• Comprehensive Ophthalmology, Neuro-Ophthalmology/Orbit

    Researchers evaluated pharmacologic treatment options for visual snow and reported the prevalence of comorbid diseases.

    Study design

    The authors examined the medical charts of 58 patients with a diagnosis of visual snow between 2007 and 2018. They collected data on prescribed medications and comorbid conditions such as migraine, tinnitus and psychiatric conditions.


    Comorbid migraine was present in 51.7% of patients, lifetime depression in 41.4% and lifetime anxiety in 44.8%. Lamotrigine—the most frequently prescribed drug—led to partial remission of symptoms in 5 of 26 patients (19.2%). No patients reported complete remission. Half of lamotrigine-treated patients experienced adverse events.

    By contrast, none of the other prescribed drugs (valproate, topiramate, acetazolamide and flunarizine) led to improvement with the exception of topiramate in 1 patient who discontinued, however, because of adverse events.​


    This study was limited by its retrospective nature. In addition, depression/anxiety questionnaire data were only available for 62.1% of patients. 

    Clinical significance

    The findings here suggest that lamotrigine can lead to partial remission of symptoms in a small minority of patients. Migraine, depression, anxiety, and tinnitus were common comorbid diseases in patients with visual snow.​