Why Am I Seeing Black Spots?

Do you sometimes see black spots in front of your eyes? If you notice specks, squiggly lines, or cobwebs in your line of sight, these are likely what's known as floaters. Floaters are clumps of the gel-like vitreous humor that fills your eye. These are very common, and while potentially annoying, they are usually not a cause for concern.

This article will discuss seeing spots in your vision, what seeing flashes might mean, possible causes, when to see a doctor, and treatment options.

Symptoms

If you have floaters, you may have noticed them but not have been exactly sure what to call them. These may appear slightly different depending upon how the vitreous gel clumps together. You might describe these as the following:

• Spots
• Squiggly lines
• Cobwebs
• Dark blobs
• Ring-shaped
• Strands of thread

Flashes

Sometimes seeing flashes of light can precede the onset of floaters. That's because floaters can occur after what's known as a posterior vitreous detachment. By age 80, more than half of the population has had a posterior vitreous detachment.

It occurs because the central part of the vitreous gel that fills the eye starts to liquefy and can no longer support the gel on the edges. This, in turn, detaches from the sides and collapses into the liquified center.

As this tugs on the retina, the light-sensing layer at the back of the eye, it can cause flashes of light. While many times the posterior vitreous may tug on the vitreous without any problem and then simply detach from this, other times there may be issues that can be more serious such as a retinal tear that can lead to a retinal detachment.

You may also experience flashes if you hit your head and this, in turn, shakes the vitreous, which may pull on the vitreous, causing you to "see stars."

In some cases, you may see flashes of light akin to a jagged lightning bolt linked to a blood vessel spasm in the brain and usually occurs just in one eye. This is called an ocular migraine and may or may not occur with a headache. Migraine with aura is a type of ocular migraine.

Causes

For many, floaters are a normal part of aging. These occur when some of the gel-like substance that normally fills the eye, known as vitreous, begins to shrink and, in turn, clumps together and forms particles. These particles can float through the vitreous into your line of sight and cast shadows on the retina as they do so.

Many times, these will eventually settle and you will no longer notice them.

In other cases, floaters may be related to having blood in the eye from leaking blood vessels which are often associated with diabetic retinopathy. Anyone with diabetes should regularly have their eyes examined to check for this condition.

Also, those who experience inflammation and swelling of the middle layer of the eye, known as uveitis, may at times get floaters.

Treatment

Many times no treatment is needed. With time, you become less aware of these, and they become less annoying.

Vitrectomy

If treatment is needed, one possibility is what's known as a vitrectomy. This at one time was the only treatment available. It involves removing all of the jelly inside of the eye and using clear sterile fluid in its place.

This treatment, however, is not without risks. These include:

• Potential for retinal detachment
• Eye infection (serious)
• Appearance of new floaters
• Retinal tear
• Cataract development (clouding of the lens)

Because of these risks, some of which can be sight-threatening, your surgeon will have to weigh the potential for these issues with the need to remove the floaters.

Laser

Another treatment option with less risk is what's known as laser vitreolysis. With this outpatient procedure, floaters are broken up with the aid of the laser. This is aimed through the dilated pupil at the floater. These, in turn, are either vaporized or broken up into smaller less noticeable pieces.

However, keep in mind that not all floaters can be treated with this approach. If the floaters are too close to the retina, as tends to be the case in younger patients, they will be unable to use the laser technique.

In deciding whether to treat your floaters with the laser, your surgeon will likely consider:

• Whether your floater has soft borders that make laser treatment possible
• If your floater is located in an area where the laser can be safely used
• If the floater came on recently due to a posterior vitreous detachment

Prevention

If possible, avoiding the development of floaters would be ideal. While currently there's nothing that can necessarily keep these from occurring, doing what you can to boost eye health is recommended.

Supplements that you may wish to consider for general eye health include:

• Vitamins A, C, and E
• Ginkgo biloba
• Omega-3 fatty acids
• Zinc

When to See a Doctor

While many posterior vitreous detachments occur without causing any lasting problems and may even go unnoticed, in other cases this can happen abruptly and can be extremely serious. If you notice a sudden increase in the number of specks or floaters in your line of sight, it's important to get this immediately checked out.

Having many new floaters can signal a tear in the retina, which, if diagnosed promptly, can usually be successfully repaired. However, if this is not treated, it can cause a retinal detachment, which can lead to vision loss if not successfully repaired.

Summary

For some, floaters are simply an annoyance, while these are noticeable enough to need treatment for others. In most cases, these are caused by what's known as a posterior vitreous detachment that happens to many people as they age.

When necessary, treatment for floaters can involve a vitrectomy with removal of the gel-like fluid in the eye and replacement of the fluid. Or, a laser can vaporize the floaters or break these into smaller pieces.

A Word From Verywell

Floaters are one of those things that many people barely notice over time. While they may start out as an annoyance, these tend to settle from sight. But if they don't, fortunately, treatment options are available.