Visual snow syndrome: a review
Reviewed by Ivan Yip

Visual snow syndrome (VSS) is a neurological condition characterised by visual phenomena described as dots moving across the visual field. Other visual symptoms can take the form of palinopsia, entopic phenomena, photophobia and nyctalopia. Tinnitus and migraine can be commonly associated symptoms. VSS is usually a benign primary condition with normal ocular and brain investigations including OCT and fields as a minimum. However, differentials which mimic VSS must be considered and these include retinal dystrophy, autoimmune / paraneoplastic retinopathy, uveitis, macular atrophy, central serous retinopathy (CSR), proliferative vitreoretinopathy (PVR), optic neuropathy, nutritional deficiencies, Leber hereditary optic neuropathy (LHON), ischaemia, idiopathic intracranial hypertension (IIH) and structural brain changes. The underlying mechanism of VSS may involve dysfunctional sensory processing and altered cortical excitability but more research is required. Pharmacological treatment is ineffective and patient management is centred around reassurance and handling other associated symptoms.

Visual snow syndrome and migraine: a review.
Silva EM, Puledda F.
EYE
2023;37(12):2374-8.