Black Spots in Vision: Are They Floaters or Something More?

Q: Black Spots in Vision: Are They Floaters or Something More?

Hello： <br>1. <br>Regarding the bright black spot you described, based on your account, it differs from typical floaters. <br>Normal floaters are usually transparent or gray and float or move within your field of vision. <br>If you notice a bright black spot that does not move, t

Black spots in the eyes?

1.
I have high myopia and astigmatism of 1000 degrees in both eyes.
I have experienced floaters since high school, and recently I've noticed occasionally seeing a bright black dot that doesn't resemble typical floaters.
This dot does not move and disappears completely after blinking two or three times.
I only see it occasionally.
I would like to ask the doctor if this is still considered a floater or if it could be another eye condition.
Do eye conditions that present as black dots also disappear? At around 18 years old, I had elevated intraocular pressure and began regular check-ups at a major hospital, where I was prescribed glaucoma medication.
I now have a yearly OCT scan and visual field test, and so far, the doctor has said everything is normal.
2.
I would like to know if these tests can detect eye conditions early, such as retinal tears or macular degeneration.
3.
Is having an annual check-up too infrequent?

Ms. Chen, 20~29 year old female. Ask Date: 2023/08/15

Dr. Gao Pilin reply Ophthalmology

Hello:
1.
Regarding the bright black spot you described, based on your account, it differs from typical floaters.
Normal floaters are usually transparent or gray and float or move within your field of vision.
If you notice a bright black spot that does not move, this is different from common floaters, but if it disappears and occasionally reappears, this issue is generally less concerning; however, I cannot diagnose the exact cause.
2.
The eye examinations you underwent, including visual field tests and optical coherence tomography (OCT), can assist the physician in detecting and monitoring eye health conditions, including retinal tears, holes, and macular degeneration.
However, some eye conditions may not be easily detectable in the early stages, so even if your examination results are normal, it is still advisable to see an ophthalmologist for further evaluation if you experience any new symptoms or changes.
3.
An annual examination frequency may be relatively reasonable, especially if your physician confirms that your eye condition is normal at each visit.
However, if you experience any new symptoms, such as changes in vision, eye discomfort, or other issues, you should seek an ophthalmological evaluation as soon as possible, regardless of the time between examinations, to ensure your eye health.

Reply Date: 2023/08/15

More Info

When it comes to understanding the presence of black spots in your vision, especially in the context of high myopia and a history of floaters (known as "vitreous opacities"), it is essential to consider several factors. Based on your description, you are experiencing occasional bright black spots that do not move and disappear after blinking a few times. This symptom can indeed be concerning, but it is crucial to differentiate between floaters and potential pathological changes in the eye.

1. Floaters vs. Other Eye Conditions: Floaters are typically small, shadowy shapes that drift across your field of vision, caused by tiny clumps of gel or cells within the vitreous humor of the eye. However, the bright black spots you describe may not fit the classic definition of floaters. Instead, they could be related to other phenomena, such as phosphenes, which are flashes of light or bright spots that occur due to stimulation of the retina or the optic nerve. In some cases, they can be associated with retinal issues, especially in individuals with high myopia, where the risk of retinal tears or detachments is increased.
2. Transient Nature of Symptoms: The fact that these black spots disappear after blinking is a positive sign, as it suggests that they may not be indicative of a permanent issue. However, any new or changing visual symptoms should be taken seriously, particularly in the context of your existing eye conditions. It is advisable to monitor these symptoms closely and report any changes to your eye care provider.

3. Regular Eye Examinations: You mentioned that you have been diagnosed with high intraocular pressure and are undergoing regular examinations, including OCT scans and visual field tests. These tests are essential for monitoring the health of your eyes, especially given your risk factors for glaucoma and retinal issues. Regular check-ups are crucial for early detection of any potential problems, such as retinal tears, detachments, or macular degeneration. While annual examinations are generally sufficient for many patients, those with high myopia or a history of eye problems may benefit from more frequent evaluations, such as every six months.

4. Detection of Eye Diseases: Routine eye examinations, including dilated fundus exams, are designed to detect various eye diseases early on. Conditions like retinal tears or detachments can often be identified during these exams, but it is important to communicate any new symptoms you experience to your eye doctor. They may recommend additional imaging or tests if they suspect any changes in your eye health.

5. Conclusion and Recommendations: Given your history of high myopia and the presence of floaters, it is essential to remain vigilant about your eye health. If you notice any changes in your vision, such as an increase in the frequency or intensity of the black spots, or if you experience flashes of light or a sudden increase in floaters, you should seek immediate medical attention. Regular follow-ups with your ophthalmologist are crucial, and discussing your concerns about the frequency of your examinations can help tailor a monitoring plan that suits your specific needs.

In summary, while the black spots you are experiencing may be benign, it is essential to maintain open communication with your eye care provider and ensure that you are receiving appropriate monitoring and care for your eye health.

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