Small black spot(s)

[Van_Diemen]

I have this problem for over 12 months now and am still quite worried. I'm 21 years old and can see one to two small black spots in my left eye. They appear next to each other and are in the natural blind spot area, furthermore they always appear in the same orientation and on the same place in my vision (as far as I can judge it myself). I can see it when looking at the sky, when I'm reading or in a bright room/area. It most visible when I move my eye. As soon as I start moving my eye (especially when making large eye movements) the spot appears like a "black" flash (colour: grey to black) and "fades out" within a second. The brighter the surrounding I'm in (or the larger the eye movement) the larger the black flash/spot appears to be. If the surroundings become darker I can hardly see the spot(s)/flash anymore even if making large eye movements. Furthermore I do have some floaters, but these mostly have no real colour and by far not as dark as the spot itself is. I have seen a retinal specialist in January this year and he said it were most likely floaters, but after doing some reading myself a scotoma seems to fit in too. How can I determine whether it is a scotoma or just a floater? Are there some symptoms that fit in with either explanation?

[Van_Diemen]

Well to be honest I don't really know whether he is a retina specialist or a general ophthalmologist. I do know that he is very experienced in Glaucoma and was the "first line" ophthalmologist at the hospital you could get if you made an appointment. As a matter of fact my GP objected at first to sent me to an ophthalmologist, because I already have had an appointment half a year before then. Sorry if I'm bothersome, but I would really like to know what you think of these symptoms whether or not they seem in place with some condition.

[John C Hagan III, MD, FACS, FAAO]

Retina specialist sometimes just zero in on retina problems and zone out on everything else. See a general ophthalmologist or a neuro ophthalmologist. FInd one at www.aao.org

JCH II MD

[Van_Diemen]

Well I already asked my Retinal MD back in January if I needed a visual field test (the last one was four years ago, which came out Ok) and he said it would not be necessary and I should make an appointment again in 2013. Furthermore I already did some amsler grid tests on my own and have never seen any of the alerting things like wavy lines. That said I only see the small black spot when indeed making large eye movements and must say that the size of the black spot is very small when you test your eyes on an object so close. Furthermore it isn't central or anything it is beyond the natural blind spot (more peripheral). I only asked this question because I would like to see what you think of these "symptoms". I know you can't diagnose anything by words, but my Retinal MD did not see anything I should be worried about and thus only had my story to judge whether or not further steps were/are necessary.

[John C Hagan III, MD, FACS, FAAO]

You can return to the retina MD or to a general Eye MD. Before you go in ask to schedule a visual field examination. If you have a scotoma it will map it out, it will also determine the size or your blind spot. Also ask that an Amsler Grid test be done.  You can also google "amsler grid" and read about the test, print the grid out and test your eyes daily to monitor for a central scotoma.

JCH IIMD

[Van_Diemen]

Some additional information that might prove useful:
- When experiencing the black flash one to two minor black spots remain visible longer than the flash itself. These spots seem to disappear after multiple seconds.
- The spots do not seem very black, they are more or less grey.
- I read somewhere that you can "diagnose" or notice a scotoma by the fact that your brain fills in the missing information with a colour similar to the background and when switching after fill in from colour A to B you should still notice the pervious colour on the scotoma spot.
The colour of the spot/flash that always appears with me is grey/black even when moving my eye over the blue sky from "blue location A" to "blue location B".

I hope you can understand what I mean and that it is useful to give a more educated guess.