Abstract
Rationale: Symptoms of floaters and signs of retinal hemorrhages are common acute visual complaints and diagnoses. Diabetic or hypertensive retinopathy is prevalent, yet their differential of Valsalva retinopathy is rare. Patient concerns: A 32-year-old lady presented with floaters was found to have bilateral multi-layered retinal hemorrhages one day after laparoscopic surgery under general anesthesia. Diagnosis: Bilateral Valsalva retinopathy after general anesthesia. Interventions: The patient was offered observational conservative treatment. Outcomes: Multi-layered retinal hemorrhages resolved, but with residual left eye metamorphopsia from epiretinal membrane formation. Lessons: Valsalva retinopathy can be differentiated from common diabetic or hypertensive retinopathy by its characteristics of multi- layered hemorrhage. Valsalva retinopathy after general anesthesia is a rare disease. General anesthesia can cause Valsalva retinopathy in a few ways: intubation, positioning, iatrogenic Valsalva maneuver intra-operatively, post-operative coughing or vomiting, etc. In addition, permanent visual impairment could sometimes occur.
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