White spots on the eyeball can vary in severity. Some may be hardly noticeable while others can cause a lot of discomfort.
Eye problems of any sort can cause long-term damage to vision. Even if the discomfort is minimal, always seek medical advice if a white spot appears on the eye.
In this article, we look at the diagnosis and treatment of white spots on the eye. We also discuss how to prevent them, and the likely outcomes.
Conditions that can cause a white spot to form on an eye include:
- corneal ulcers
A doctor or optician should assess any changes in the eye.
Image credit: Molly Kurnit, M.P.H., 2008
Corneal ulcers can lead to permanent vision damage. They can also lead to blindness if left untreated.
The ulcers occur when the cornea is damaged. Causes of damage can include:
- something hitting or penetrating the eyeball
- contact lens issues
- severe scratching from a foreign object
If something breaks through the surface of the cornea, an infection can develop. Germs that could lead to infection in the cornea include:
- fusarium, a fungus
- acanthamoeba, a parasite
- herpes simplex virus
Other conditions that can cause corneal ulcers are
- eye allergies, including allergies to cosmetics or airborne allergens
- immune system disorders, such as multiple sclerosis
- inflammatory diseases, such as psoriasis
Pingueculas are another common cause of white spots on the eye. They can occur when the eyes:
- are exposed to ultraviolet rays
- come into contact with dust or sand
- become dry, perhaps through exposure to wind
- become irritated by contact lenses
- are exposed to arc welding
Pinguecula spots are white or yellow and consist of fat or protein deposits. They appear on the conjunctiva, which is the transparent covering of the white part of the eyeball. These spots are usually irregular in shape and commonly form on the part of the eye nearest the nose.
Cancers can also form on the eyeball. These include:
Ocular cancers, as they are known, are relatively rare. Some cancers have environmental causes, such as sun exposure. In other cases, they can occur due to a person's genetics.
Image credit: CDC/ Brinkman, 1963
Image credit: Red eye2008, 2008
Image credit: WikiMichi, 2011.
Image credit: IceclanI, 2015
A corneal ulcer, pinguecula, or ocular cancer can share some common symptoms, such as:
- irritation on the eyeball
- reddening in and around the eye
- blurred vision
Each cause also has some unique symptoms.
Corneal ulcer symptoms
- excessive tear production
- light sensitivity
- puss or discharge
- severe soreness
- swelling of the eyelids
- blurred vision
Although pingueculas can occur with no additional symptoms, they may be accompanied by:
- the appearance of extra blood vessels
- a burning sensation
Ocular cancer symptoms
Eye cancers can initially seem like minor conditions. An eye test should pick up any signs of eye cancer, including:
- a bulge in one eye
- a dark patch that grows over time
- a lump on the lid or eyeball that is growing
- vision disturbance, such as light, shadow, or wiggly lines
When to see a doctor
Anyone who has an eye problem that does not clear up in a day or two should seek treatment.
It is essential to see a doctor if there is:
- any rapid change in vision
- sudden pain
- discharge from the eye
A doctor can refer someone to an ophthalmologist or optometrist. These are eye specialists who can run a full range of tests.
An eye exam can help diagnose the cause of white spots.
An eye doctor will examine the eye, and ask about any recent injuries. They may also carry out a slit lamp exam. To do this test, the ophthalmologist or optometrist drops a dye called fluorescein onto the eye, which they will examine using a special microscope.
If the eye doctor suspects an infection, they may take a tiny amount of tissue for analysis. This is called a biopsy or culture.
Doctors can also identify pingueculas by examining the eye or using fluorescein. This will usually be enough, but a doctor may request a biopsy if they are unsure.
A doctor can diagnose eye cancer with the following tests:
- a biopsy
- a fluorescein angiogram, using the dye to help photograph suspected cancers
- ultrasound scanning to create an image of the eye and anything in it
Treatment of corneal ulcers
A doctor will remove any foreign bodies from the eye and then treat the damage.
A person should not wear contact lenses during treatment and recovery, even if they are not the cause of the corneal ulcer.
Eyedrops are one of the most common treatments for corneal ulcers. The best type of eye drop to use depends on the causes. The range of eye drops includes:
Pain relief medication is available in the form of both eye drops and pills.
Once an infection has cleared up, people may use steroid eye drops to treat any scarring that has formed. Steroids can make things worse if used before an infection clears up, however.
Tear substitutes can help if the eyes are not producing enough moisture.
If the damage to the cornea is severe, doctors may replace part or all of the cornea with a new donor cornea.
Treatment of pingueculas
Eye drops and ointments can usually treat pingueculas.
If a pinguecula affects a person's vision or causes severe discomfort, they may require surgery to remove them. Laser treatment is becoming more common.
Treatment of ocular cancers
The treatments for eye cancers depend on the type and stage of the tumor. Treatment methods include:
- brachytherapy, where a doctor places radioactive metal plates near the tumor
- radiotherapy, using beams of radiation to target cancerous cells
- surgery to remove the tumor
- eye removal
The best way to prevent white spots developing on the eyes involves looking after the eyes. The following steps can all help to protect eye health:
- Keeping eyes shaded from the sun. This can protect the area around the eyes too.
- Wearing sunglasses with 100-percent UVA and UVB protection.
- Avoiding dusty conditions. Particles in the air can cause damage.
- Being wary of swimming in unclean water.
- Washing hands regularly.
- Avoiding leaving make-up on overnight.
- Wearing eye protection when necessary.
- Keeping the area around the eyes clean at all times.
- Using a product to keep dry eyes moist.
If someone has a cold sore, they should avoid touching their eyes.
People who wear contact lenses should always follow the guidelines for use. It is essential to clean the lenses with the correct solution, remove them regularly, and replace them if they are damaged or ill-fitting.
The outlook for white spots on the eye can vary greatly. It is most likely that a white spot is a short-term condition. In terms of treatment, the outcomes after diagnosis are excellent.
Although the chances of a white spot being cancer are low, the potential risks are high.
White spots on the eye tend to be easily treatable. An early diagnosis will help to limit the impact. It is essential, therefore, to speak to a doctor if there are any signs of white spots on the eye.
Good hygiene practices are always recommended and will help prevent a lot of eye issues. Take care to protect eyes against the sun, particles in the air, and bacteria.