A driver friend came to see me and said that 3 days ago the front of his eyes flashed gold, then there was a black shadow obscuring the bottom, gradually becoming larger, and now it has obscured a large part of the visual field, and only a small part of the visual field above is visible. After listening, I told him that he needed to be examined and surgically treated, and that it was likely to be a retinal detachment. Flashing black shadows in front of the eye The flashing black shadows in our visual field are formed after the movement of the degenerated vitreous, which patients often describe as being like cellular structures, some like feathers, some like flies and mosquitoes, and all kinds of colors. These degenerative and diseased vitreous bodies can also damage our retina and form retinal fissures. Of all the fissures, the most common are the atrophic round fissures and the horseshoe-shaped fissures formed by retinal tears. Round holes are often formed in the atrophied, thin, poorly nourished peripheral retina, which is like a thin, old piece of cloth that breaks at the slightest touch, a condition commonly seen in moderate to high myopia. Horseshoe-shaped tearing holes can occur in any eye condition and are primarily associated with abnormal vitreoretinal adhesions. The normal retina produces light perception when stimulated by an external light source, and our eyes can sense the stimulated light flickering when the external light source flickers. After the formation of retinal fissure, the liquefied vitreous body enters between the retinal neuroepithelium and pigment epithelium by the fissure. When the optic cells of the neuroepithelium are irritated by the vitreous body on the retinal surface and the liquefied vitreous body under the retinal neuroepithelium, the electric waves of the retina are disturbed, and a continuous flashing sensation appears in the field opposite to the retinal fissure and detachment, just like lightning, often with open eyes and with closed eyes It is often seen with the eyes open and closed, and is more pronounced in dark places. Retinal detachment is a form of blinding, one of the diseases that seriously endanger human visual function. Patients are more male than female, mostly adults over 30 years of age, rare in children under 10 years of age, with differences between the left and right eyes, the incidence of binocularity is about 15% of the total number of patients, mostly in myopic eyes. The most common clinical condition is hole-derived retinal detachment, which is usually preceded by a fissure and followed by retinal detachment. Patients gradually increase from black shadows to visual field defects and vision loss, and with the occurrence and development of retinal detachment, the liquefied vitreous body enters more and more under the retinal neuroepithelium, and patients feel a curtain-like black shadow gradually extending from the fissure and the place where the detachment started to the center, and when the retinal detachment involves the macula, there is When the retinal detachment involves the macula, there will be a sharp decrease in central vision, distortion of vision and water ripple-like changes. If the retinal detachment does not involve the macula, the patient’s central vision can be unaffected. When the lesion involves the macula or the retina is completely detached, the vision is severely impaired and can be reduced to the point where the patient can only see manually in front of the eyes, or even only the sense of light, and finally the patient can become blind due to the atrophy of the eye. There is a potential cavity between them. Under normal circumstances, the vitreous body does not pull on the retinal neuroepithelium, but supports it to adhere to the pigment epithelium, and the pigment epithelium also has a certain adsorption function to hold the retinal neuroepithelium tightly. Together, the retina forms a complete retina, which completes the function of photoreceptor cells for light sensing and visual information formation and conduction to the optic nerve to ensure that the objects we see are clear and bright. The normal vitreous body is a colorless, transparent, uniform jelly-like structure that adheres tightly to the retina only at the optic nerve papillae, macula, and peripheral retina, and loosely elsewhere. When the vitreous and retina are normal, the image of the object is clearly projected on the retina and there is no obstruction in our visual field. In some pathological conditions, such as liquefaction of the vitreous with age, it is no longer a homogeneous structure, but becomes viscous in some places and liquefies into an aqueous structure in others, or inflammatory lesions of the vitreous retina, abnormal adhesions or degeneration occur, and its transparency is altered. If there is a black shadow flying in front of the eyes with a constant flash of light in a fixed direction, you should visit an ophthalmologist for a careful fundus examination, and make sure to exclude retinal fissures and retinal detachment. In today’s treatment, if laser retinal fissure photocoagulation is performed when the fissure has just occurred and no retinal detachment has occurred, most patients can be treated without retinal detachment, thus reducing the risk to visual function, as well as reducing the difficulty of surgery and surgical complications and saving medical costs.