exami­nation, each patient was examined under maximal pupillary dilatation with the help of indentation indirect ophthalmoscope. This was further supplemented by posterior segment biomicroscopy with the help of goldmann's.3­mirror contact lens. The findings were recorded on a conventional fundus chart.

  Observations Top

Out of 100 patients examined 25 (25%) had a demonstrable vitreo-retinal disease which was bilateral in four patients, Thus, in all 29 eyes were found to have pathology in the­ retinal periphery. The various pathological deg­enerative lesions were either seen as isolated or concurrently with one another [Table - 1]. lattice degeneration of retina was the commonest vitreo-retinal abnormality seen in 21 out of 29 eyes having pathological 9 (31.03%) eyes it was associated with round holes which were characteristically seen in the substance of lattice islands. The number of round holes in lattice lesions varied from one to four. Other types of tractional peripheral retinal degenera­tions observed in the symptomatic eyes were snail track degeneration, white with pressure (WWP) and white without pressure (WWOP) lesions. Isolated symptomatic round holes and horse shoe tears were seen in 7(24.14%) out of 29 eyes having pathological lesions while four patients had symptoms of lightening streaks in one eye due to acute posterior vit­reous detachment (PVD).

  Discussion Top

Various degenerative lesions of retina breaks are located in the retinal periphery. A determined effort to screen the peripheral retina by indentation indirect ophthalmoscopy to detect pathological degenerative lesions specially in symptomatic eyes would certainly be helpful in the prevention of retinal detach­ment.

Berens[1] at al described ocular findings in 33 out of 36 patients having light flashes or ligh­tening streaks. Morse at a1[2] similarly found demonstrable vitro-retinal disease in 23 subjects out of 100 having symptoms of photopsia. The general incidence of retinal breaks in asympto­matic eyes has been reported as 6.4%[5], 7.8%[4] and 5.8%[5] while in autopsy eyes the correspo­nding incidence has been reported as 10.5%[6], 5.4%[7], 6%[8] and 2%[9]. In the present study an incidence of 7% in symptomatic eyes. This is more or less similar to the incidence of retinal breaks in living and autopsy eyes. However, the symptoms of light flashes or lightening streaks in association with retinal breaks can not be ignored and as such this incidence assume special significance over the incidence of reti­nal breaks in general population. Horse shoe tears are specially dangerous lesions and should always be looked upon with suspicion. In eyes having asymptomatic or symptomatic horse shoe tear without any retinal detachment, prophylatic treatment should always be consi­dered. Such tears undergo a routine prophy­latic cryopexy with or without localized buck­ling in patients attending our clinic.

Lattice degeneration of retina is another notorious condition which predisposes to reti­nal breaks. Round holes are commonly seen in the substance of islands and arc in fact a part and parcel of the disease rather than being a complication thereof. Frank horse shoe tears are also seen, although not very common at the posterior margin of lattice lesions. In reti­nal detachment cases, the incidence of lattice degeneration has been reported as 20%[10] and 65%[11]. Shukla and Ahuja[12] reported that nearly one third of normal eyes having lattice degeneration are associated with retinal breaks mostly round holes while lattices degeneration is the causative factor in about one fourth of all the rhegmatogenous retinal detachment cases. In view of lattice degeneration being closely associated with retinal breaks and reti­nal detachment, prophylactic treatment of this condition is justified more so in symptomatic eyes.

The incidence of retinal break formation in relation to acute posterior vitreous detach­ment (PVD) has been described as 11 %[13] , 15.%[14], and 12%[15]. In these reports posterior vitreous detachment was commonly associated with symptoms of light flashes or lightening streaks.

In view of lightening streak being impor­tant symptoms of vitres-retinal disease, it is extremely essential to explore the peripheral retina of patients having these symptoms with indentation indirect ophthalmoscopy and Goldmann's-3-Mirror contact lens. Even if no demonstrable lesion is found in the initial examination a regular follow up and evalua­tion should be a must in such eyes.

  Summary Top

Photopsia or light flashes is an important symptom of a vitreo-retinal disease. 100 patients with this symptom were screened and demonstrable vitreo-retinal pathology was seen in 29 eyes of 25 patients. It is emphasised to recognise this symptom as a certain due to a retinal disease so that many pathological degenerative lesions including retinal breaks can be detected early and suitable treated by prophylactic means. Such an approach would indeed go a long way in the prevention of retinal detachment.

  References Top

Berens, C., Cholst, M., Emmerich, R. and McGrath., 1954, Trans. Amer. Ophthal. Sec.52 :35.  Back to cited text no. 1
Morse, P.H., Scheie, H.G., and Aminlari, A 1974, Arch. Ophthalmol. 91 : 179.  Back to cited text no. 2
Halpern, J. 1., 1966, Amer. J. Ophthalmol. 62:99.  Back to cited text no. 3
Rutnin, U., and Schepens, C.L., 1967 Amer. J. Ophthalmol, 64 : 1063.  Back to cited text no. 4
Byer, N.E., 1967, Trans. Amer. Acad. Ophthal­mol. Otolaryng, 71 :461.  Back to cited text no. 5
Foos, R.Y. and Allen, R.A., 1967, Arel. Ophthal­mol. 64 : 643.  Back to cited text no. 6
Barishak, Y.R. and Stein, R., 1972, Acta. Opht­halmol, 50: 147.  Back to cited text no. 7
Speneer, L.M., Straatsma, B.R., and Foos, R.Y. 1969, Symposium on retina and retinal surgery, C.V. mosby St. Louis, page 103.  Back to cited text no. 8
Foos, R.Y. , 1975, Tears of peripheral retina Pathogenesis, incidence and classification in autopsy eyes. In new research on the etiology and sur­gery of retinal detachment (Modern problems in ophthalmology-ed, streiff, E.B), S. Karger. Basel, page. 68.  Back to cited text no. 9
Michaelson, I.C., 1954, Acta XVII Concilium Ophthalmelogicum, 1-392.  Back to cited text no. 10
Meyer-Schwickerath, G., 1960, Light Coagula­tion, C.V. Mosby, St. Louis, page 58.  Back to cited text no. 11
Shukla, M., and Ahuja, O.P., 1980, pros. XXIX All India Ophth. Conf. (in press).  Back to cited text no. 12
Linder, B., 1966. Acta. Ophthalmologicum, supl. 187 : 1.  Back to cited text no. 13
Jaffe, N.S., 1968, Arch. ophthalmol., 79 : 568.  Back to cited text no. 14
Tasman, W.S.,1968, Trans. Amer. Acad. Opht­halmal. otolaryng, 72 : 217.  Back to cited text no. 15


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