Sudden Black Spots in Vision: Causes and Insights - Ophthalmology

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Fundoscopic examination?


Hello Dr.
Wang: I suddenly noticed a large number of small black dots in my eyes, resembling the dirt on a glass that hasn't been cleaned for a long time, particularly in the upper part of my visual field.
The symptoms lasted for about a day and then disappeared.
I consulted an ophthalmologist, who performed a dilated fundus examination but did not provide an explanation.
After the dilation, I noticed that my eyes appeared larger (my eyelids were more open, and I have some looseness in the upper eyelids due to aging).
Could you please explain why this happened?

ANG, 50~59 year old female. Ask Date: 2015/03/14

Dr. Wang Zhishun reply Ophthalmology


Hello: If there are changes in the symptoms of floaters, a follow-up fundus examination is necessary.
The dilation of the eyes after the administration of mydriatic drops is due to the medication temporarily elevating the eyelids, but this effect is pharmacological and transient.

Reply Date: 2015/03/14

More Info


Hello! Thank you for your question regarding the sudden appearance of small black spots in your vision. This phenomenon can be concerning, and it's important to understand the potential causes and implications.

The small black spots you are experiencing are often referred to as "floaters." Floaters are tiny clumps of gel or cells that form in the vitreous humor, the clear gel-like substance that fills the eye. As we age, the vitreous can become more liquid and may pull away from the retina, leading to the formation of these floaters. They can appear as small dots, lines, or cobweb-like structures and are typically more noticeable against a bright background.

In your case, the fact that these symptoms appeared suddenly and then resolved within a day is noteworthy. While floaters are common and usually harmless, sudden changes in vision, especially if accompanied by flashes of light or a curtain-like shadow, can indicate more serious conditions such as retinal detachment or a vitreous hemorrhage. It is good that you have already consulted an eye specialist and undergone a dilated eye exam, as this is crucial for ruling out any serious issues.

Regarding the use of dilating drops, these are commonly used during eye examinations to allow the doctor to get a better view of the retina and other internal structures of the eye. The drops temporarily enlarge the pupils, which can lead to increased sensitivity to light and a feeling of the eyelids being more open. This is a normal reaction and should subside as the effects of the drops wear off, typically within a few hours.

The appearance of your eyelids being more relaxed or "sagging" could be related to the natural aging process, which can lead to changes in the skin and muscle tone around the eyes. If you have noticed that your upper eyelids are becoming more droopy, this could be a separate issue that may warrant further discussion with your eye doctor or a specialist in oculoplastics.

In summary, while the sudden appearance of floaters can be alarming, they are often benign, especially if they resolve quickly and are not accompanied by other symptoms. However, it is essential to remain vigilant and seek medical attention if you notice any new symptoms, such as flashes of light, a sudden increase in floaters, or any changes in your peripheral vision. Regular eye examinations are crucial, especially as we age, to monitor for any changes in eye health.

If you have further concerns or if the symptoms recur, I recommend following up with your eye care provider for a comprehensive evaluation. They can provide personalized advice and reassurance based on your specific situation. Thank you for reaching out, and I hope this information helps clarify your concerns!

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