Sudden visual loss associated with sexual activity
T. R. Friberg, R. A. Braunstein and N. M. Bressler
Department of Ophthalmology, University of Pittsburgh, Pa, USA.
OBJECTIVE: To characterize the ocular fundus findings of patients who
suffered sudden visual loss associated with sexual activity. DESIGN: Case
series. SETTING: Outpatient ophthalmic practice. PATIENTS: Six patients
presented with a precipitous decrease in vision in one eye with no apparent
predisposing factors. After obtaining a careful history, each patient
revealed that he or she had been engaging in rigorous sexual activity
immediately before experiencing the visual loss. INTERVENTION: Five of the
six patients were followed up without intervention. One patient required
prophylactic laser photocoagulation of a retinal tear to decrease the risk
of retinal detachment. RESULTS: Six patients aged 24 to 53 years suffered
sudden loss of vision secondary to intraretinal, preretinal, or vitreous
hemorrhaging. Visual acuity in the affected eyes ranged from a mild
decrease (20/40) to profound visual loss (counting fingers at 6 in). Five
of the six patients were followed up for at least 1 month and showed
spontaneous improvement in vision as the blood cleared. Those who returned
for long-term follow-up enjoyed complete visual recovery without any
sequelae. CONCLUSIONS: Sudden debilitating visual loss may occur during
sexual activity from the rupture of retinal blood vessels in the macular
region or from the development of vitreous bleeding from an induced retinal
tear. The long-term prognosis after such hemorrhaging appears to be
excellent, with good visual recovery occurring as the blood resorbs
spontaneously.
