A 28-year-old man with no past ophthalmic history presented with sudden loss of left central vision after dancing vigorously at a night club. On examination, visual acuity in the left eye was 6/60. Fundoscopy revealed a well circumscribed, dense preretinal haemorrhage obscuring his left fovea (Figure A). Optical coherence tomography confirmed the haemorrhage to be located just under the internal limiting membrane (Figure B). Conservative management was applied, and the patient’s vision returned to 6/6 after 3 months.

First described by Duane in 1972,1 Valsalva retinopathy is now a well recognised cause of retinal haemorrhage that typically occurs in association with strenuous activity and the Valsalva reflex.