The psychotherapy of a borderline patient is described, during which the patient developed angiospastic retinopathy. An attempt is made to reach some understanding of the psychosomatic aspects of angiospastic retinopathy out of a detailed examination of the patient's psychological problems, and to correlate this disorder with the primitive phobia of penetration. Treatment with prednisone and chlordiazepoxide hydrochloride was successful. Great care should be taken in diagnosing "hysterical blindness." The appearance of any visual disturbances in psychotherapy should call for immediate ophthalmological examination, for only then can psychosomatic angiospastic retinopathy be diagnosed. If untreated, permanent retinal damage may occur.