A 33-year-old woman presents with a 3-day history of seeing "spots" floating around in her eye. Today, she notes streaks of light in the same eye accompanied by a "shadow" in her peripheral vision that moves when looking up and down. Her medical history is significant for migraine headaches; however, she has never had such visual symptoms with her headaches. What is the most likely diagnosis?
High-Yield Explanation
Retinal detachment: The history suggests retinal detachment. the vitreous detach from the retina and causes the perception of "floaters" Vitreous detaching from the retina may cause a peripheral "horseshoe" tear in susceptible areas of the retina. The tear allows fluid within the vitreous to accumulate under the retina and cause a detachment. When the retina is paially detached and the eye moves, the patient may notice a "shadow" that corresponds to the torn retina. Retinal detachment is ophthalmic emergency because the detachment can progress to the fovea and threaten central vision. Opthalmic migraine: an eye condition that causes brief attacks of blindness or visual problems like flashing lights in 1 eye. Amaurosis fugax: Condition in which a person cannot see from one or both eyes due to transient failure of blood supply to retina.