PURPOSE:

To present a complication of repeated Valsalva maneuver.

METHODS:

Case report with serial intravenous fluorescein angiography and comprehensive workup for coagulopathies.

RESULTS:

After playing strenuous musical pieces, a solo trombonist suffered within 1 year three attacks of visual loss in the right eye; he had two attacks of inferior hemi-central retinal vein occlusion 2 months apart, followed by central retinal vein occlusion 10 months later. Final best spectacle-corrected visual acuity was 6/60. He ended his professional career, and no further attacks occurred in the following 10 years.

CONCLUSION:

Retinal vein occlusion with irreversible visual loss can occur after playing a strenuous piece of music on a high-resistance instrument.