Seeing red spots in your vision signals a disturbance in the visual system and demands professional evaluation. This anomaly is often a form of photopsia—the perception of light or shapes without an external source—or it can be a sign of physical material within the eye. Causes vary widely, ranging from temporary neurological events to serious physical damage requiring immediate medical intervention. Visual symptoms can arise from issues within the eye, such as bleeding, or they can be related to underlying systemic conditions affecting the entire body. A medical professional must determine the exact source of the spots for appropriate treatment.
Understanding Internal Bleeding and Hemorrhages
A common and often serious reason for seeing red spots is a vitreous hemorrhage, which is the presence of blood within the eye’s interior. The vitreous humor is the clear, gel-like substance filling the space between the lens and the retina. When blood vessels rupture, the blood mixes with this gel, blocking light and causing the perception of floaters, cobwebs, or specks. These spots often appear worse in the morning because blood cells settle over the macula, the area of sharpest vision, while a person is lying down.
One direct cause of bleeding is a posterior vitreous detachment (PVD), where the vitreous gel shrinks and pulls away from the retina as a person ages. If the gel is strongly adherent, this pulling can tear the retina or damage a tiny blood vessel on the retinal surface, leading to hemorrhage. A retinal tear is a particularly serious event because fluid can seep beneath the retina, potentially causing detachment, which is a sight-threatening emergency. Trauma to the eye is another frequent cause of vitreous hemorrhage, especially in younger individuals.
Visual Disturbances Linked to Migraines
Not all visual spots are physical; some originate from neurological activity associated with migraines. A migraine aura is a transient neurological event that often precedes or accompanies a headache, though it can occur in isolation, known as an ocular migraine. These visual disturbances are caused by changes in electrical or chemical activity spreading across the visual processing centers of the brain.
The visual symptoms, often called scintillating scotomas, manifest as shimmering spots, flashing lights, zigzag lines, or geometric patterns that expand across the field of vision. Although they may be perceived as colored, including red or yellow, these spots are distinct from floaters because they affect both eyes simultaneously and are transient, usually resolving within an hour. Retinal migraines are a rarer form where visual symptoms, such as temporary vision loss or blind spots, affect only one eye due to temporary narrowing of blood vessels supplying the eye.
Systemic Diseases That Affect Eye Health
Chronic health conditions affecting the body’s vascular system significantly compromise the integrity of the eye’s delicate blood vessels. The most common systemic cause of recurrent bleeding is diabetic retinopathy. High blood sugar damages retinal blood vessels, leading to reduced blood flow and oxygen deprivation. This stimulates the growth of fragile, abnormal new blood vessels, called neovascularization. These new vessels are prone to leaking or rupturing easily, resulting in hemorrhages seen as red spots or floaters in the vision.
Severe hypertension, or high blood pressure, also stresses the retinal vasculature, leading to hypertensive retinopathy. Chronically elevated pressure damages vessel walls, causing them to leak fluid and blood into the retinal layers, which can appear as flame-shaped hemorrhages. Other systemic vascular disorders, such as sickle cell disease or retinal vein occlusions, also create an ischemic environment where fragile vessels form and bleed. Management of these underlying conditions is necessary to prevent serious visual symptoms and preserve sight.
When to Seek Immediate Medical Attention
A sudden or dramatic change in vision always requires immediate medical evaluation by an eye care professional, such as an ophthalmologist. Specific accompanying symptoms signal a potential emergency that requires urgent attention.
These urgent signs include:
- A sudden shower or significant increase in the number of red or dark spots.
- Spots accompanied by flashes of light, which may indicate a retinal tear or detachment.
- The appearance of a dark shadow, curtain, or veil moving across the field of vision, signaling possible retinal detachment.
- Visual spots occurring alongside severe eye pain, sudden vision loss, or following trauma to the head or eye.
A dilated eye examination is necessary for a definitive diagnosis to identify the source of bleeding or check for retinal damage.