Valsalva retinopathy in a young healthy individual

Abstract

The Valsalva manoeuvre is the forced exhalation against a closed glottis. First described by an Italian anatomist in 17th century Antonio Maria Valsalva, it is now a well known entity amongst medical practitioners. It is not an innocuous manoeuvre as it appears to be. It leads to increased intra thoracic and intra abdominal pressure and raised central venous pressure. There are no valves in the venous system rostral to the heart hence a rise in the reflux venous pressure occurs in the head and neck region of the body. Preretinal haemorrhage caused by this sudden rise in venous pressure was first termed as Valsalva haemorrhagic retinopathy by Duane TD in 1972.1 Valsalva retinopathy is a rather common occurrence but its recurrence is infrequent. A case of recurrent Valsalva retinopathy in a young healthy individual which occurred following a bout of vomiting after a gap of 4 years is described. Valsalva manoeuvre like stress is a part of day to day life. This case is unique because young individuals can generate sufficiently high reflux venous pressure which can lead to rupture of capillaries. It is important to be aware of this condition not only for correct diagnosis and management but also to prevent its recurrence in future.