Valsalva-like retinopathy following hyperopic laser in situ keratomileusis

A 50-year-old woman presented with unilateral acute loss of vision 15 hours after undergoing bilateral hyperopic laser in situ keratomileusis (LASIK). She denied "straining." Fluorescein angiography showed no retinal vascular abnormalities but demonstrated blocked fluorescence corresponding with subhyaloid, intraretinal, and subretinal hemorrhages seen clinically in the left eye. YAG laser vitreolysis was performed after noting posterior cortical vitreous thickening with a loculated subhyaloid hemorrhage. Best spectacle-corrected visual acuity was restored to 20/20 by the 2-month follow-up examination. Valsalva-like retinopathy, possibly the result of the rapid rise and fall of intraocular pressure during the microkeratome and suction ring operation, may occur following hyperopic LASIK surgery.