Tuesday, April 9, 2024

Black Spot In Peripheral Vision

What Is Macular Degeneration

Facts about Floaters – those black spots blocking your vision -Dr. Nikhil Nasta

The macula is the name given to the centre of the retina . It is responsible for detailed vision and for colour vision. It is the most sophisticated piece of tissue in the body and works flat out from the moment you open your eyes in the morning to the moment you go to sleep. It is responsible for converting the focused image of light striking the retina into electrical impulses that are sent to the brain to give us sight. The cells at the macular that are responsible for changing the light into electricity are called photoreceptors . They work so hard that they need both a very good blood supply called the choroid and a layer of cells beside them called the Retinal pigment epithelium to help them function. The rods and cones need to recycle material in order to function in an efficient manner and the RPE assists in this recycling.

As the macular is working at full stretch it is not surprising that with the passage of time it is more prone to the ageing process than other tissues in the body. The light that focuses on the macula and in particular the blue end of the spectrum has high energy and can damage the cells in a variety of ways. The high energy light can produce particles called free radicals which damage the cells and the high energy light can also damage the genetic material in the cells called DNA that controls the function of the cell.

What Is Wet Macular Degeneration

Wet age-related macular degeneration usually develops on top of previous dry changes and is less frequent than dry AMD but usually produces more sudden and serious loss of central vision.

The retina are the most active cells in the body requiring the greatest amount of oxygen and sugar from the blood in order to function . The retina is unique in having two blood supplies. There is a blood supply that is under the RPE called the choroid and supplies the oxygen and sugar to both the RPE and the overlying rods and cones. As this is under the pigmented layer of the RPE it is not usually visible on the photographs of the retina that the optometrist may take. The blood vessels seen on these photographs are the second blood supply to the retina that give oxygen and sugar to the nerve connections of the retina that lie above the photoreceptors.

Patients with macular degeneration can accurately assess the quality of their central vision and monitor the situation with a simple test called an Amsler grid.

Please here to obtain an Amsler grid you can download and print out.

What About Vitamins And Macular Degeneration

If you are a smoker then the single most important thing that you can do is stop smoking. Patients with mild macular degeneration should have a heathy balanced diet with plently of fresh fruit and dark green leaved vegetables. If you have more significant macular degeneration then you should take a vitamin supplement with the AREDS 2 formula containing Vitamin C, Vitamin E, Lutein, Zeaxanthin, Zinc and Copper. Patients who should be taking the AREDS 2 formula are those patients with wet macular degeneration in one eye and dry changes in the fellow eye and those patients with medium to high risk characteristics of converting from dry to wet degeneration. This depends on the appearance of the macular and you can only get guidance on this from your optometrist or eye doctor. The yellow drusen that is found in dry macular change can have different appearances. Small hard looking drusen are at lower risk of progressing to wet macular degeneration than large soft looking drusen. It is this latter group of patients who should be taking the AREDS 2 formula. The optometrist may be able to tell you what type of drusen and advise on vitamin supplements.

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What Do Blind Spots In Vision Look Like

A central scotoma is a blind spot in the center of your vision. It can appear in various ways, including:

  • A black or gray spot
  • A blurred smudge
  • Distortion in your central vision

Most of the time, you dont see an object directly in front of you until you move your eyes or head away from the blind spot.

Blind spots may begin as a minor nuisance and then become larger. Or there may be several scotomas that block your field of vision.

Scotomas in the periphery of a persons vision are not as concerning or disabling as those in the center.

Aging And Macular Degradation


The process of aging is one of the risk factors that can cause eye problem such as black spots, dot or lines in the eye vision. Black spots in the field of vision are eye conditions that often occur naturally in people with advanced age.

Age-related macular wear out is a known eye problem that is liked to advanced age. According to the American Academy of Ophthalmology, the degradation of macular cells at the eye retina may result in loss of central vision.

Macular is specialized tissue or part of the retina that helps to differentiate fine detail of the image. The aging process may lead to degradation or wearing out of macular tissue hence you may lose your central eye vision. However, peripheral or side vision may not be affected.

Ophthalmologists suggest that it is very simple to determine if your eye has a damaged macule on the retina. You can just look at your hand clock with one eye open while you close the other one for about five seconds.

If you are unable to see the central clock hands together with peripheral clock number or symbols, this is a clear indication that you might have slight dark spots in your eye vision.

