Have you ever had black spots in your vision & wondered what they were or if you should be concerned? Essentially, there are only a handful of things that can cause black spots in your vision. The main are “floaters”, an intermittent and temporary lack of adequate blood supply to the eye, and a retinal break. We will talk briefly about each and help you to better understand them.
Floaters. We’ve all had them at some point. For those lucky few, who perhaps haven’t yet, count your blessings! It is only a matter of time however until you too develop floaters. So what exactly are they? Floaters are a layman term for vitreal degeneration or a posterior vitreal detachment. They are the result of a natural breakdown of the vitreous gel within the posterior vitreous of our your eye. Imagine a ball of jelly that begins to liquefy over time. As it breaks apart, clumps or pieces of it float within the aqueous portion of the vitreous, casting a shadow upon the retina as it floats in front of it. They are typically translucent or partially opaque, but can be seen through. Most, though not all, move with your eye movements as they float freely in the liquid vitreous. Some may partially block your view as you look straight ahead. Typically, they are more noticeable under fluorescent lighting, when surrounded by a white or lightly colored room, or while reading. The good news, is that typically they subside with time and your brain learns to ignore them.
Breakdown of the vitreous is a normal part of aging and floaters are usually a benign (or non-worrisome) finding. If however, you notice a new floater all of a sudden in one eye, this can carry a higher risk for a problem with the retina. If we make the analogy of the eye to a camera, your retina is analogous to the film in the camera; without it functioning correctly, you will not have the necessary components to create a clear picture. When someone notices a sudden, new floater, it is called an acute posterior vitreal detachment. This carries a higher risk for a problem with your retina and you should see an eye doctor for a thorough, dilated fundus (or retinal) exam as soon as possible. As the vitreous begins to break down & liquefy, it eventually collapses in on itself & pulls away from it’s attachment to the tissues within the eye; namely, the optic nerve head, macula, and peripheral retina.
A problem arises, when the vitreous pulls so hard that when it detaches, it results in a hole, break, or tear developing in the retina of the eye. This is an eye emergency as liquid can seep underneath the retina, leading to a retinal detachment. Usually a retinal break is accompanied with similar, but very different symptoms. The most common is an acute (or sudden) onset of black spots in one eye, a curtain, veil, or part of your vision missing or distorted, or photopsia (lightening bolts or streaks of light that are persistent in one area; many patients describe this as analogous to an electrical storm). If you experience any of these symptoms, you should see your eye doctor (optometrist or ophthalmologist) IMMEDIATELY. Do not eat or drink anything, just drive in to the nearest eye doctor. If you have had a retinal detachment, there is a window of time in which it can be successfully repaired and time is of the essence to ensure the best outcome.
Black spots can also be caused by a temporary and inadequate blood supply to the eye. If you suffer from low blood pressure and have ever risen quickly from a chair, you know the lightheaded feeling and black spots that often result. Similarly, if you suffer from ocular migraines, you may experience black spots or parts of your vision that are missing and then come back and blotchy patterns. If you experience these symptoms you should see your eye doctor and primary care physician to rule out serious underlying pathology.
In closing, there are several things that can cause you to see black spots in your vision. Each of these, warrant a discussion and thorough examination by an eye care professional. They should not be taken lightly. After all, the eyes you were born with are the only two you will ever have! Over seventy percent of your external stimuli comes from your vision. Your eyes are a valuable commodity you should not easily take lightly.