Understanding photopsia—stars or flashes in your vision

Photopsia is when you see flashes of light or sparkling images, even when there’s no light shining towards your eye. It can feel like seeing “stars” in your vision or brief bursts of light, similar to lightning streaks or tiny fireworks. . People might notice these visual changes more frequently in low-light conditions or after sudden movements. It’s important to note that photopsia is a symptom and not a condition itself, meaning there is typically a root cause. If you’re experiencing photopsia, reach out to your eye care professional immediately.

• Sparkles of light, like glitter in your field of vision
• Zig-zagging lines in your peripheral vision, often moving rapidly
• Flickering lights that blink on and off, like camera flashes in a dark room
• Dotted patterns or bright dots that may pulse or change shapes

Retinal detachment

This is when the retina pulls away from the back of the eye. It’s a serious condition that can happen suddenly and requires immediate medical attention. If you experience rapid flashes of light along with floaters and/or a dark shadow creeping into their vision, it could be a sign of this problem. It’s very important to act fast in these situations, as retinal detachment can lead to permanent vision loss if not treated right away.

Migraines

A migraine is a really painful type of headache that sometimes comes with something called aura, which can include photopsia. When someone has a migraine with aura, they might see flashes of light, zig-zag lines, or shimmering patterns before or during their headache. These flashes can happen even without an accompanying headache, which can be confusing. If you know you get migraines, trying to manage things that stress you out may help reduce how often these flashes occur. Remember—flashes can come from more serious emergency causes as well, so if you typically experience migraine with aura, but are having a different experience, immediately contact your eye doctor for an examination of the retina to rule out a retinal tear or detachment.

Vitreous detachment

As we grow older, the jelly-like substance inside our eyes, called the vitreous, can start to pull away from the retina (the light-sensitive layer at the back of the eye). This condition is known as posterior vitreous detachment or PVD, and it’s something that many older adults experience. When the vitreous pulls away, it may tug on the retina, and that’s what creates those sparkly sensations. If you are experiencing photopsia as part of an active vitreous detachment, your eye doctor will want to follow you closely to ensure that it separates without tearing the retina.

Eye injury

If you bump your eye or rub it too hard, it can sometimes cause flashes of light as well. This is because the pressure you put on your eye can stimulate the retina, creating those sparkling effects. Usually, these flashes are temporary, but if you see them after an injury, you should get checked out by a doctor to make sure everything is okay, especially because “seeing stars” can also be a sign of a serious concussion.

Neurological issues

Sometimes, issues with the brain can cause photopsia, too. For example, problems in an area of the brain that helps us see, called the occipital lobe, can create these flashes of light. Conditions like seizures might also create similar experiences. If you notice any unusual symptoms, like confusion or weak muscles, seek help right away.

Blood pressure changes

If you have high blood pressure, it can lead to problems in the eye that may cause photopsia. On the flip side, getting up too quickly after sitting or lying down can cause blood pressure to drop suddenly, which can also create brief flashes of light or cause a sensation of “blacking out.” Keeping an eye on blood pressure and managing any medical conditions may help with these symptoms.

If you notice new light flashes in your vision, seek the care of your eye doctor immediately. During your appointment, they’ll ask about your symptoms and medical history. They might want to know specific details, like when you first noticed your flashes, what they look like, and how long they last. After discussing your symptoms, the doctor will likely conduct a thorough eye exam. This might include:

• Vision tests to check how well you see at different distances
• Dilated retinal examination using eye drops to widen your pupils, allowing your doctor to thoroughly inspect your retina and vitreous for any abnormalities
• Eye pressure measurement to rule out conditions such as glaucoma, which can also affect your vision

Once diagnosed, your treatment will depend on the underlying cause of your photopsia. The treatment your your eye care professional recommends may include:

Observation

If the cause is a natural process like vitreous detachment without any accompanying symptoms, your doctor may opt for observation, as many cases resolve on their own.

Medication

For photopsia linked with migraines, medications may be prescribed for pain relief as well as anti-nausea drugs, depending on the symptoms experienced during migraine attacks.

Surgery

In cases of retinal detachment or significant eye trauma, immediate surgical intervention may be necessary to repair damage and restore normal vision. For instance, retinal surgery aims to reattach the retina to the eye wall, helping prevent further vision loss.