Black Spots in Vision After Eye Trauma: What to Know

Regarding the appearance of black spots in the visual field after trauma?

I am a person with high myopia (right eye -1350, left eye -1250).
A week ago, I was in a car accident and was struck by a hard object on the brow ridge above my right eye.
The next day, my right eye was completely swollen, leaving only a slit.
After applying ice urgently, I noticed a black spot in my right eye that moves with my line of sight.
Wherever I look, the black spot follows.
So, I immediately went to a nearby ophthalmologist for an examination.
The doctor performed a fundus examination and said there didn't seem to be any issues.
He advised me to ice the area for two days and to monitor it for a week to see if there were any other injuries.

After a week, my right eye appeared to be no longer swollen, but the area where I was struck still has some swelling and pain.
The bruising has started to fade, but the entire right eye socket remains discolored.
The black spot in my vision is still present, fluctuating in size.
Today, I went to a larger hospital for further examination.
The doctor also said that the retina looks fine, but there is some swelling in the macula.
He prescribed anti-inflammatory medication and advised me to observe for another 12 days.

I would like to ask if the black spot in my vision is a normal phenomenon? Will it go away? Can I apply ice or heat to the swollen area now?

Xiao Yu, 20~29 year old female. Ask Date: 2007/05/11

Dr. Zhang Yanrui reply Ophthalmology

Since I cannot perform an actual examination, I can only suggest possible causes.
You may be experiencing vitreous degeneration due to a trauma, commonly known as floaters.
Floaters typically do not improve unless surgically removed, but surgery is not recommended because floaters themselves do not affect vision.

Reply Date: 2007/05/11

More Info

Experiencing black spots in your vision after an eye injury can be concerning, especially given your history of high myopia and the recent trauma to your eye. Based on the information provided, it seems that you have sustained an injury to your right eye, which has resulted in swelling and the appearance of a moving black spot in your field of vision. This phenomenon is often referred to as "floaters," which are small specks or spots that drift through your field of vision.
Floaters can be caused by a variety of factors, including changes in the vitreous humor (the gel-like substance that fills the eye) or damage to the retina. In your case, the trauma from the accident could have led to changes in the vitreous or even minor retinal issues, which might explain the persistent black spot you are observing. It is important to note that while floaters are common and often benign, they can sometimes indicate more serious conditions, especially following an eye injury.

The fact that your retina has been examined and deemed normal by the ophthalmologist is reassuring. However, the noted swelling in the macula (the central part of the retina responsible for sharp vision) could be contributing to your symptoms. Macular edema can occur after trauma and may lead to visual disturbances, including the perception of floaters or blurred vision. The treatment prescribed to reduce the swelling is a positive step, and monitoring your condition over the next few weeks is advisable.

Regarding your questions about the black spot: it is not uncommon for floaters to persist after an eye injury, and while they may diminish over time, they may not completely disappear. Many individuals learn to adapt to floaters, and they often become less noticeable as the brain adjusts to their presence. However, if you notice any sudden changes in your vision, such as an increase in the number of floaters, flashes of light, or a curtain-like shadow over your vision, you should seek immediate medical attention, as these could be signs of more serious complications.

As for the application of ice or heat to the swollen area, ice is typically recommended in the initial stages of an injury to reduce swelling and inflammation. After a few days, if the swelling persists, you might consider switching to warm compresses, which can promote blood flow and healing. Always follow your doctor's advice regarding treatment and care for your injury.

In summary, while the presence of a black spot in your vision following eye trauma can be alarming, it is often a result of changes in the vitreous or minor retinal issues. Continuous monitoring and following your ophthalmologist's recommendations are crucial. If your symptoms change or worsen, do not hesitate to seek further evaluation. Your eye health is paramount, and staying proactive about any changes will help ensure the best possible outcome.

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