Criteria of Macular Bleeding Following the Valsalva Maneuver
• usually affects young adults
• following a sudden increase in intrathoracial pressure
• symptoms sudden red or dark scotoma
• usually unilateral
• slightly decreased visual acuity unless fovea affected
• ophthalmoscopically: small to large preretinal hemorrhage anterior to the fovea
• most cases resolves Spontaneously and completely without sequelae
• if large or persistent YAG laser can be tried to open the posterior hyaloid face in the most dependent part away from the fovea
Procedure
• topical anaesthesia
• Mainster area centralis (Ocular) lens
• Q-switch Nd Yag laser power between (1.9 – 11.5 mj )
• fire at the anterior surface and inferior margin of the hemorrhage away from the fovea
• 2 to 3 openings were made until a rapid stream of blood was seen trapped into the vitreous cavity.
Criteria of Macular Bleeding Following the Valsalva Maneuver
