The common causes of fixed black shadows in the eyes are as follows: 1. They may be caused by foreign body residue in the central part of the cornea, or by keratitis, clouding of the central part of the lens, optic neuritis, optic neuropathy or macular disease. 2. In addition, if a patient has refractive error and wears glasses, black shadows caused by lens contamination and wear should also be excluded. If it is caused by cataract, because it is cloudy in the central area, the pupil will shrink when encountering strong light, which will lead to obvious black shadow obscuring vision loss. 4.If it is macular lesion in the fundus, it can usually be diagnosed by macular OCT, which is usually more common in the elderly, such as age-related macular degeneration.