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Recurrent retinal vein occlusion after playing a wind instrument.
Zaher H Sbeity1, Ahmad M Mansour
1Department of Ophthalmology, Bonn University Eye Hospital, Germany.
Summary
Repeated Valsalva maneuver, like playing a strenuous musical piece, can cause retinal vein occlusion. This condition leads to irreversible vision loss, impacting professional musicians.
Area of Science:
- Ophthalmology
- Cardiology
- Music Performance Science
Background:
- The Valsalva maneuver, involving forced expiration against a closed glottis, is common in activities like playing wind instruments.
- Repetitive strain and intrathoracic pressure changes during such activities may pose risks to ocular vasculature.
Observation:
- A professional trombonist experienced recurrent episodes of vision loss in his right eye.
- These episodes progressed from inferior hemi-central retinal vein occlusion to central retinal vein occlusion within a year.
Findings:
- The patient's visual acuity ultimately decreased to 6/60.
- Intravenous fluorescein angiography and coagulopathy workup were performed.
- No further attacks occurred after the patient ceased professional musical performance.
Implications:
- Playing high-resistance wind instruments can precipitate retinal vein occlusion.
- This complication can result in permanent visual impairment.
- Musicians, particularly those playing strenuous wind instruments, should be aware of potential ocular risks.