What Is Valsalva Retinopathy?

Valsalva retinopathy is bleeding from the small blood vessels usually in or near the macula, which is located at the center of the retina. This is the part of your eye that detects light and colors.

This condition occurs following a sudden and often non-serious rise in venous blood pressure, which is caused by an increase in pressure in the chest or abdominal cavities. It typically affects healthy eyes and usually resolves on its own.

Valsalva Retinopathy Symptoms

In Valsalva retinopathy, the sudden increase in pressure in the chest and abdomen can rupture the small blood vessels in the retina. The bleeding from the rupture of the blood vessels is usually under the macula’s internal limiting membrane.

Bleeding into the vitreous, the gel-like fluid that fills your eye, and under the retina can also occur.

Valsalva retinopathy typically affects only one eye. Symptoms of valsalva retinopathy can include:

• A black spot in front of the eye
• Floaters
• Reddish hue of vision
• Blurry vision
• Loss of vision

People with this condition may have different symptoms depending on the severity and location of the bleeding, but they don’t usually experience pain.

Causes

The Valsalva maneuver is a breathing technique that can be used to unclog ears, restore heart rhythm, or diagnose a problem in the autonomic nervous system, which regulates unconscious bodily functions like breathing heartbeat. It is performed by closing your mouth and pinching your nose while breathing out.

While helpful, this maneuver can increase the pressure in your chest and abdomen and cause Valsalva retinopathy.

Certain daily actions can have a similar effect to the Valsalva maneuver and cause Valsalva retinopathy, including:

• Coughing
• Vomiting
• Violent sneezing
• Lifting, especially while holding your breath
• Straining while having a bowel movement
• End-stage labor
• Blowing into musical instruments

Diagnosis

An eye specialist, such as an optometrist or ophthalmologist, can diagnose a Valsalva retinopathy using a slit lamp, a microscope with a bright light. It helps them evaluate the anterior segment and the fundus of the eye.

The anterior segment of the eye is typically normal, and bleeding in your conjunctiva, a layer of clear tissue that covers the white part of your eye, is rarely seen. Examination of the fundus, the inside, back surface of the eye, typically shows bleeding behind the retina, usually under the macula.

Imaging tests an eye specialist may perform to diagnose Valsalva retinopathy include:

• Optical coherence tomography: Determines the location of the bleeding
• Retinal fluorescein angiography: Rules out other active leakage or abnormal blood vessel growth, which may also be leaking blood

Treatment

Valsalva retinopathy typically resolves on its own without any medical interventions. It usually resolves within weeks to months, depending on how much bleeding is occurring in the eye.

During recovery, people affected by Valsalva retinopathy should avoid strenuous physical activity or using medications that could make the bleeding worse, such as blood thinners.

Prognosis

Prognosis for a person affected with Valsalva retinopathy is good. Typically, complete recovery to baseline visual acuity is expected.

Summary

Valsalva retinopathy is bleeding that results from the rupture of small blood vessels, usually in the macula area. This bleeding can extend to the vitreous or under the retina. It occurs following a sudden increase in the pressure in your stomach or chest after physical exertion that has similar effects to the Valsalva maneuver.

A Word From Verywell

Sudden changes to vision, such as decrease in visual acuity or seeing blurry spots in peripheral vision, should be evaluated quickly by an eye specialist, such as an optometrist or ophthalmologist. The good news is that Valsalva retinopathy typically resolves on its own quickly and your vision will return to normal within weeks or months.