Ophthalmologist warns of sudden, painless vision loss because of heavy weightlifting, coughing, vomiting, even sneezing

Exercise mistakes: When people push themselves (during heavy lifting, physical exertion) and forget to breathe properly, this pressure causes the tiny retinal capillaries to break, leading to blood inside the eye (Image: Pexels)

Exercise is a key element of being healthy. But misuse or misunderstanding the body can cause injury. One such danger is Valsalva Retinopathy - sudden, painless vision loss because of broken tiny blood vessels in the retina (the light-sensitive tissue lining the back of the eye). The episodes are usually brought on by a quick rise in pressure inside the chest or belly, such as that which causes the Valsalva manoeuvre.

This may happen while you’re doing things that require you to strain or hold your breath, like heavy weightlifting, coughing, vomiting, and even forceful sneezing. And when internal pressure surges suddenly, the fragile blood vessels in the retina can break, causing bleeding in the eye and a blood-clouded or obscured view.

Dr Raman Mehta, Senior Ophthalmologist at IVision Care, Bengaluru, tells Moneycontrol, “Valsalva Retinopathy is rare but not unheard of. It’s something that many young and healthy people feel after intense workouts or exertion. The issue is identifying early signs and having an eye evaluation done as soon as possible to prevent permanent vision loss.”

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What Is Valsalva Retinopathy?

Valsalva can cause retinal hemorrhage following sudden elevation of venous pressure. When people push themselves (during heavy lifting, physical exertion) and forget to breathe properly, this pressure causes the tiny retinal capillaries to break, leading to blood inside the eye (known as the macula responsible for central vision).

Early Signs and Symptoms of Valsalva Retinopathy

The most common initial symptom is the development of sudden, painless vision loss or blurring in one or both eyes. Some experience appearance of dark spots, floaters or a reddish tint to their vision. Unlike other eye conditions, there is generally no pain or redness, so it can be easy to ignore initially.

Causes of Valsalva Retinopathy

In addition to hoisting, this can be the result of coughing spasms, violent vomiting, powerful sneezing or labour while giving birth or playing a wind instrument. You are likely to bleed out of your eye by doing something that makes you tense and have to hold your breath against pressure. Any activity that will essentially make you Valsalva in some fashion while exerting toilet-like pressure can lead to a retinal bleed.

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How to treat Valsalva Retinopathy

• If you experience sudden vision changes after strenuous exercise:
• Cease at once and do not push further.
• If you can, avoid rubbing your eyes or trying to “clear” the vision.
• Get emergency medical help from an eye doctor.

In mild cases, the bleeding resolves on its own after weeks or months. But if the bleeding impairs central vision, a laser or surgery (vitrectomy) might be necessary. The earlier it is detected, the greater the chance of a good recovery and avoiding long term problems.

How to prevent Valsalva Retinopathy

Dr Mehta recommends mindful breathing by weightlifters and athletes: exhaling during lifting, not holding the breath and decreasing strain intensity. Regular eye examinations are also necessary for people who do lots of hard training.

FAqs on Valsalva Retinopathy

What is Valsalva Retinopathy?

Valsalva Retinopathy involves sudden, painless vision loss due to broken tiny blood vessels in the retina, often caused by a quick rise in chest or belly pressure from activities like weightlifting, coughing, vomiting, or sneezing.

What are the early signs and symptoms of Valsalva Retinopathy?

The initial symptoms include sudden, painless vision loss or blurring in one or both eyes. Dark spots, floaters, or a reddish tint to vision may also appear, with no pain or redness, making it easy to overlook.

What causes Valsalva Retinopathy?

It can result from activities causing strain and breath-holding, such as heavy lifting, coughing spasms, violent vomiting, powerful sneezing, labour, or playing wind instruments, leading to retinal bleeding.

How is Valsalva Retinopathy treated?

If sudden vision changes occur after strenuous activity, stop immediately, avoid rubbing your eyes, and seek emergency medical help. Early evaluation by retinal photography is crucial, and treatment may involve laser or surgery if central vision is affected.

How can Valsalva Retinopathy be prevented?

Mindful breathing during exertion, exhaling while lifting, avoiding breath-holding, and reducing strain intensity are recommended. Regular eye examinations are also necessary for those engaging in intense training.

Disclaimer: This article, including health and fitness advice, only provides generic information. Don’t treat it as a substitute for qualified medical opinion. Always consult a specialist for specific health diagnosis.