Macular hemorrhage secondary to increased intrathoracic pressure and difficult intubation.

Retinal hemorrhages are relatively common ophthalmologic findings associated with many ocular as well as systemic disease processes. While identifiable ocular or Systemic disease is found in most instances, hemorrhage can also be found in apparently healthy individuals secondary to various forms of physiologic or environmental stress such as that associated with high altitudes, in the newborn, secondary to severe compression injury to the head or body (Purtscher’s Retinopathy). Spontaneous macular hemorrhages may also occur from increased intra-thorac ic or intra-abdom inal pressure, especially against a closed glottis as in severe coughing, retching or vomiting and as in bending or lifting heavy objects. Duane in 1972 described three patients with posterior pole hemorrhages, at least one of whom described bl}ny vision following a difficull intubation 1,2 .( We report a case of macular hemorrhage secondazy to difficult intubation.