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What Does A Black Patch In Peripheral Vision Indicate?

Posted on Thu, 24 Jul 2014

Question: I am 31 years old and experiencing medium size black patch on right side of peripheral vision of left eye. My central vision is fine 6/6 and I am able to read letters without any issues. I have undergone FFA and OCT tests twice (in span of 9 weeks) as suggested by one of the retina specialists. Earlier FFA test was indicating small patch of blood on peripheral retina which was blocking incoming light and causing black patch. There is no macular edema and there no blockages in retinal arteries or veins. I started experiencing this problem when I was sick due to fever and headache. Retina specialist is saying that this has happended due to inflammation of vessel walls. I am healthy person, fitness freak and doesn't have habits like smoking or drinking. Blood report for cholestrol and suger level is also normal.

As per Doctor's advice, I am taking wysolone, emanzen forte, neurobion forte and homochek for reducing inflammation. Its been 9 weeks now and there is only 10% improvement. Per latest FFA report, patch of blood on peripheral retina is completely resolved but still black patch which I am experiencing is not resolved. Shape of black patch is exactly same as patch of blood on retina indicated by earlier FFA reprot.

My concern to sought second opinion is -

Almost 9 weeks are over and this black patch is blocking 10% of the view of left eye close to nose. Will this black patch gets resolved over time since the patch of blood is completely absorbed?
How much would be required for complete recovery if you had encountered patient reprting similar problem before?
I can see this black patch as white patch when I close both the eyes. Is this related to any phenomenon?

I have attached all the reports (old as well as new FFA and OCT) along with black patch which I am experiencing. Please advise your thoughts. Thanks.

Regards,
XXXX

Answered by Dr. N K Mishra (26 hours later)

Brief Answer:
Retinitis

Detailed Answer:
Dear XXXXXXX
Thanks for sending your query to us. In a person of your age with no apparent physical illness such a retinal problem following fever with such Flourescein Angiography and OCT the diagnosis is retinal perivasculitis.
These patches go away with the passage of time and at times a small defect may persist.
A dose of 20mg steroids that you are taking has to be watched and not to be continued too long.
Rest of the treatment being given to you looks fine.
It will take some time for you to recovery.
Please do get back to me in case of any further query in this regard

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. N K Mishra (30 minutes later)

Dr. N. K. Misra,

Thanks for your inputs. I have few more questions -

1. I can see this black patch as white patch when I close both the eyes. Is this related to any phenomenon?

2. How much would be required for complete recovery if you had encountered patient reporting similar problem before?

Regards,
XXXX

Answered by Dr. N K Mishra (14 minutes later)

Brief Answer:
retinitis

Detailed Answer:
Dear Tuahar,
Thanks for getting back to us.
Your seeing as white the blck spot is perfectly normal. Such inflammation may take sometime to resolve completely.
My issue is continuing oral steroids, which cause anything from osteoporosis to diabetes and gastric ulcers.So they are to be continued only as long as necessary. There are topical anti inflammatory drops also available with less systemic side effects.
Again any further query, I am available.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. N K Mishra (13 minutes later)

Dr. N. K. Misra,

Thanks again for detailed inputs.

I have stopped taking steroids. Now I am taking homochek and neurobion forte for 1 month.

My concern is almost 2 months are over and there is only 10% improvement. In such case, how much time is usually required for resolution of inflammation and visual recovery?

Please advise your thoughts.

Answered by Dr. N K Mishra (8 minutes later)

Brief Answer:
retinitis

Detailed Answer:
Dear XXXXXXX
Thanks for getting back to us
two months is a short time. These cases take 3-6months to resolve.
continue with the tt and you will be fine

Above answer was peer-reviewed by : Dr. Prasad