What are these circular spots in my vision after an eye injection?
Sometimes after an eye injection, a patient may see one or more black circular spots that move in the vision with head movement. They are usually in the lower part of the visual field, though they move up toward the center of the visual field if you position your head face down.
What causes these symptoms?
These black spots are due to air bubbles in the medicine that is injected into the eye. They appear immediately after injection. They are harmless and take 1-2 days to dissolve and disappear. Less commonly, small black circular spots may float in the vision after injection due to small silicone bubbles that are used to lubricate the syringe. These silicone bubbles do not dissolve, but they may float away from the retina and become less noticeable over time.
What should be done about these symptoms?
If the spots are due to air bubbles, these symptoms fade without treatment. If the spots are due to silicone bubbles, they may come and go over time. It is best not to track them with your eyes as they may become more bothersome. Try to look past these floaters and ignore them if possible. If they persistently interfere with the vision, vitrectomy surgery may be considered to remove them. This is rarely necessary.
What other symptoms can mimic this problem?
These black spots are considered a type of “floater.” Floaters are any visual spot in the vision that “floats” or moves somewhat independent of eye movement. Sometimes floaters may come on suddenly and appear like dots and fibers. This is typical for bleeding inside the eye. If dots and fiber-like floaters come on more slowly (hours to days), they may be a sign of infection or inflammation. Rarely, cancer may present as many tiny floating spots in the vision.
Floaters are distinct from blind spots (scotoma) that are fixed in the visual field and move only when the eye moves. You cannot “catch up” or move away from a blind spot by moving the eye. Blind spots are usually due to problems with the retina or optic nerve. A progressive blind spot that begins in the peripheral vision and enlarges over hours to days may be due to a retinal detachment and requires a prompt examination. Retinal detachment is often described as a curtain or shadow covering the vision.
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