Abstract
Background
Emergency physicians frequently evaluate patients with vision changes. The differential
for this chief symptom is broad. We present a unique cause of a fixed scotoma that
started while the patient was running sprints.
Case Report
The patient described a bright central scotoma that later became a dark oblique line
across her central vision. This painless defect moved predictably with eye movements.
Ocular ultrasonography was performed and revealed a well-demarcated hyperechoic lesion
in the posterior segment of the right eye. There was no similar lesion found in her
left eye. In consultation with ophthalmology, the patient's history and examination
were consistent with valsalva retinopathy. To our knowledge, this is only the second
published case of valsalva retinopathy/premacular hemorrhage identified on ocular
ultrasonography in emergency medicine literature. In this article, we further expand
on management and provide correlating fundoscopic images.
Why Should an Emergency Physician Be Aware of This?
Emergency physicians frequently evaluate patients with visual changes. Valsalva retinopathy
is a rare cause of a visual scotoma that can be diagnosed through history and ultrasound.
It often resolves over weeks to months without intervention. However, it does require
urgent ophthalmologic evaluation to rule out peripheral retinal tears, which may require
laser retinopexy or surgical management.
Keywords
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References
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Article info
Publication history
Published online: October 23, 2020
Accepted:
September 12,
2020
Received in revised form:
August 9,
2020
Received:
May 16,
2020
Identification
Copyright
Published by Elsevier Inc.
