In your experience have patients who experienced a mini-stroke also complain of flashing lights, flashing rainbow lights like a christmas tree and floaties after the stroke? Would a vitreous detachment be a more likely culprit than a mini-stroke or TIA? Does pain above the eyes like I described earlier go along with vitreous detachment? Furthermore, with vitreous detachment can the person take Aspirin on a daily basis without harmful side effects (ie. make it less prone to detach from retina properly)? One last thing, has stroke been known to trigger vitreous detachment? Please answer as detailed as possible. Thank you!

Thank you for getting back.

I am sorry that I may not be able to give you detailed answers on vitreous detachment, as those cases are seen by ophthalmologist, and not a neurologist like me.

However, I agree that similar symptoms could occur with vitreous detachment. Vision loss in cases of vitreous detachment are more severe, as compared to your case. Aspirin is safe in cases of vitreous detachment, however, it should be avoided in patients with vitreous haemorrhage.

Best wishes, Would be glad to answer if you have any further queries.
Dr. Sudhir Kumar MD (Medicine), DM (Neurology)
Senior Consultant Neurologist

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Additional Reply by Dr. Manish Malhotra, Consultant Ophthalmologist.

With these symptoms, posterior vitreous detachment or retinal detachment is a possible diagnosis. However the symptoms are not very specific or confirmatory for diagnosis. This photopsia and related symptoms can also occur in TIA , migraine with aura etc. The concern here is the short period of memory loss and name finding difficulty. A vitreous detachment in isolation should not cause any of these symptoms as it has got nothing to with the brain. On the other hand a TIA in the occipital lobe can cause all of these findings.

Neverthless you will require an opthalmic evaluation + CT/MRI scan of the brain. Till then I DO NOT recommend aspirin or other medications.

Hope this helps
Feel free to ask followup questions
Thank you

Hello,

This consult has been reassigned to me :

"Do you know patients that had a sudden vitreous detachment and left them confused for a bit when it suddenly began (brain overload or what have you)? " - Yes, this is quite possible . There could be a lot non specific CNS symptoms , for which the cause is not well know. In your case my primary suspicion would be an opthalmologic problem like PVD. However an important aspect from a clinical point of view NOT to restrict the diagnosis only to the eye alone and keep the diagnostic possibility of TIA in mind.

In a real clinical scenario this will evolve like this - patient presents with symptoms - I do a quick Opthalmologic examination - Suggestive of PVD or Not. If an ophthalmologic diagnosis is confirmed I would not consider TIA --> proceed with PVD approach. But in the other I would consider the diagnosis of TIA. Floaters as you rightly said is more diagnosis of an eye problem. But again this is a subjective phenomenon and I would not risk a diagnosis just based on this alone.

The interesting thing is that there is a good chance that in the end after all evaluation there might not a Vitreous detachment or TIA and the cause could remain as a undiagnosed mystery.

I understand you are trying a symptom analysis for a definitive diagnosis , but without a physical examination it is really difficult to proceed.

Hope this helps
Thank you
Dr. Manish Malhotra.