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Case Reports and Small Case Series
January 1998

Valsalva-Induced Subperiorbital Hemorrhage During Migraine

Arch Ophthalmol. 1998;116(1):117-118. doi:

Common causes of orbital hemorrhage include trauma, surgery, vascular anomalies, tumors, and blood dyscrasias. Subperiorbital (subperiosteal) hemorrhage is less frequent. This entity has been reported rarely in healthy individuals after forceful Valsalva maneuver.1-3 We describe a 37-year-old man who suffered subperiorbital hemorrhage after an episode of migraine-associated emesis.

A 37-year-old white man with a medical history remarkable only for migraine headaches was seen 2 days after a typical migraine episode that included nausea and emesis. Immediately following emesis, the patient noted diplopia, decreased visual acuity of the left eye, pain with eye movement, and fullness about the left orbit.