Black spots in your vision: Floaters or something else?

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 one larger dark or black spot in the center of your vision.

Age-related eye changes

Among the most common causes of seeing 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 — 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 conditions such as diabetes can put you at a higher risk of eye floaters. People who have had cataract or other eye surgery 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. 

A retinal tear or detachment

A retinal tear 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 retinal tear may happen due to age-related changes in the eyes. As you get older, the vitreous humor can stick to and pull the retina, causing a tear. A torn retina can cause dark spots in your vision or flashes of light. In some cases, blood can leak into the gel and cause you to suddenly see a lot of floaters.

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.)

• Family or personal history of retinal detachment in the other eye

• Thin spots in the retina (associated lattice degeneration) 

If you see a large number of floaters suddenly, 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 a laser or cryotherapy (freezing) to repair the tear.

Eye inflammation

In some cases, severe eye inflammation can lead to seeing black spots. 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 (posterior uveitis) can cause black spots in the vision. 

Posterior uveitis is the rarest form of uveitis (inflammation of the uvea) and also the type most likely to cause vision loss.

You also may 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 macula is the part of the retina that allows for clear central vision and color vision.

There are two types of AMD: dry AMD and wet AMD. Dry AMD is a less severe form of the disease and 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. 

This occurs because, with wet AMD, abnormal blood vessels grow in the eye and may leak blood into the vitreous humor. This can cause the appearance of dark spots.

AMD is more common in Caucasian patients, smokers and those with a family history of the eye disease. 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 blood vessels can cause the appearance of dark spots with a reddish color. If you 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 can occur in both eyes at once. 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 for a few months to see if 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, eye cancer is so rare, that there’s no need to panic. Black spots in your vision are far more likely caused by age-related eye changes or another more common eye condition.

See your eye doctor

If you’re suddenly seeing spots in your vision, make an appointment with an eye doctor right away. 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.

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Page published on Wednesday, October 12, 2022

Medically reviewed on Thursday, October 6, 2022