Conjunctival Spots: What You Need to Know About Eye Health

Q: Conjunctival Spots: What You Need to Know About Eye Health

Hello： <br>Q1. <br>Based on your description, the black spots on the limbus of the cornea may represent corneal pigmentation. <br>This pigmentation can be caused by factors such as age, sun exposure, and genetics, and is usually harmless. <br>However, the best approach is to have

Questions regarding the conjunctiva?

Dear Dr.
Gao,
Hello.
I have observed spots on the conjunctiva of both my left and right eyes, which appear to be black and gray.
I would like to ask you the following questions:
Q1.
I have noticed some black spots at the 9 o'clock position of the limbus of my left eye (near the nasal side) and at the 3 o'clock position of the limbus of my right eye (also near the nasal side).
These spots look like the black part of the cornea has slightly spread outward, with a width of about 0.1 cm.
Based on this description, what do you think these black spots might be?
Q2.
When I evert my left lower eyelid, I see a small black spot; similarly, there are some black and gray spots on the everted upper and lower eyelids of my right eye.
Is it easier for black spots to form on the eyelids? If so, what could be the cause?
Q3.
Regarding the previous question, the black spots on my left lower eyelid and the upper and lower eyelids of my right eye are small, about 0.1 to 0.2 cm in size, resembling moles.
However, on the everted upper eyelid of my right eye, there is a larger spot that is a faint gray-black color, not very prominent, approximately 0.3 cm in size, and it is not point-like but rather a flat, irregularly shaped area.
I only noticed it yesterday and am unsure how long it has been there.
This flat spot is not painful or itchy and does not affect my vision.
In your opinion, what could this 0.3 cm faint gray-black flat spot on my right upper eyelid be? Could it possibly be a birthmark? It does not resemble a mole.
Q4.
All the described spots, whether point-like or flat, currently do not cause any pain or affect my vision.
What do you think I should do next? Should I continue to observe them, or should I seek medical examination directly?
Q5.
Additionally, when I evert my right lower eyelid, I see a small black spot surrounded by a thicker blood vessel that curves in a smile-like shape, resembling ╰╯.
However, the blood vessel is not straight but has a zigzag appearance.
Is this type of thicker, curved blood vessel on the conjunctiva normal?
Thank you, Dr.
Gao.

Kris, 40~49 year old female. Ask Date: 2023/10/05

Dr. Gao Pilin reply Ophthalmology

Hello:
Q1.
Based on your description, the black spots on the limbus of the cornea may represent corneal pigmentation.
This pigmentation can be caused by factors such as age, sun exposure, and genetics, and is usually harmless.
However, the best approach is to have an eye examination to ensure that these spots are not indicative of other ocular issues.
Q2.
The appearance of black spots on the eyelid is relatively rare, but not impossible.
The causes of these spots may include pigmentation, vascular changes, or other factors.
A detailed examination by an ophthalmologist is necessary to determine the specific cause of the black spots.
Q3.
Regarding the black spots on the eyelid you described, it is difficult to ascertain their nature without an actual examination.
They may be pigmentation, but could also be due to other factors.
If you have concerns about their nature, it is advisable to see an ophthalmologist for further evaluation and diagnosis.
Q4.
Currently, these spots do not cause pain, itching, or vision problems, but to ensure your eye health, it is recommended to have an eye examination.
A professional ophthalmologist can assess the nature of these spots and determine whether further intervention or ongoing observation is necessary.
Q5.
The blood vessels appearing on the conjunctiva are usually normal, but their shape may vary among individuals.
If the vessels appear serrated or irregular, it typically may not be a significant issue.
However, if you have concerns about these vessels or if they are accompanied by other ocular symptoms, it is best to see an ophthalmologist to ensure eye health.
An ophthalmologist can provide a detailed assessment and recommendations.

Reply Date: 2023/10/05

More Info

Hello! Thank you for your detailed questions regarding the conjunctival spots and other observations about your eye health. Let's address each of your concerns systematically.

Q1: Black Spots on the Corneal Margin
The black spots you describe at the corneal margin could be a few different things. They might be related to a condition known as "pinguecula," which is a yellowish, slightly raised growth on the conjunctiva, often caused by UV exposure, or they could be "pterygium," which is a growth of fleshy tissue that can extend onto the cornea. However, if they appear black, they might also be related to pigmentation changes or even foreign bodies. It’s essential to have these evaluated by an eye care professional to determine their exact nature.

Q2: Black Spots on the Eyelids
The presence of black or gray spots on the eyelids can be more common than you might think. These spots could be seborrheic keratosis, which are benign growths that can appear as dark spots on the skin, or they could be moles or other pigmented lesions. The eyelids are indeed more prone to such changes due to their thinner skin and exposure to environmental factors.
Q3: Irregular Gray-Black Lesion on the Eyelid
The irregular gray-black lesion you describe on your upper eyelid could potentially be a nevus (mole) or a seborrheic keratosis, especially since you mentioned it is flat and not raised. However, the irregular shape and color change warrant a closer examination. It is crucial to monitor any changes in size, shape, or color, as these could indicate a need for further evaluation.

Q4: Recommended Action for Current Spots
Since you have multiple spots and some irregularities, it is advisable to consult with an ophthalmologist or a dermatologist. While many of these lesions can be benign, a professional evaluation is necessary to rule out any serious conditions, especially if there are changes in appearance or if they begin to cause discomfort.

Q5: Curved Blood Vessel on the Conjunctiva
The presence of a prominent, curved blood vessel on the conjunctiva can be normal, especially if it has been present for a long time and has not changed. However, if it appears new or has changed in appearance, it should be evaluated. Blood vessels can become more prominent due to various factors, including irritation, inflammation, or increased blood flow.

Conclusion and Recommendations
In summary, while many of the changes you are observing may be benign, it is essential to have them evaluated by a healthcare professional. Regular eye examinations are crucial, especially for individuals with changes in pigmentation or new lesions. Monitoring your symptoms and any changes in your eye health is vital. If you notice any discomfort, changes in vision, or if the spots begin to itch or bleed, seek medical attention promptly.

In the meantime, protect your eyes from UV exposure by wearing sunglasses with UV protection, and maintain a healthy lifestyle that includes a balanced diet rich in antioxidants, which can support overall eye health. Thank you for your questions, and I hope this information helps you understand your eye health better!

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