Understanding seizure risk with wide field fundus photography: Implications for screening guidelines in the era of COVID-19 and telemedicine

Purpose: To report two cases of photosensitive seizures due to fundus photography flash.

Observations: Two patients with seizure history present to a retina clinic for routine follow up. While obtaining imaging, these patients experienced a seizure triggered by fundus camera flash.

Conclusions: Fundus photography is essential and ubiquitous amongst optometry and ophthalmology practices, especially in the rising era of telemedicine in the setting of the recent COVID-19 pandemic. To our knowledge, there are no other reports in the literature of seizures triggered by fundus photography flash. However, we believe this to be an under-reported phenomenon and suggest that all eye care providers screen patients for a history of seizures or epilepsy prior to fundus photography.

Keywords: Fundus camera flash; Fundus photography; Photic seizure; Photosensitive epilepsy; Wide-field fundus photography.