Vitreous hemorrhage and retinal vein rupture

We examined a 23-year-old woman who had a sudden onset of floaters after self-induced emesis.

Examination showed a dense vitreous hemorrhage originating from a rupture site in the wall of the superotemporal branch vein. We postulate a preexisting weakness in the retinal vein wall as a predisposing factor to rupture. This mechanism may explain some cases of vitreous hemorrhage associated with a Valsalva maneuver.