The eye is a complex organ where spots can manifest as visible changes on the surface or as shadows perceived within the field of vision. These spots involve the eye’s protective outer layers (the sclera and conjunctiva) or the internal vitreous humor. Understanding the location and nature of these changes is key to determining their significance. While many spots are common and harmless features of aging or environmental exposure, others signal the need for timely attention from an eye care professional.
Spots on the Eye’s Surface: Static Pigmentation and Growths
Spots on the conjunctiva are chronic features that develop slowly, often related to sun exposure. A common type is a conjunctival nevus, which is essentially a mole on the eye’s surface. It appears as a flat or slightly raised area of pigmentation, varying in color from yellowish-brown to dark brown. These spots are typically monitored for any changes in size or shape.
A frequent and benign surface change is a pinguecula, presenting as a yellowish, slightly raised patch on the conjunctiva, often near the cornea. This growth is a deposit of protein, fat, or calcium, caused by chronic exposure to UV radiation, wind, or dust. Pingueculae rarely cause visual issues, though they can become inflamed, leading to temporary redness and irritation.
A related but potentially more problematic growth is a pterygium, sometimes called “surfer’s eye.” A pterygium is a fleshy, triangular-shaped tissue that starts on the conjunctiva and can extend across the clear cornea. If a pterygium grows large enough to cover the central cornea, it can interfere with vision. This interference occurs by causing blurriness or inducing astigmatism, which distorts the corneal shape.
Spots Indicating Acute Change or Injury
A spot that appears suddenly on the white of the eye often points toward an acute event, such as a vascular issue or localized infection. The most dramatic example is a subconjunctival hemorrhage, a bright red patch on the sclera. This occurs when a tiny blood vessel breaks beneath the conjunctiva, causing blood to pool in the area.
This hemorrhage usually results from minor events that momentarily increase pressure, such as a forceful cough, sneeze, or strain. Despite the startling appearance, a subconjunctival hemorrhage is typically painless, does not affect vision, and resolves on its own within one to two weeks as the blood is reabsorbed. The color of the spot often changes from bright red to yellow or green as it heals.
In contrast, a sudden white or grayish spot on the clear cornea requires immediate professional evaluation. This appearance can signal a corneal ulcer, an open sore often caused by infection from bacteria, viruses, or fungi. Corneal ulcers are frequently associated with contact lens wear and present with severe pain, redness, and light sensitivity. Unlike the painless hemorrhage, a corneal ulcer is a medical urgency because it can rapidly lead to scarring and permanent vision loss if not treated promptly.
Spots Seen Within Your Vision (Floaters and Shadows)
The perception of spots that drift or float within the field of vision, known as floaters, originates inside the eye. The eyeball is filled with the vitreous humor, a clear, gel-like substance composed of water and fine collagen fibers. As a person ages, the vitreous gel naturally liquefies and shrinks, a process called syneresis.
This liquefaction causes collagen fibers to clump together into small, dense strands. These clumps float within the vitreous and cast shadows onto the retina, the light-sensitive tissue at the back of the eye. These shadows are perceived as dots, cobwebs, or wispy strands. Floaters are most noticeable when looking at a bright, plain background, such as a blue sky or a white wall.
A common age-related event is a Posterior Vitreous Detachment (PVD), where the shrinking vitreous gel separates from the retina. The sudden onset of a large number of new floaters, sometimes accompanied by a prominent, ring-shaped floater called a Weiss ring, is a characteristic sign of this separation.
During PVD, the separation can cause mechanical stimulation of the retinal tissue. This tugging is perceived as brief flashes of light, known as photopsias, often described as lightning streaks in the peripheral vision. While PVD is generally harmless, the sudden appearance of flashes and floaters necessitates an eye examination to ensure the vitreous is separating cleanly without tearing the retina.
Identifying Red Flags and When to Seek Urgent Care
While many eye spots are benign, certain associated symptoms act as red flags requiring immediate medical attention. Any sudden loss of vision, or a noticeable shadow or curtain descending across the visual field, should prompt an emergency eye examination. These symptoms indicate a retinal detachment, a condition where the retina is pulled away from its supportive tissue, which can lead to permanent vision loss if not repaired quickly.
A sudden, significant increase in floaters, especially when accompanied by new or worsening flashes of light, also warrants an urgent assessment. While this combination often signals a Posterior Vitreous Detachment, the same symptoms can precede a retinal tear. The presence of moderate to severe eye pain, intense redness, and sensitivity to light, particularly with a spot on the cornea, suggests a serious infection like a corneal ulcer.
Any pigmented spot on the eye’s surface that exhibits rapid growth, a change in color, or an irregular border should be evaluated promptly by a specialist. Regular, dilated eye examinations are the definitive way to diagnose the cause of spots, ensuring that conditions requiring urgent care are addressed without delay.