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Palinopsia and polyopia in the absence of drugs or cerebral disease

From the Department of Ophthalmology, Harvard Medical School and the Neuro-Ophthalmology Unit, Massachusetts Eye and Ear Infirmary, Boston, MA.

Address correspondence and reprint requests to Dr. Howard D. Pomeranz, University of Maryland, Department of Ophthalmology, 419 West Redwood Street, 4th Floor, Baltimore, MD 21201.

OBJECTIVE: To report the occurrence of palinopsia and polyopia in patients who neither used drugs nor had diseases of the cerebral hemispheres, a group in which these visual symptoms have not been reported. Method:— The patient records in the database of an academic neuro-ophthalmology unit were reviewed.

RESULTS: Seventeen patients were identified in the database with the diagnosis of palinopsia or polyopia, of whom eight had diseases of the cerebral hemispheres, leaving nine patients for analysis. No patients with a history of drug toxicity were identified. In one patient the symptoms presented during an initial episode of demyelinative optic neuritis in the absence of clinical or laboratory evidence of cerebral lesions. In another patient they developed immediately after laser treatment of diabetic macular edema. A third patient developed the symptoms in association with visual loss from Leber’s hereditary optic neuropathy. The other six patients were healthy individuals.

CONCLUSION: Palinopsia and related visual symptoms can occur in otherwise healthy individuals and in patients with disease apparently confined to the eye or the optic nerve.

Key words: Palinopsia—Polyopia—Visual hallucinations—After-image

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