Black Shadows in Vision: Causes and Concerns - Ophthalmology

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Hello! Thank you for your detailed question regarding the visual disturbances you are experiencing, particularly the black shadows and flashes in your vision. Given your history of high myopia and floaters, it is understandable that you are concerned about these new symptoms.

Based on your description, the black shadows you see, especially when looking in certain directions, could be related to a few potential causes. One possibility is that these shadows are a manifestation of the vitreous gel in your eye pulling away from the retina, which is often referred to as vitreous detachment. This condition can lead to symptoms such as flashes of light (photopsia) and floaters, which you have already experienced. The fact that you have high myopia increases your risk for vitreous detachment, as the vitreous gel is more likely to change with age and the elongation of the eyeball.

Another concern is the possibility of retinal issues, such as a retinal tear or detachment. Although your recent eye examination indicated that your retina was healthy, the appearance of new symptoms warrants further investigation. Retinal tears can sometimes occur without significant warning and can lead to retinal detachment, which is a serious condition that requires immediate medical attention. Symptoms of a retinal tear may include sudden flashes of light, an increase in floaters, or a shadow or curtain effect in your peripheral vision.

The fact that you mentioned seeing a small black circle when looking in certain directions could suggest that there is some form of obstruction in your visual pathway, possibly related to the vitreous gel or even the retina itself. It is essential to monitor these symptoms closely. If the black shadows persist, worsen, or are accompanied by other symptoms such as a sudden decrease in vision, it is crucial to seek immediate evaluation from an eye care professional.

Given your history of high myopia and previous retinal issues in your right eye, I would recommend that you schedule a follow-up appointment with your ophthalmologist. They may perform a comprehensive eye exam, including a dilated fundus examination and possibly optical coherence tomography (OCT), to assess the condition of your retina and vitreous more thoroughly. These tests can help determine if there are any changes that require intervention.

In summary, while the symptoms you are experiencing could be related to vitreous changes, the risk of retinal complications in patients with high myopia cannot be overlooked. It is always better to err on the side of caution when it comes to eye health. Regular monitoring and prompt evaluation of any new symptoms are key to maintaining your vision and preventing potential complications. Please take care and do not hesitate to reach out to your eye care provider for further assistance.