Black Spots in Vision: Causes and Solutions for Eye Issues

When looking at a light bulb or small reflective surfaces, there are large dark spots obscuring vision?

Hello, doctor.
I am glad to have found this excellent website during this helpless time.
I have floaters, astigmatism of 50 and 100, and my myopia is -4.50 and -5.50.
Around the evening of August 14, I noticed that when looking at small lights (such as the light from an extension cord or the lights on a modem) with my right eye, the originally circular and radiating light appeared to have a black spot at the 10 o'clock position.
The farther the light source was from me, the larger the black spot became, almost covering the entire light.
There was a very small halo around the black spot.
I also noticed that my left eye had a black spot, but it was not like the right eye, as the black spot in the left eye would disappear after blinking.
It is not just with lights; any reflective "dot" would show the same phenomenon.
When I look at the light reflected from my right eye, there is also a black spot, and it moves with the light source.
The more light sources there are, the more black spots appear.
However, in my right eye, regardless of blinking or moving my eyes, the black spots do not move.
The more bright points there are, the more black spots accumulate on the lights, moving with the light.
When driving at night, I notice these black spots on distant car headlights, and even when wearing glasses, they are quite noticeable on the headlights and traffic lights.
I have consulted a local doctor in Taitung, who dilated my pupils at night, but the doctor said my retina is fine and there is no cataract.
My vision test with glasses showed 1.0, and the prescription is fine, but there must be some issue with a part of my eye.
Could you please advise me on what kind of examinations I should request from the doctors at National Taiwan University Hospital? The journey from Taitung to Taipei is quite long, and I want to resolve my concerns.
Thank you.
Over the past couple of months, I have been using my phone a lot while crying, and I wonder if this has caused any damage to my eyes.
I truly feel helpless.

Han, 20~29 year old female. Ask Date: 2016/09/21

Dr. Gao Pilin reply Ophthalmology

Hello,
Based on your description, it seems to resemble the symptoms of floaters.
The dilated eye exam showed no issues, so there is essentially no need to worry, as such symptoms typically do not affect vision over time.
It’s advisable to avoid using your phone in the dark, although there is no medical evidence that this harms the retina, it can at least help reduce eye strain.
Crying should not cause any harm to your eyes.
If it's inconvenient to visit Taipei for an examination, Taitung Mackay Memorial Hospital should also be able to conduct the necessary checks.
After the examination, the doctor will explain the results or perform further tests if needed.

Taiwan E-Hospital Puzi Hospital Ophthalmology: Monday to Friday from 8:00 AM to 12:00 PM and Wednesday from 1:00 PM to 4:30 PM.
Please note that online responses should only be used as a reference; it is essential to seek medical care at a healthcare facility if necessary.
I hope to have the opportunity to assist you.
Best regards,
Gao Pilin

Reply Date: 2016/09/21

More Info

Hello! Thank you for reaching out with your concerns about the visual disturbances you are experiencing. Based on your description, it sounds like you are dealing with a combination of symptoms that could be related to your existing conditions, such as myopia (nearsightedness) and astigmatism, as well as the phenomenon known as "floaters" or "visual snow."

Understanding Your Symptoms
1. Black Spots and Floaters: The black spots you see, especially when looking at bright lights, could be related to floaters. Floaters are tiny clumps of gel or cells inside the vitreous, the clear gel-like substance that fills the eye. They can cast shadows on the retina, which is why you see them as black spots, especially against bright backgrounds. This is a common occurrence and often becomes more noticeable with age or changes in the vitreous gel.

2. Visual Disturbances with Lights: The fact that you see these black spots more prominently when looking at lights, and that they seem to move with the light source, suggests that these are indeed floaters. However, the presence of a small halo or light ring around the black spots could indicate that there is some degree of light scattering occurring, which can happen with certain refractive errors or corneal irregularities.

3. Night Driving Issues: Your difficulty seeing lights clearly while driving at night, combined with the presence of these black spots, can be concerning. Night vision issues can be exacerbated by conditions such as astigmatism or even early cataracts, which can cause glare and halos around lights.

Potential Causes and Recommendations
Given your history of myopia and astigmatism, along with the recent onset of these symptoms, it is essential to consider a few possibilities:
- Vitreous Detachment: As we age, the vitreous gel can shrink and pull away from the retina, leading to an increase in floaters. This is generally benign but should be monitored.

- Retinal Issues: Although your previous examinations showed no retinal problems, it is crucial to ensure that there are no underlying issues, such as retinal tears or detachments, especially since you are experiencing new visual symptoms.

- Corneal Health: The mention of your cornea being darker than expected could indicate a need for further evaluation. Conditions such as corneal pigmentation or irregularities can affect how light enters the eye and may contribute to your symptoms.

Next Steps
1. Comprehensive Eye Examination: I recommend scheduling a comprehensive eye examination with a specialist, preferably a retinal specialist or an ophthalmologist who can perform detailed imaging tests such as Optical Coherence Tomography (OCT) or a fundus examination to assess the health of your retina and vitreous.

2. Visual Field Testing: This can help determine if there are any areas of vision loss that may not be immediately apparent during a standard eye exam.

3. Consider Neurological Evaluation: If your symptoms persist or worsen, it may be worthwhile to consult a neurologist to rule out any neurological causes, especially since visual disturbances can sometimes be linked to migraines or other neurological conditions.

4. Lifestyle Adjustments: Given your mention of screen time and emotional stress (crying), it might be beneficial to take regular breaks from screens, practice good eye hygiene, and manage stress levels, as these factors can exacerbate eye strain and discomfort.

Conclusion
While floaters are often benign, the combination of your symptoms warrants further investigation to ensure there are no serious underlying issues. It’s understandable to feel anxious about your vision, especially with the changes you’ve described. I encourage you to seek a thorough evaluation at a reputable eye care center, such as the one at National Taiwan University Hospital, where they can provide the necessary tests and peace of mind. Remember, early detection and intervention are key to maintaining eye health. Take care, and I hope you find the answers you need soon!

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