Spontaneous visual phenomena with visual loss: 104 patients with lesions of retinal and neural afferent pathways.

Fifty-seven percent of 104 consecutive patients with retinal or neural visual loss reported spontaneous visual phenomena (SVP). Elementary SVP occurred more commonly (51% of patients) than complex SVP (21%). SVP occur with lesions of any portion of the visual pathways. Unlike irritative hallucinations, they do not aid in localization of the lesion. SVP occur significantly more frequently with visual acuity of 20/50 or less in both eyes. These purely visual hallucinations are unlikely to herald psychiatric disease and may be release phenomena stemming from loss of inhibitory visual input.