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Abstract
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SIGNIFICANCE: Visual snow syndrome is a recently recognized condition with its own diagnostic criteria, evolving pathophysiologic research, and potential treatment options.
PURPOSE: This report documents a rare, but likely underdiagnosed condition called visual snow syndrome. A review of the current literature on pathophysiology and treatments is discussed. CASE REPORT: A 40-year-old white male started experiencing symptoms of constant pulsating pixels throughout his entire visual field approximately 3 weeks after a series of mild concussions. Additionally, he experienced a persistence of images and photosensitivity. The patient had normal eye exams, visual fields and retinal imaging. Brain magnetic resonance imaging, magnetic resonance angiography, electroencephalography, and cerebrospinal fluid analysis were unremarkable. A positron emission tomography scan demonstrated hypometabolism in the posterior parietal lobes and left posterior cingulate gyrus. Pharmacological treatment with anti-epileptic and migraine medications were unsuccessful. Tinted lenses were essentially ineffective with a 10% reduction in symptoms reported with the use of a custom blue tinted lens. Vision rehabilitation aids with optical character recognition were utilized for prolonged reading needs.
CONCLUSIONS: Although rare, visual snow syndrome should be considered in all patients reporting continuous pixelations in their vision for over 3 months, especially when accompanied by at least two of the following: photosensitivity, palinopsia, enhanced entopic phenomena, or nyctalopia. The pathophysiology is still unclear at this point with evidence suggesting a link to the secondary visual cortex, specifically the lingual gyrus. More studies are needed to determine the exact cause, especially studies that separate visual snow syndrome patients with and without comorbid migraine. Because the pathophysiology is unclear, the treatment course is also unclear. Anecdotal evidence may suggest that tinted lenses may be of some value.
Language: en |