High Altitude Retinopathy in an Emergency Physician Working at Everest Base Camp: A Case Report

Abstract

High altitude travel can lead to high altitude retinopathy (HAR), characterized by retinal vascular dilatation, edema, and hemorrhage, particularly in young, physically active individuals with poor acclimatization. Although it is usually asymptomatic unless it affects the macula of the eye, it sometimes may lead to permanent vision loss. This report discusses a 31-year-old Belgian male at Everest Base Camp who developed scotoma in his right eye at 5300 m. Ophthalmoscopic evaluation revealed cotton wool spots in the eye and a macular bleed in the right eye, raising the suspicion of HAR. There are no signs and symptoms suggesting acute mountain sickness or high altitude cerebral edema. After halting his ascent and descending, the patient’s condition gradually improved, with scotoma persisting for up to 8 wk before fully resolving without surgical intervention. This case highlights the critical need for early recognition and treatment of HAR to prevent permanent visual impairment.