A?25-year-old woman with no clinically significant medical history and with normal coagulation and hematologic studies went bungee jumping from a vertical height of 150 ft (45.7 m). Immediately afterward, she noticed a substantial decrease in vision in her left eye, with a large central scotoma; no
other symptoms were noted and there was no pain.
On examination, the patient’s
right eye was found to have a normal disc and vessels (Panel A, arrowhead) and normal fovea and macula (Panel A, arrow).
Examination of the left eye showed a normal
disc and vessels (Panel B, arrowhead), but the foveal and macular architecture was
obscured by a large macular hemorrhage just below the level of the internal limiting
membrane (Panel B, arrow).
Vision was 20/400 in the left eye when the patient used
peripheral scanning and 20/20 in the right eye.
The patient had a form of Valsalva
retinopathy due to increased venous pressure in the upper body, brought about by sudden deceleration in the head-down position (such as occurs during bungee jumping).
She underwent surgery with evacuation of the blood in the left eye. Visual acuity in
the left eye 1 week later was 20/25 and has remained stable.