= Haemorrhagic retinal pathology secondary to sudden rise in intrathoracic pressure.
Happens in normal eyes and resolves spontaneously.
Haemorrhages at sub ILM layer (commonly) but can be subhyaloid or vitreous.
Sudden painless loss of vision with history suggestive of Valsalva maneouver.
Well-circumscribed red elevation (round or bi-lobed) at premacular region below ILM.
Occasionally subhyaloid bleed or vitreous haemorrhage.
Blood – bright red –> yellow (after days-to-weeks).
Resolves sponatenously and vision recovers.
Diagnosis of exclusion
Rule out DM, SCD, anaemia and other blood dyscrasia – perform FBC, glucose, sickle cell prep, APTT, PT, serum electrophoresis, antiphospholipid antibody and urinalysis.
OCT / FFA
Observe and propped up positioning.
Nd:YAG in subhyaloid haemorrhage (< 3 weeks old and > 3 DD size)
PPV – non-resolving VH.