Valsalva Retinopathy

= 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.

Clinical presentation:

  • 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.

Location Birmingham Midlands Eye Centre 76 Dudley Road Birmingham B18 7QH UK Phone 0121 554 3801 Hours Mr Ch'ng | Vitreoretinal Clinic Sessions: Monday: 8.30am - 12.30pm Wednesday (alternate): 8.30am - 5.00pm Thursday: 8.30am - 12.30pm Friday: 8.30am - 12.30pm | Vitreoretinal Theatre Sessions: Wednesday (alternate): 8.30am - 5.00pm & Friday (emergency cases): 1.30pm - 5.00pm | Eye Casualty Session: Monday 1.00pm - 4.30pm |
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