Visual phenomena, disturbances, and hallucinations

The visual system and its processing of sensory information can be affected in a variety of ways that may be either normal or associated with numerous disorders and diseases. Visual images produced by the intrinsic components of the eyes are often normal and are known as entoptic phenomena. In contrast, the visual system may be disrupted by various disorders and pathologic processes, which can result in metamorphopsia, transient loss of vision, and positive scotomas. Such disruptions can be secondary to retinal and optic nerve disease, migraines associated with visual auras, and cerebrovascular and neurologic diseases; they can also be side effects of certain drugs. In addition, the visual system may process incoming sensory information in such a way that what is seen is perceived incorrectly, i.e. illusion; or the visual system may produce images of things not really there, i.e. hallucination. Various types of visual phenomena, disturbances, and hallucinations are discussed. The numerous visual presentations need to be differentiated so that appropriate treatment, management, and patient education can be rendered.