Dark spots (not floaters) in vision when looking extreme up and sides

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History of PVD, floaters/flashes for years. Diagnosed with PVD by my hometown ophthalmologist back in early 2019 in my mid 20's. At that time he theorized it was due to repeated trauma from a long football career. My visual symptoms have always been made worse with poor sleep, long periods of screen use (studying for board exams, ICU rotations, etc.) and improves with rest. I also have had orbital headaches off and on for several years, also correlated with poor sleep and increased screen time. Lately, I've noticed what seems to be paracentral scotomas bilaterally with extreme gaze to the sides and upwards. Not present with normal gaze. I feel like they have been there for a long time, but being more conscious of them I feel as if I notice them more lately. The spots are upper outer visual field, both eyes, more noticeable in dimly lit room, difficult to see/not present in normal daylight and dark. They are fairly uniform in each eye. My vision has not been affected at all.

I am not sure what to make of them. I had a totally normal exam 2 months ago. Have a repeat exam coming up with ophthalmology soon, but anxiety is getting the best of me Any ideas?

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Thanks for your help!

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