RESUMO
A 29-year-old male patient presented to eye emergency clinic after noticing a left paracentral scotoma on waking. On direct questioning the patient revealed an episode of vigorous sexual intercourse the preceding evening. During orgasm the valsalva manoeuvre can produce a sudden increase in retinal venous pressure resulting in vessel rupture and haemorrhagic retinopathy. Valsalva retinopathy is managed conservatively and the patient's symptoms resolved spontaneously without intervention. This case report highlights the importance of focused history taking of patients which can thereby obviate the need for further investigations. This case also emphasises the importance of considering sexual activity as a cause of stress-induced pathology.
Assuntos
Coito , Hemorragia Retiniana/complicações , Escotoma/complicações , Manobra de Valsalva , Adulto , Diagnóstico Diferencial , Humanos , MasculinoRESUMO
UNLABELLED: A nationwide postal survey of all consultant ophthalmologists in the United Kingdom was conducted to determine attitudes and techniques of cataract surgery trainers, identify trainer-related factors that determine surgical opportunity, and ascertain whether trainers had received adequate training in how to teach surgery. The response rate was 43% (410/950). Seventy-nine percent of respondents were men; 46% worked in a university teaching hospital (UTH). University teaching hospital consultants provided more surgical opportunities to their trainees (P<.001). Surgical opportunity was directly correlated with number of vitreoretinal surgeons in the department independent of UTH status (P<.001). Eighty-three percent of trainers had received no formal training in how to teach surgery; only 12% of these expressed a desire to undertake such training. Further research is required to determine optimal methods for delivery of ophthalmic surgical training. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.