What causes black spots in your vision?
Black spots in your vision are commonly caused by eye floaters. These small spots may be the result of aging, a retinal tear, inflammation or other eye conditions. Age-related macular degeneration (AMD and other conditions may cause a larger dark or black spot in the center of your vision.
In general, seeing black spots, such as floaters, in your vision is usually nothing to worry about. However, if you notice a sudden onset of new floaters or dark spots, it’s important to schedule a comprehensive eye examination with your eye care provider.
What underlying eye conditions can cause floaters and spots?
Age-related eye changes
Among the most common causes of seeing black spots in your vision are floaters caused by normal aging. Floaters often appear as black dots, spots or specks that move across your vision as you turn your head or move your eyes.
Note that floaters aren’t always black spots in your vision. They can also look like squiggles, wavy lines or wispy strands.
Floaters form when the collagen in your vitreous humor (also known as the vitreous body) — the gel-like substance that gives your eye its shape — begins to stick together. These clumps cast tiny shadows on the retina that look like dark spots in your vision. These age-related floaters are typically harmless and don’t cause any serious vision issues.
Being very nearsighted or having conditions such as diabetes can put you at a higher risk of developing eye floaters. People who have had surgery for cataracts or other eye conditions may also be more likely to experience eye floaters.
In addition to normal age-related eye changes, there are other issues and conditions that may cause floaters in your vision. These may include:
A retinal tear or detachment
Posterior vitreous detachment (PVD) is a common age-related condition in which the vitreous body naturally shrinks and separates from the retina. In some cases, the pulling of the vitreous body can place stress on the retina and lead to a retinal tear. This is an eye emergency, so it’s important to seek care from an eye doctor right away. A torn retina can lead to a detached retina, which can cause vision loss.
A retinal tear can cause the sudden appearance of black dots like “someone shaking pepper in your vision,” according to the American Society of Retina Specialists.
A torn retina can also cause flashes of light or a black curtain over your vision. In some cases, blood can leak into the vitreous, causing a sudden decrease in vision. Factors that increase your risk of a retinal tear may include:
- Age
- An eye injury
- Certain glaucoma medications that constrict the pupil
- Nearsightedness
- Eye surgery (cataract surgery, etc.)
- History of retinal detachment in the other eye
- Thin spots in the retina (associated lattice degeneration)
If you suddenly see a large number of floaters, flashing lights, shadows on the sides of your vision or a gray “curtain,” these could be signs of a retinal tear or detachment. This requires a visit to an eye doctor right away.
If treatment is required, a retinal tear can typically be treated quickly and easily in your eye doctor’s office with laser coagulation or cryotherapy (freezing) to repair the tear.
Eye inflammation
In some cases, severe eye inflammation can lead to black dots in your vision. These black dots or specks may be caused by white blood cells floating in the vitreous humor. For example, inflammation of the back part of the middle layer of the eye (a condition known as posterior uveitis) can cause black spots in your vision.
Posterior uveitis is the rarest form of uveitis (inflammation of the uvea) and the type most likely to cause vision loss.
You may also be at higher risk of black spots in your vision from inflammation if you have an autoimmune disease such as lupus or sarcoidosis.
Age-related macular degeneration
Age-related macular degeneration (AMD) can cause blurry central vision as well as black spots in your vision. This eye condition occurs when aging causes damage to the macula — the part of the retina that allows for clear central vision and color vision.
There are two types of AMD:
- Dry AMD is a less severe form of the disease and is less likely to cause vision issues.
- Wet AMD is a more severe form of the disease and is the type that can cause you to see dark spots.
With wet AMD, abnormal blood vessels grow in the eye and may cause blood to enter the vitreous humor, which can cause the appearance of dark spots.
AMD is more common in Caucasian patients, smokers and those with a family history. If you have dry AMD, you may be able to take special vitamin supplements to help your eyes. If you have wet AMD, your eye doctor may recommend injectable drugs, possibly combined with laser therapy.
Diabetic retinopathy
Diabetic retinopathy can lead to abnormal new blood vessels growing into the vitreous humor. Leaking and bleeding from these abnormal blood vessels can cause the appearance of dark spots with a reddish color.
If you’re diabetic and notice dark spots in your vision, call your eye doctor right away.
Central serous chorioretinopathy
Central serous chorioretinopathy is an eye condition that doesn’t cause floaters but can cause blurriness, distortion or a dark area in your central vision.
This eye condition is caused by fluid buildup underneath the retina. It usually starts in one eye first, but it can occur in both eyes at the same time. It is more common in middle-aged men than in women or younger men.
If you have central serous chorioretinopathy, your eye doctor may recommend waiting a few months to see whether the fluid buildup goes away. If it does not, they may prescribe medication to treat the condition.
Rare types of eye cancer
In extremely rare cases, certain cancers can lead to seeing black spots in your vision. These may include lymphoma or retinoblastoma. In these cases, the spots would be caused by cancerous cells floating in the vitreous humor.
The good news is that eye cancer is so rare, there’s no need to panic. Black spots in your vision are far more likely to be caused by age-related eye changes or other more common eye conditions.
When to see your eye doctor
A sudden shower of black spots in your vision can be an emergency, particularly if it’s accompanied by flashes of light or a black curtain over your vision. It’s important to see an optometrist or ophthalmologist right away if you experience these symptoms.
They can do a comprehensive eye exam to determine the cause of these black spots in your vision. If necessary, they can recommend treatment to help protect and preserve your vision.
