Valsalva Retinopathy Secondary to Habitual Ear Popping in the Setting of Chronic Bilateral Eustachian Tube Dysfunction

Abstract

Purpose: To describe a case of severe Valsalva retinopathy secondary to habitual ear popping in the setting of chronic Eustachian tube dysfunction. Methods: A retrospective chart and literature review were conducted. Results: A 40-year-old woman with chronic Eustachian tube dysfunction developed sudden loss of vision in the left eye (to 20/400) following habitual ear popping. Examination demonstrated features consistent with Valsalva retinopathy, including vitreous, subhyaloid, sub–internal limiting membrane, and retinal hemorrhages. Following an initial observation period of 6 months, she underwent pars plana vitrectomy, which improved her vision to 20/20. Conclusions: Habitual ear popping can lead to severe Valsalva retinopathy and significant vision loss, particularly in individuals with underlying Eustachian tube dysfunction. Given the prevalence of Eustachian tube dysfunction, clinicians should be aware of the association between habitual ear popping and Valsalva retinopathy to ensure timely diagnosis and management.