Black blob in peripheral vision

[shelbymm]

Hi! So my eye problem journey started about two years ago with more floaters showing up all of a sudden. I went from having one my whole life to having about twenty. Also my vision began to get blurry too. I went to the eye doc and he said my eyes were fine and I needed glasses. He said to try my best to just live with the floaters. About a year later the floaters began increasing again. I also was having bad headaches and sometimes it seemed like my vision was strobing. Also, I have a little bit of visual snow and sparkles. Then the scariest of all is having a black blob appear when I look extreme up. This occurs in my right eye only. My left eye, there is no black blob but there is a shimmering going on. The black blob looks a bit rainbowish too. It looks exactly like a pressure phosophene! If I look extreme up very slowly, it doesn’t appear. But it’s always there. It’s been there about 5 months now. I went to the eye doc and they did a bunch of tests but nothing came up. Now my headaches are gone for the most part, thank goodness.  I still worry about it all the time tho. Sometimes it feels like I have something irritating that eye too. Like I have something in it. I did get sand in it awhile back and maybe was too aggressive when I was cleaning it that I damaged it? Why would I have a constant pressure phosophene in the corner of my eye?

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

There is no single cause for all your symptoms. I will take them sequentially  1 floaters and flashes. To tell you 'not to worry' you need to be seen by an Eye MD that specializes in retina, vitreous and macular surgery. Among the tests you need are dilated exam with scleral depression of peripheral retina, macular OCT, perhaps fluorscene angigraphy. After this is done if new floaters, flashes, loss or peripheral vision occurs you need to see the retina specialist immediately. The flashes of light with a retina tear or posterior vitreous detachment (PVD) are momentary. If your flashes persist to 5-30 minutes are are constant like a neon sign that is not what retina flashes look like which are momentary, very short duration.  2. your eye being irritated. This is not due to PVD and may be some minor extermal problem, an external exam by a general ophthalmologist should find the cause quickly. 3. Visual strobing and headache. If these reoccur you will need to see an ophthalmologist and perhaps a neurologist. So not a single cause.   Your final questions a constant spot in the peripheral vision can be due to vascular problems in the eye, fluid under the retina. Tell the retina surgeon about it. A visual field, peripheral vision test would be indicated also.

[shelbymm]

Thank you very much for your response!
I have seen 3 eye doctors now. Two were Optometrists. One said I was fine and the other said I have macular degeneration. Then I went to an ophthalmologist and she said I didn’t have macular degeneration and that my eyes looked absolutely fine. I told her about the black blob in my peripheral vision and she recommended a neurologist. I just had an mri done and it came back fine!  Why wouldn’t the ophthalmologist recommend going to a retinal specialist? I will certainly start pursuing this. Could the black blob and reddish looking floaters I have be the warning signs that a tear or hole are impending? Thank you!

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

As an ophthalmologist, I have to use judgment and discretion. Many patients I see have unusual complaints that I can't explain. There are some 'red flags' that call for prompt referral to a ophthalmology subspecialist, or the patient's personal physician, some even straight to the emergency room.  Others are not on the 'red flag' list. I often say "if your symptoms persist, or get worse or something new alarming develops let us know." Your symptom in the face of a normal eye exam with normal OCT would not fall on the urgent referral list. Tests, and referrals are expensive and the health system is already straining to take care of the rapidly increasing number of people entering this country (many countries).