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How To Treat Eye Floaters

Treatment for eye floaters depends on the cause of your eye floaters. For example, if you have a torn retina, your ophthalmologist may perform laser photocoagulation. They will use a laser to make tiny burns around your retina tear to create a barrier of scar tissue and stop it from tearing more.

Another laser treatment is called YAG vitreolysis, which vaporizes floaters by heating them up.8 However, this treatment is controversial.

If your eye floaters are due to an eye disease or diabetes, your doctor will prescribe you certain medications and a course of treatment that addresses the root of the floaters. A comprehensive eye exam can help your eye doctor determine the best treatment for your particular case.

Some eye floaters will eventually settle and go away on their own.

What Are The Possible Causes

According to the American Academy of Ophthalmology, seeing flashes of light in the corner of your eye can be caused by a variety of factors or conditions. Some causes may be related to your eye health, while others may be related to other types of health conditions.

Several types of eye-related issues may cause flashes of light to appear in the corner of your eye or field of vision.

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Can Floaters Be Treated

Most floaters dont actually require treatment they might be a bit annoying but they usually dont impair your vision. In fact, most people can forget that theyre there and naturally, with time, begin to ignore them. Sometimes, however, floaters can be so large in number and packed so closely together, that they impair a persons vision. A procedure called a vitrectomy is available for these cases which removes the vitreous gel and its floating debris from the eye. It is replaced with a salt solution which imitates the vitreous gel and its properties. This treatment is considered quite risky as it can lead to retinal detachment, retinal tears, and bring on cataract formation.

A safer alternative is a laser procedure called laser vitreolysis. A laser beam is shone into the eye through the pupil and applied to the large floaters to break them down or vaporise them. This either makes them small enough to not interfere with the persons sight again, or means that they disappear entirely.

A Sudden Burst Of Black Spots In My Eye Turned Out To Be A Threat To My Sight

Dystonia Symptoms & Eye Diagnosis PVD Posterior Vitreous Detachment (Black Spots in Vision)

It started late on a Thursday afternoon last May, when I noticed a wispy dark shadow in the lower left corner of my right eye. At first, I didnt worry about it. But being 62 at the time a baby boomer I should have.

For years, I have had floaters in both eyes. Small moving spots that appear in a persons field of vision, floaters typically occur when tiny pieces of the eyes gellike vitreous humor break loose within the inner back portion of the eye. While annoying, ordinary floaters are very common and rarely are cause for alarm.

But a sudden burst of floaters can be a warning sign that a tear is starting to develop in the retina, the light-sensitive membrane in the back of the eye. An early-stage retinal tear can be treated in an eye doctors office with laser surgery that creates a weld around the edges of the tear and usually keeps the retina from detaching, according to Vinay Desai, an ophthalmologist with the Retina Group of Washington .

I should have called my regular ophthalmologist right away, but I didnt have health insurance at the time for financial reasons. If this is just another floater, I told myself, I can live with it.

I hadnt been hit in the eye or experienced any other eye-related injury, so the idea that my retina might be torn never crossed my mind.

He urged me to call Byrnes immediately. The retinal surgeon told me to meet him at RGWs Fairfax office right away. He would take a look and see what he could do.

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What Are Eye Floaters

Eye floaters are small specks that can appear in a persons field of vision and are usually harmless. They get their name from their floating appearance, but they can also appear as black or grey spots and lines or clouds in vision. These specks and spots often disappear when theyre directly focused on, drifting off once your eyes stop moving. Theyre also most noticeable when something bright or plain is looked at, such as a blue sky, blank computer screen or a white wall.

Automated Perimetry Testing Showed A Left Homonymous Inferior Quadrantanopia

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A 62-year-old man presented to the New England Eye Center comprehensive ophthalmology clinic for an urgent evaluation of a black shadow in the inferotemporal field of his left eye that started suddenly 4 days prior while he was sitting.

He did not have any pain, flashes, floaters, decrease in central vision, field loss in the right eye or injection. He otherwise felt well. The shadow moved slightly when he moved his head from left to center, and it was more prominent in brighter lighting. His ocular history included a right superotemporal operculated retinal hole with vitreous hemorrhage, for which he underwent laser retinopexy 6 years prior. He had not followed up for routine eye care since that time.

His medical history included mechanical mitral valve replacement after endocarditis for which he took warfarin and reported good compliance, history of opiate addiction for which he was on methadone, attention deficit disorder and anxiety, which was treated with clonazepam. He reported a 15-year history of smoking.


Ancillary testing

Automated perimetry testing showed a left homonymous inferior quadrantanopia . OCTs of both the macula and the retinal nerve fiber layer were unremarkable.

