Our bodies sometimes experience changes and sudden discolorations. Sometimes we may wake up to find a random bruise on our thigh or arm. Other times, these changes might be more intentional—like soaking in the sun for a glowy tan.
Our eyes are also susceptible to such changes.
Some people may notice a black spot, known as an eye freckle, on the whites of their eyes. Generally, this is something we’re born with, but it can also develop later in life.
For the most part, eye freckles are benign and needn’t be a cause of worry. However, if you notice changes in the color, shape, or size of the freckle, you should visit your optometrist.
What is an Eye Freckle?
A black spot on the eye is often a benign freckle or mole, similar to the ones we get on our skin. Eye freckles can form on the sclera (the white of the eye), the iris, or on the back of the eye.
An eye freckle, known as a nevus, is generally harmless. It develops from an accumulation of pigment-producing cells called melanocytes.
However, changes in eye freckles deserve closer attention, as changes may indicate a more serious concern that requires monitoring.
Your optometrist can have a look at your eye freckle during a routine eye exam.
During the health evaluation part of a routine exam, your optometrist will examine the surface of your eye using a slit lamp. A slit lamp provides high magnification, making it easier to identify and evaluate any abnormalities, including pigmented spots on the sclera.
Your optometrist will observe the size, shape, and color of any freckles they detect. If they decide that an eye freckle needs a more thorough assessment, they may use OCT scans to capture detailed images of the eye’s structure, helping to monitor any changes over time.
Causes & Symptoms
An eye freckle is caused by the same cells that produce the pigment in our bodies that color our hair, skin, and eyes. These cells are called melanocytes. They’re normally spread evenly through the body, but can sometimes clump together, forming a freckle.
Currently, the exact causes of the development of eye freckles are being studied. However, some potential causes include:
- Genetic predisposition: Those with a family history of eye freckles have a higher likelihood of developing these spots.
- Environmental exposure: prolonged and unprotected exposure to sunlight and ultraviolet (UV) rays has been linked to the development of pigmented lesions, including those in the eye, as UV radiation can cause changes in melanocyte cells.
- Hormonal changes: Fluctuations in hormone levels, experienced during periods such as puberty, pregnancy, or menopause, can influence the activity and distribution of melanocytes, potentially leading to the formation of an eye freckle.
While a majority of freckles are harmless, a spot that develops later in life has a greater risk of becoming serious.
Eye freckles often develop silently without accompanying symptoms. You may not realize that a freckle has developed until it becomes visible.
While there aren’t any associated symptoms, monitoring for changes in the eye freckle is critical. Certain signs to watch for include:
- Subtle changes in the size or color of the existing spot
- Occasional irritation or discomfort
- Blurry vision
- Appearance of floaters
When to See an Eye Doctor
Generally, these black spots are benign and nothing to worry about. But it’s worth remaining attentive to any changes in the spot’s appearance.
An eye freckle that changes shape, color, or size may indicate a more severe condition, like malignant melanoma, requiring immediate treatment.
It’s strongly recommended to visit your optometrist when you experience:
- Noticeable changes in the black spot.
- Visual disturbances like blurry vision or floaters.
- Discomfort or irritation.
Treatment & Prevention
Due to their non-threatening nature, benign eye freckles rarely require removal. Under certain circumstances, however, the freckle can be removed for cosmetic reasons or to alleviate discomfort.
Eye freckles cannot be treated using at-home remedies or over-the-counter solutions. Surgical intervention or gradual laser sessions are required to target the lesion effectively.
These freckles can be removed in one of two ways:
- Surgical procedure: This is an option for removal when an eye freckle is suspected of posing a risk to health or vision. These procedures are performed under local or general anesthesia.
- Laser treatment: This treatment uses targeted laser beams to reduce or eliminate pigmentation. Multiple sessions are generally necessary to achieve the desired result. Laser treatment is often reserved for benign freckles, and is a good option for cosmetic removal.
Your optometrist doesn’t perform these procedures themselves. Rather, they evaluate the ongoing presence of the freckle and refer their patients to ophthalmologists who will take over care. After treatment, regular monitoring through follow-ups is recommended to confirm ongoing ocular health, wellness, and vision.
Currently, there’s no guaranteed method to prevent eye freckles from developing, but certain measures may help minimize their risk of formation.
Since factors like UV exposure are believed to play a role in melanocyte activity, protecting eyes from excessive sun exposure is key. Wearing UV-protective sunglasses, sunscreen, and wide-brimmed hats outdoors can reduce UV exposure to the eyes as well as the surrounding skin.
Maintaining a healthy lifestyle that supports overall ocular health, like a balanced diet rich in antioxidants, and scheduling routine eye exams contribute to preventing potential eye concerns and maintaining healthy vision.
Schedule a Visit
Maintaining a healthy lifestyle that supports overall ocular health includes regular eye exams. Your optometrist is your frontline for preventative care, and getting regular eye check-ups will let them detect potential concerns early enough for timely intervention. Connect with our team at Dr. Henslick Vision Center to schedule an appointment for your routine eye exam.
