Those of you who have done some reading on what causes eye floaters would have gotten familiar with terms like posterior vitreous detachment and retinal detachment. But are you aware that some activities performed under certain conditions may also cause floaters to appear? What do these activities – weight lifting, blowing musical instruments, aerobic exercise, bungee jumping, end-stage labor, coughing, vomiting, and sexual activity have in common that could cause a sudden appearance of eye floaters?

At first glance, the idea that these activities could in any way cause eye floaters seems remote. However, studies revealed that there is a possible correlation between these activities, and the sudden appearance of floaters. In many of these activities, the person involved performs what is called the Valsalva Maneuver. This is the act of holding the breath and attempting to blow out with the nose and mouth closed. In some cases, such as weight lifting, this is done consciously, while in others, such as constipation, it is done sub-consciously. This is also the same act that is performed when attempting to ‘de-pressurize’ the ears during air travel.

WHAT IS VALSALVA RETINOPATHY?

During the Valsalva Maneuver, the body experiences a rapid increase in blood pressure. This in turn causes a rise in the intraocular venous pressure, which may cause a sudden rupture to some of the retinal capillaries. This is referred to as a pre-retinal hemorrhage, and it is a condition known as Valsalva Retinopathy. The bleeding appears to the patient in the form of floaters.

RISK FACTORS

Persons engaging in the Valsalva Maneuver are more likely to suffer from Valsalva Retinopathy if they suffer from one or more of the following conditions[1,2];

  • retinal vein occlusion (an obstruction in the veins carrying blood away from the retina)
  • idiopathic thrombocytopenic purpura (a condition that results from a low platelet count)
  • anemia (a condition that results from a low concentration of red blood cells)
  • sickle cell disease
  • hypertension
  • diabetes

ACTIVITIES THAT MAY LEAD TO VALSALVA RETINOPATHY

Generally any activities involving the Valsalva Maneuver can lead to Valsalva Retinopathy. Such activities include[3] weight lifting, aerobic exercise, blowing musical instruments, bungee jumping, constipation, end-stage labor, forceful coughing, vomiting and sexual activity.

TREATMENT OPTIONS

If your doctor confirms that your floaters are caused by Valsalva Retinopathy, then the good news is that they usually disappear by themselves and do not require any treatment. Doctors would generally advise such patients to refrain from strenuous physical activities until the retina has fully recovered.

If, on the other hand, your doctor confirms your floaters are not a result of any serious eye disorders, then don’t despair. There are solutions out there – both surgical and non-surgical.

References

1. Mansour AM, Salti HI, Han DP, et al. Ocular findings in aplastic anemia. Ophthalmologica. 2000;214(6):399-402.

2. Karagiannis D, Gregor Z. Valsalva retinopathy associated with idiopathic thrombocytopenic purpura and positive antiphospholipid antibodies.

3. Robert S Duszak, OD, FAAO Attending, Philadelphia Veterans Affairs Medical Center; Consulting Staff, Nemours Health Clinic, Mayfair Eye Associates; Adjunct Clinical Faculty, Eye Institute of the Pennsylvania College of Optometry