What is your diagnosis?

See answer below.

Dark spot in peripheral vision

Workup and management


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What To Do If You See A Black Spot

It is important that you see a specialist if you detect a black spot, as it can be a sign of serious eye diseases. Paying attention to this symptom and not ignoring it will help us diagnose and treat a possible pathology early on, something essential in many cases for your eye health.

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Assistive Technology For Blind Spots

Usher syndrome: for patients

Your healthcare provider may suggest using assistive devices and technologies to support your decreased vision.

Tools that can help include:

  • Large-number phone keypads and watch faces
  • Filters to lessen the glare on computer screens
  • Talking clocks or scales
  • Audiobooks, magazines, newspapers, or machines that read printed material aloud
  • Large type printed books
  • Enlarging the type size in an eReader on electronic devices like iPads, Nooks, or Kindle
  • Personal computer hardware like lighted keyboards and software that magnifies screens and transforms text to speech for computers and mobile phones
  • Closed CCTV systems that use video cameras
  • Large TV screens to enlarge reading material
  • Magnifying eyeglasses, hand-held magnifiers, or stand magnifiers to enlarge reading material or other objects
  • Prism lenses to move images from blind spots into areas with normal vision

Speak with your eye doctor or healthcare provider for professional medical advice on treating the blind spot.

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When Should I Worry About Eye Floaters

Most floaters and occasional flashes are not cause for concern. They may happen from time to time in both eyes or in the same eye.

You should call your doctor right away if:

  • You notice a sudden increase in or appearance of floaters or flashes
  • You experience spots, floaters, or flashes with other vision problems
  • You begin seeing spots after an eye or head injury

Seeing Black Spots And Dizzy

What causes dizziness and seeing black spots? Feeling dizzy and seeing spots in your vision is a clear indication of a health problem. However in women, a feeling of dizzy and seeing spots while pregnant is normal but rare.

According to Web MD, there are several conditions that may cause seeing black spots with a headache or other symptoms like nausea and white flashes. These conditions include Ear infections, Diabetes, Cardiac problems, Anemia, Hypertension and hypotension, intense panic, Epilepsy, Body dehydration, Toxic shock, and Cancer.

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What Is The Treatment Of Wet Macular Degeneration

Treatment for wet age-related macular degeneration improved significantly from 2006 with the development of the drugs Lucentis , Avastin and Eylea . They are a class of medication called anti-VEGF drugs. Prior to this date the only treatment available for wet AMD were various forms of laser treatment with limited efficacy. The natural course of wet macular degeneration is that the central vision can deteriorate significantly in the first 6 months following the development of the condition with the greatest deterioration within the first few months. The development of anti-VEGF drugs for the first time resulted in a treatment that could improve the vision in a significant minority of patients and prevent the vision from getting worse in most patients.

These types of drug were first developed to treat cancer patients. In order for a cancer to grow it needs a good blood supply to nourish the cancer cells. The body in health produces a chemical called VEGF that results in new blood vessel formation but VEGF is also produced by tumour cells to help supply blood to the tumour. The drugs are called anti-VEGF drugs as they stop VEGF from working. They are a type of antibody that attaches to the VEGF protein and stops it from working. If there is no functioning VEGF present it impairs the blood supply to the tumour and can help destroy the tumour.

Are Eye Floaters An Emergency

Ask An Eye Doc: What are the black specks floating in my eyes?

Eye floaters are usually not an emergency. If you see the occasional eye floater, it typically isnt something to worry about. You should let your eye care provider know about the floaters and have your eyes checked regularly to make sure there are no other vision issues, but this isnt an emergency.

However, if you suddenly have more floaters than normal, reach out to your healthcare provider right away. This could be a sign of a retinal tear or detachment and it will need to be treated quickly.

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What Are The Symptoms

Floaters earn their name by moving around in your eye. They tend to dart away when you try to focus on them.

They come in many different shapes:

  • Black or gray dots
  • Threadlike strands, which can be knobby and almost see-through

Once you get them, they usually donât totally go away. But you usually notice them less over time.

Noticeable Symptoms When One Eye Is Closed

Sometimes patients will only notice vision changes in AMD when they close one eye, for example when applying makeup. When the good eye is closed, the impaired central vision in the eye with advanced AMD is noticed for the first time. This is because the good eye has been compensating for the advanced AMD eye. Thats why its important for patients with early AMD to check vision in each eye separately by covering one eye at a time, at least once a week.

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