Valsalva retinopathy is characterized by preretinal hemorrhages caused by increased intrathoracic pressure.
So, what can actually lead to it?
It can be triggered by everyday activities such as weightlifting, aerobic exercise, playing musical instruments, straining, physical exertion, sexual intercourse, cardiopulmonary resuscitation, and compression injuries. Pregnancy is also considered a risk factor.
Symptoms
Patients with Valsalva retinopathy often present with sudden, painless, unilateral (rarely bilateral) vision loss, preceded by a history of Valsalva-like maneuvers (mentioned above). Symptoms include a black spot (scotoma) in front of the eye, floaters, a reddish hue to vision, or blurred or lost vision, depending on the severity and location of the bleed.
Treatment/Management
Instigating factors should be addressed — for example, advising against heavy lifting or prescribing stool softeners in cases of constipation.
- Laser treatment — membranotomy may be performed to create an opening in the posterior hyaloid or internal limiting membrane (ILM), allowing blood to escape into the vitreous cavity and settle inferiorly.
- Surgical treatment — vitrectomy may be considered in cases of significant, long-standing premacular hemorrhage or dense vitreous hemorrhage obscuring retinal evaluation.
The reassuring part? Valsalva retinopathy is usually self-limiting, with most hemorrhages resolving on their own within weeks to months. But sudden vision changes should never be ignored, if you ever notice a sudden blur, spot, or shadow in your vision after straining or exertion, get it checked. Early recognition is what keeps a scary symptom from becoming a lasting one.
MBH/PS