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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 11360
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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What is a dark spot on the back of eye, visible only to a

Customer Question

what is a dark spot on the back of eye, visible only to a doctor? This is a human eye.  Male 64.
Submitted: 6 years ago.
Category: Eye
Expert:  Dr. Rick replied 6 years ago.
Dr. Rick :

Hi. I'm online and happy to answer your question today.

Dr. Rick :

There are many things that could be a dark pigmented lesions on the retina (back of the eye). Can you tell me more about it? Is your vision affected?

Dr. Rick :

Was the doctor who noticed the spot during her exam an optometrist, ophthalmologist or a retina specialist?

Dr. Rick :

I also noted that you have posted three other questions that received good answers but you only accepted one of them? What is your intent if you obtain a good answer this time?

Dr. Rick and other Eye Specialists are ready to help you
Expert:  Dr. Rick replied 6 years ago.
I look forward to your response to the above inquiries and helping you with your question.
Customer: replied 6 years ago.

Dear Dr. Rick: Sorry I missed you online. The black spot is on the back of the eye. Not noticable at all except by an eye doctor. The black spot is not causing anything to his vision. It was an Opthamoligist who found this in a routine eye exam. He has forwarded him on to a specialist that we will be seeing on Monday morning.

Customer: replied 6 years ago.
I will accept an answer from any of your eye surgeons. Thank you.
Expert:  Dr. Rick replied 6 years ago.
Thanks for that information. Well, the fact that an ophthalmologist is not sure what the spot is and is sending you on to a ?retina specialist for further exam lends more weight to the issue in my mind.
Would you like me to go through a wide-ranging differential diagnosis of all the things that can be pigmented in the back of the eye? The list is extensive and includes things as benign (don't worry about them....) as a nevi (birth mark) to as scary as malignant melanoma (not a good thing....). I have seen and treated most of these conditions in my retina practice over the last two decades.
Let me know what information you would like. Right now, without more information about the black spot (Guess this is not the Dreaded Black Spot of Pirate Lore, eh :), I really can't give you much useful information.
However, if you wanted, after you see the retina specialist, I could go over the information she gives you in greater detail along with treatment options, prognosis, etc. You could just post back to this thread on Monday and we could spend as much time as you needed on the subject.
How does that sound to you? Let me know what would be best.....I Owe you a great answer ;o)
Customer: replied 6 years ago.
He is being referred to the retina specialist. We will be there on Monday and I will let you know his diagnosis. In the meantime, the doctor did explain that it could be a tumor, malignant or benign. How do the actually know if it is malignant? If it is, what can be done if anything? The doctor did tell us the worst.......removal of the eye. My husband will never be able to deal with that and he is completely stressed over this. sm
Expert:  Dr. Rick replied 6 years ago.
There are ultrasound, fluorescein angiogram and visual clues that help to tell if a lesion is benign or malignant. All of these tests can be done in the retina specialists office.
Rarely needed...... a biopsy can be obtained using special surgical techniques.
If it is malignant there are a number of things that can be done, depending on the specific findings, location of the lesion etc. It is too early to go over all the options..... Also, if you are willing to travel, I can give you some referrals for treatment if it becomes necessary.
Tell you husband to not panic until more information is available.
I know, easy for me to say :) .......
Talk to you Monday.
Customer: replied 6 years ago.
Thank you Dr. Rick: Based on the results on Monday I will let you know the outcome. A doctor at UCSF has been recommended for the next step after Monday if necessary. I will let you know the complete conversation we have with the doctor. Thank you for you support. It is greatly appreciated. sm
Expert:  Dr. Rick replied 6 years ago.
My pleasure. Talk to you then.
Customer: replied 6 years ago.

Good Morning Dr. Rick: The retina specialist found the spot to be a mole. He used the word Nevus. It could be benign or malignant. It is on the lower left bottom of the eye. It is not in the retina. He is scheduling an appointment asap with another specialist in

San Francisco. That person will do tests to determine whether is malignant or not. If it is malignant they may have to use radiation. They don't want to do that because he most likely would be blind in that eye. He said its a mole. I have never heard of such a thing. But we do feel somewhat positive in that it isn't on the retina. I will keep you informed of the specialist we will see and his report. Thank you, Rick. We can leave this thread open so that I can keep you informed. I understand its a very, very rare tumor.

Expert:  Dr. Rick replied 6 years ago.
Thanks for the update. Nevi are fairly common and only a small percentage of them turn out to be a cancer (most commonly melanoma :(
You will get excellent care at the retina department at UCSF. But, just in case you want to know, the worlds experts consist of a husband and wife team at Wills Eye Hospital in Philadelphia, PA, Dr's Jerry & Carol Shields. I have met both of them on a number of occasions and you could do no better.....
Customer: replied 6 years ago.

Thank you Dr. Rick. We have not heard when the appointment is and who it is with.

I do know it will be Pacific Medical Center. However, I would like my husband to get an opinioin from Dr's Jerry and Carol Shields. Thank you for the recommendation. I

The retina doctor did tell us all about melanoma. :(


Expert:  Dr. Rick replied 6 years ago.
Lets hope it is not a melanoma.....but if it is, take a road trip East.
Let me know how things come along. Keep a stiff upper lip :)
Customer: replied 6 years ago.
Hello Dr. Rick: We have not been told when my husband's appointment will be with Pacific Medical in SF? Should I call the retina doctor who is supposed to be making the appointment? thank you, sm
Expert:  Dr. Rick replied 6 years ago.
I would give a call and put a fire under his chair. It is not an emergency but there is no reason to be dragging his feet.