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What Does Black Spot In Peripheral Visual Field With History Of Cataract Surgery Indicate?

Posted on Tue, 17 Mar 2015

Question: I am a 74 year old man. I had cataract surgery 5 years ago - had two lens implants with mono vision. I have a lot of eye dryness and pain unless I wear sunglasses (mostly in the near vision eye). I take Restates and Lotemax drops. For the last month I can see a large black scorpion shaped object at the peripheral portion of my right eye (distant vision eye) and it is slowly getting larger. It doesn't seem to be a floater. I have no flashes, pain in the eye, no change in my vision (20/20) and have been checked by an ophthalmologist, who just asked to see me in a month (for another refraction) but offered no diagnosis and I hate to worry for another month!

Answered by Dr. Dadapeer K (2 hours later)

Brief Answer:
It can be because of age related floater or dry spot on cornea.

Detailed Answer:
Hello
Welcome to Health care magic

I am Dr. DADAPEER K, an Ophthalmologist and I answer health problems related to eye.

I reviewed your history.
It seems from the history that you are having a black spot in the peripheral visual field.
The most common causes to be ruled are
1. Floaters
2. Black outs of vision
3. Dry spots on the cornea
4. Retinal problems like retinal detachment, retinal tear...

Floaters are because of age related degenerations in the vitreous. These are the commonest causes for the black spots in vision and usually does not require treatment.
Retinal problems like retinal tear, retinal detachment..., need to be suspected when floaters are of sudden in onset and associated with flashes of light.

Black outs of vision are usually seen in migraine, hypovolemia, hypotension, hypoglycemia. These are usually transient and recover on its own in few minutes.

The dry spots on the cornea can sometime present as black spots in the visual field and require treatment for the dry eyes.

Since ophthalmologist has examined your eyes and there are no flashes of light this rules out retinal problems like retinal tear, retinal detachment....
Since the black spots in the vision are persistent this rules out black outs of vision.

Hence we are left with floaters and dry spots on the cornea. Since you are on treatment for dry eyes this can be the cause or it can be because of age related floater.

Hope I have answered your question and the information is helpful to you.
Do write back to me for further questions.

Thank you

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Dadapeer K (6 hours later)

I'm very impressed and will use this service again. I'm a retired Periodontist so know a little bit about the subject. I liked how you presented your thoughts. I think if I summarized your reply you thought (no conclusion but your tentative thought) was that it is nothing to worry about but go back and see the doctor next month?

Thanks again.
XXXXX XXXXXXX

Answered by Dr. Dadapeer K (5 hours later)

Brief Answer:
Thank you

Detailed Answer:
Thank you for writing to me on Health care Magic. I am glad to know that the answer was helpful to you.

With regards

Above answer was peer-reviewed by : Dr. Yogesh D