STUDY - Technical - New Dacian's Medicine
Photopsias (light flashes) (Classical / Allopathic Medicine)
A cardinal
symptom of vision-threatening retinal detachment, light
flashes (photopsias) can occur locally or throughout the
visual field. The patient usually reports seeing spots,
stars, or lightning-type streaks. Flashes can occur suddenly
or gradually and can indicate temporary or permanent vision
impairment.
In most cases,
light flashes signal the splitting of the posterior vitreous
membrane into two layers; the inner layer detaches from the
retina and the outer layer remains fixed. The sensation of
light flashes may result from vitreous traction on the
retina, hemorrhage caused by a tear in the retinal
capillary, or strands of solid vitreous floating in a local
pool of liquid vitreous.
HISTORY:
Ask the patient when the light flashes began. Can he pinpoint their location, or do they occur throughout the visual field?
If the patient is experiencing eye pain or headache, have him describe it.
Ask the patient if he wears or has ever worn corrective lenses and if he or a family member has a history of eye or vision problems.
Review the patient's medical history for other problems, noting especially hypertension or diabetes mellitus, which can cause retinopathy and retinal detachment.
Obtain an occupational history because light flashes may be related to job stress or eye strain.
Ask the patient when the light flashes began. Can he pinpoint their location, or do they occur throughout the visual field?
If the patient is experiencing eye pain or headache, have him describe it.
Ask the patient if he wears or has ever worn corrective lenses and if he or a family member has a history of eye or vision problems.
Review the patient's medical history for other problems, noting especially hypertension or diabetes mellitus, which can cause retinopathy and retinal detachment.
Obtain an occupational history because light flashes may be related to job stress or eye strain.
PHYSICAL
ASSESSMENT:
Inspect the external eye, lids, lashes, and tear puncta for abnormalities and the iris and sclera for signs of bleeding.
Observe pupil size and shape. Check for reaction to light, accommodation, and consensual light response.
Test visual acuity in each eye. Also test visual fields; document light flashes the patient reports during this test.
Inspect the external eye, lids, lashes, and tear puncta for abnormalities and the iris and sclera for signs of bleeding.
Observe pupil size and shape. Check for reaction to light, accommodation, and consensual light response.
Test visual acuity in each eye. Also test visual fields; document light flashes the patient reports during this test.
SPECIAL
CONSIDERATIONS:
Provide emotional support because the patient may be upset about the potential loss of vision.
Provide emotional support because the patient may be upset about the potential loss of vision.
PEDIATRIC
POINTERS:
Children may experience light flashes after minor head trauma.
Children may experience light flashes after minor head trauma.
PATIENT
COUNSELING:
If the patient has retinal detachment, prepare him for reattachment surgery. If he doesn't have retinal detachment, reassure him that his light flashes are temporary and don't indicate eye damage. Advise him to take an analgesic, darken the room, minimize other stimuli, and obtain adequate sleep when a headache occurs.
If the patient has retinal detachment, prepare him for reattachment surgery. If he doesn't have retinal detachment, reassure him that his light flashes are temporary and don't indicate eye damage. Advise him to take an analgesic, darken the room, minimize other stimuli, and obtain adequate sleep when a headache occurs.
Bibliography:
1. Rapid Assessment, A
Flowchart Guide to Evaluating Signs & Symptoms, Lippincott
Williams & Wilkins, 2004.
2. Professional Guide to
Signs and symptoms, Edition V, Lippincott
Williams & Wilkins, 2007.
3. Guide to common
symptoms, Edition V, McGraw - Hill, 2002.
Dorin,
Merticaru (2010)