Valsalva retinopathy in a teenager treated with Nd:YAG laser posterior hyaloidotomy

A 14-year-old otherwise healthy male patient presented with acute left loss of vision for 3 hours following weightlifting. Examination showed dense pre-macular sub-hyaloid hemorrhage (A). The patient and his parents did not like to wait for gradual spontaneous resolution of the hemorrhage. Neodymium-doped yttrium aluminum garnet (Nd:YAG) laser posterior hyaloidotomy was performed with quick drainage of blood into the vitreous cavity (B, C, D). He maintained stable vision and retinal exam over 20 months of follow-up. Valsalva retinopathy can affect pediatric as well as adult age groups. Nd:YAG laser posterior hyaloidotomy is minimally invasive and safe procedure that provides rapid visual rehabilitation in cooperative patients.