John S. King, MD » A Motor Vehicle Accident Causing Valsalva Retinopathy OD While Racing A Side By Side 4 Wheel Off Road Vehicle

  • A Motor Vehicle Accident Causing Valsalva Retinopathy OD, While Racing A Side By Side 4 Wheel Off-Road Vehicle

    Apr 29 2020 by John S. King, MD

    43-year-old white male who was injured while racing a side by side 4-wheel off-road vehicle (see Video: https://imagebank.asrs.org/file/53854/sxs-crash-during-a-race-causing-valsalva-retinopathy-od). He presented about three weeks after the injury. He was being seen by his local eye doctor who wanted an evaluation for the retinal heme and scotoma. His main complaint was a central/parcentral scotoma described as a greyish area in vision. Va 20/50 OD, nomotensive, no APD (by technician), anterior segment u/r; see picture for the fundus exam - of note there are superficial/preretinal heme, with layering of the heme superiorly, and small superficial heme at nasal edge of the optic disc; in the parafoveal region nasally there is some mottling of the RPE that may indicate an area of prior commotio retinae (also possible to have TON), which may account for his scotoma. Really bad accident (video), and amazingly, he had no LOC or injuries other than the right retina. Helmet and racing harness seat belt were used.

    Photographer: Asli Ahmed

    Imaging device: Topcon 50

    Condition/keywords: valsalva retinopathy

  • A Motor Vehicle Accident Causing Valsalva Retinopathy OD, While Racing A Side By Side 4 Wheel Off-Road Vehicle

    May 5 2020 by John S. King, MD

    A 43-year-old white male who was injured while racing his side by side 4 wheel off-road vehicle (this is a video he showed me on his phone). He presented about three weeks after the injury. He was being seen by his local eye doctor who wanted an evaluation for the retinal heme and scotoma. His main complaint was a central/parcentral scotoma described as a greyish area in vision. Va 20/50 OD, nomotensive, no APD (by technician), anterior segment u/r; see {https://imagebank.asrs.org/file/53828/sxs-crash-during-a-race-causing-valsalva-retinopathy-od} for the fundus exam - of note there are superficial/preretinal heme, with layering of the heme superiorly; in the parafoveal region nasally there is some mottling of the RPE that may indicate an area of prior commotio retinae (also possible to have TON), which may account for his scotoma. Really bad accident, and amazingly, he had no LOC or injuries other than the right retina. Helmet and racing harness seat belt were used.

    Condition/keywords: motor vehicle accident, trauma, valsalva retinopathy