A white spot in the eye can be concerning, signaling an underlying issue that warrants attention. Understanding the potential reasons behind such a spot is the first step toward addressing the concern.
Common Causes of White Spots on the Cornea
White spots on the cornea, the clear, dome-shaped outer layer of the eye, are frequently linked to conditions like corneal ulcers. A corneal ulcer is an open sore on the cornea, often caused by infections from bacteria, viruses, fungi, or parasites. Bacterial infections are particularly prevalent, especially among contact lens wearers who may not adhere to proper hygiene. Viral infections, such as herpes simplex, can also lead to recurring corneal ulcers. Fungal infections, often associated with improper contact lens use or injury from plant material, and rarer parasitic infections like Acanthamoeba keratitis, can also result in ulcers.
Corneal scars can also appear as white spots, forming from healed injuries or infections that left opaque tissue. Keratitis, which is inflammation of the cornea, can also lead to white spots. This inflammation may be infectious or non-infectious, arising from minor injuries, prolonged contact lens wear, or severe dry eyes. Symptoms associated with these corneal conditions often include eye redness, pain, excessive tearing, blurred vision, and sensitivity to light.
Other Types of White Spots and Their Origins
Not all white spots originate from the cornea; some can appear on other structures of the eye or have different underlying causes. Conjunctival concretions, for instance, are small, hard, yellowish-white deposits that form on the conjunctiva, the transparent membrane covering the white part of the eyeball and the inside of the eyelids. These concretions are typically harmless and often occur with age or chronic inflammation, and while usually asymptomatic, larger ones can cause irritation or a foreign body sensation.
Cataracts, another common cause, involve the clouding of the eye’s natural lens. Cataracts often progress slowly, causing vision to become blurry or hazy, and in advanced stages, the lens may appear cloudy, whitish, or yellowish. They are frequently age-related, but can also develop due to injury, other eye conditions, or underlying health issues like diabetes.
Pinguecula and pterygium are growths that occur on the conjunctiva that appear as whitish or yellowish spots or bumps. A pinguecula is a yellowish-white bump made of fat, protein, or calcium, usually located on the side of the eye closest to the nose. A pterygium, which can sometimes develop from a pinguecula, is a flesh-like growth that can extend onto the cornea and potentially affect vision. Both are often linked to exposure to ultraviolet (UV) radiation, dry eyes, wind, or dust. Less commonly, cotton wool spots are pale white or gray lesions on the retina, not visible to the patient and usually discovered during a professional eye exam. These spots indicate reduced blood flow to the retina and can be a sign of systemic conditions such as high blood pressure or diabetes.
When to Seek Professional Medical Advice
Any new or changing white spot in the eye warrants evaluation by an eye care professional, as early diagnosis can prevent vision damage. Prompt medical attention is important if the white spot is accompanied by warning signs. These include sudden onset of the spot, eye pain or discomfort, blurred vision, or a decrease in vision.
Additional symptoms that indicate a need for urgent care include excessive tearing or discharge from the eye, sensitivity to light (photophobia), or a feeling that something is constantly in the eye. If the white spot is growing in size or changing in appearance, or if there is noticeable redness or swelling around the eye, it is advisable to seek professional medical advice without delay. Such symptoms could signal a serious underlying condition that requires timely intervention to preserve vision and overall eye health.
How White Spots Are Diagnosed and Managed
When evaluating a white spot in the eye, eye care professionals employ a comprehensive approach to determine the underlying cause. A thorough eye examination is typically performed, which may include assessing visual acuity and observing the external structures of the eye.
A key diagnostic tool is the slit lamp examination, which uses a specialized microscope with a bright light to provide a magnified, three-dimensional view of the eye’s various components, including the cornea, lens, and retina. This allows the doctor to precisely locate and characterize the white spot and any associated abnormalities.
During the examination, a fluorescein eye stain test may be used. This involves applying a special orange dye, fluorescein, to the eye’s surface. The dye temporarily stains damaged areas of the cornea or conjunctiva, making them visible under a blue light and highlighting problems like abrasions or ulcers that might not otherwise be apparent. In cases of suspected infection, a small tissue sample from the spot may be taken for laboratory analysis to identify the causative organism.
Management strategies for white spots depend entirely on the diagnosis. For infectious causes like corneal ulcers, treatment typically involves medicated eye drops, such as antibiotics for bacterial infections, antivirals for viral infections, or antifungals for fungal infections. Non-infectious conditions, such as pinguecula or dry eye-related keratitis, might be managed with lubricating eye drops or anti-inflammatory medications. In some instances, particularly for advanced cataracts or significant corneal scarring that impacts vision, surgical intervention may be necessary to remove the clouded lens or replace the damaged cornea.