Valsalva maculopathy.

The Valsalva manoeuvre comprises forcible exhalation against the closed glottis, thereby creating a sudden increase in the intrathoracic or intra-abdominal pressure. A simultaneous rapid rise in intraocular venous pressure may result in the spontaneous rupture of perifoveal capillaries, leading to a characteristic clinical picture of a preretinal haemorrhage in an otherwise healthy eye. The haemorrhage typically occurs at the macula and in the vast majority of cases resolves without compromising visual acuity. Valsalva maculopathy is an isolated and self-limited event. A case of Valsalva maculopathy in a young healthy male attributable to an incontrovertible Valsalva stress associated with weightlifting is presented.

Differentiation between retrocorneal pseudoexfoliative material and keratic precipitates.

A 62-year-old female presented with unilateral pseudoexfoliation syndrome. Apart from the classic pseudoexfoliation of the lens capsule, she also manifested conspicuous endothelial deposits of pseudoexfoliation material (PXM). The potential exists to misdiagnose endothelial deposits of PXM as keratic precipitates (KP). This patient was subsequently erroneously diagnosed with Fuchs' heterochromic cyclitis. Close inspection of the endothelial deposits should allow for appropriate differentiation between PXM and KP, particularly when one examines them in the context of the presenting symptoms and other ocular findings. It is incumbent on the practitioner to make the appropriate diagnosis to prevent the patient undergoing unnecessary clinical investigations or therapies.

Benign intracranial hypertension with minocycline therapy.

A 17-year-old Caucasian female patient, who had been prescribed minocycline for acne vulgaris, presented with postural visual obscurations. Ophthalmoscopic examination revealed papilloedema in each eye. Neuro-imaging of the brain and orbits was normal. A diagnosis of minocycline induced benign intracranial hypertension was made. Withdrawal of minocycline led to resolution of her symptoms and the papilloedema.

Degenerative retinoschisis threatening central vision.

A 65-year-old white male patient presented with asymptomatic bilateral degenerative retinoschises. The striking feature of this case was the posterior extent of the retinoschises. In each eye the posterior margin of the retinoschisis lay within 15 degrees of the macula, thereby potentially endangering central vision. The posterior border of a retinoschisis often lies posterior to the equator. However, it seldom reaches the major retinal vascular arcades. It is even rarer for a retinoschisis to approach the macula.