= 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.