Highlights
- •Our case series of visual snow (VS) patients is similar to previous reports.
- •Tinnitus, migraine and tremor are associated non-visual features.
- •Tinted lenses in the yellow-blue colour spectrum, improves VS symptoms.
- •Visual snow may be a thalamocortical dysrhythmia of the visual pathway.
Abstract
In this paper we review the visual snow (VS) characteristics of a case cohort of 32
patients. History of symptoms and associated co-morbidities, ophthalmic examination,
previous investigations and the results of intuitive colourimetry were collected and
reviewed. VS symptoms follow a stereotypical description and are strongly associated
with palinopsia, migraine and tinnitus, but also tremor. The condition is a chronic
one and often results in misdiagnosis with psychiatric disorders or malingering. Colour
filters, particularly in the yellow-blue colour spectrum, subjectively reduced symptoms
of VS. There is neurobiological evidence for the syndrome of VS that links it with
other disorders of visual and sensory processing such as migraine and tinnitus. Colour
filters in the blue-yellow spectrum may alter the koniocellular pathway processing,
which has a regulatory effect on background electroencephalographic rhythms, and may
add weight to the hypothesis that VS is a thalamocortical dysrhythmia of the visual
pathway.
Graphical abstract

Graphical Abstract
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Clinical NeuroscienceAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Palinopsia revamped: a systematic review of the literature.Surv Ophthalmol. 2015; 60: 1-35
- Should ‘visual snow’ and persistence of after-images be recognised as a new visual syndrome?.J Neurol Neurosurg Psychiatry. 2014; 85: 1057-1058
- ‘Visual snow’ – a disorder distinct from persistent migraine aura.Brain. 2014; 137: 1419-1428
- The relation between migraine, typical migraine aura and “visual snow”.Headache. 2014; 54: 957-966
- FMRI evidence that precision ophthalmic tints reduce cortical hyperactivation in migraine.Cephalagia. 2011; 31: 925-936
- Is colour modulation an independent factor in human visual photosensitivity?.Brain. 2007; 130: 1679-1689
- Visual snow. From a symptom to a syndrome?.Arch Soc Esp Oftalmol. 2015; 90: 51-52
- The visual snow phenomenon.J Fr Ophtalmol. 2014; 37: 722-727
- Tinnitus in migraine: an allodynic symptom secondary to abnormal cortical functioning?.Headache. 2005; 45: 1083-1087
- Mechanisms of increased sensitivity to noise and light in migraine headache.Cephalalgia. 1993; 13: 417-421
- Correlation between essential tremor and migraine headache.J Neurol Neurosurg Psychiatry. 1990; 53: 1060-1062
- Migraine: multiple processes, complex pathophysiology.J Neurosci. 2015; 35: 6619-6629
- Vision in subjects with hyperawareness of afterimages and “visual snow”.Act Ophthalmologica. 2012; 90
- Ophthalmological assessment of cannabis-induced persisting perception disorder: is there a direct retinal effect?.Doc Ophthalmol. 2015; 130: 121-130
- Disorders of visual perception.J Neurol Neurosurg Psychiatry. 2010; 81: 1280-1287
- Sustained visual cortex hyperexcitability in migraine with persistent visual aura.Brain. 2011; 134: 2387e95
- Clinical recognition of allodynia in migraine.Neurology. 2004; 63: 17
- Hallucinogen persisting perception disorder in neuronal networks with adaptation.J Comput Neurosci. 2012; 32: 25-53
- Migraine pathophysiology: lessons from mouse models and human genetics.Lancet Neurol. 2015; 14: 65-80
- Visual memory, visual imagery, and visual recognition of large field patterns by the human brain: functional anatomy by positron emission tomography.Cereb Cortex. 1995; 5: 79-93
- Neural correlates of imagined and synaesthetic colours.Neuropsychologia. 2006; 44: 2918-2925
- Functional (psychogenic) movement disorders.Curr Opin Neurol. 2012; 25: 507-512
- Thalamocortical dysrhythmia: a neurological and neuropsychiatric syndrome characterized by magnetoencephalography.Proc Natl Acad Sci USA. 1999; 96: 15222-15227
- A nosographic analysis of the migraine aura in a general population.Brain. 1996; 119: 355-361
- Photophobia in primary headaches.Headache. 2015; 55: 600-604
- A neural mechanism for exacerbation of headache by light.Nat Neurosci. 2010; 13: 239-245
- Multiple hypothalamic cell populations encoding distinct visual information.J Physiol. 2011; 589: 1173-1194
- Hypothalamic and basal ganglia projections to the posterior thalamus: Possible role in modulation of migraine headache and photophobia.Neuroscience. 2013; 248: 359-368
- Posterior hypothalamic modulation of light-evoked trigeminal neural activity and lacrimation.Neuroscience. 2013; 246: 133-141
- A third parallel visual pathway to primate area V1.Trends Neurosci. 1994; 17: 305-310
- The koniocellular pathway in primate vision.Annu Rev Neurosci. 2000; 23: 127-153
- Slow intrinsic rhythm in the koniocellular visual pathway.Proc Natl Acad Sci USA. 2011; 108: 14659-14663
- Infraslow oscillations modulate excitability and interictal epileptic activity in the human cortex during sleep.Proc Natl Acad Sci USA. 2004; 101: 5053-5057
- Dyslexia: a review of two theories.Clin Exp Optom. 2008; 91: 333-340
- The magnocellular theory of dyslexia.Dyslexia. 2001; 7: 12-36
- Experimental evidence for a transient system deficit in specific reading disability.J Am Optom Assoc. 1990; 61: 137-146
- Visual stress theory and its application to reading and reading tests.J Res Reading. 2004; 27: 152-162
- Treatment of photosensitive epilepsy using coloured glasses.Seizure. 1999; 8: 444-449
- A functional neuroimaging case study of Meares-Irlen syndrome/visual stress (MISViS).Brain Topogr. 2012; 25: 293-307
Article info
Publication history
Published online: January 11, 2016
Accepted:
December 2,
2015
Received:
October 8,
2015
Identification
Copyright
© 2015 Elsevier Ltd. All rights reserved.