Minerva

A 20 year old woman presented to eye casualty with a history of three grey patches in her left vision for one week since a visit to a water park where she had ridden on a high water slide. Her visual acuity was normal but examination showed superficial disc and retinal haemorrhages (top). There was no posterior vitreous detachment and all investigations, including fluorescein angiography and a systemic workup, showed no abnormality. Two weeks later the signs had resolved (bottom). The haemorrhages were attributed to the violent water rides and the associated Valsalva manoeuvre, aggravated by spikes of high venous pressure caused by sliding head first down a variable gradient in the prone position. P Puri, specialist registrar, M A Ahad, senior house officer, J F Talbot, consultant, department of ophthalmology, Royal Hallamshire Hospital, Sheffield S10 2J