a 57-year healthy avid mountain climber came with 20 days history of sudden onset painless diminution of vision in the left eye . best corrected visual acuity ( bcva ) was 20/20 in the right eye and 20/50 in the left eye . 1 and 2 ] revealed multiple flame shaped superficial hemorrhages located in all the four quadrants up to the mid periphery . in addition , the left eye also had a dark blotchy intra retinal hemorrhage at the fovea measuring approximately 0.5 dd . od color fundus montage at presentation showing multiple superficial hemorrhages os colour fundus montage at presentation showing multiple scattered superficial hemorrhages and a blotchy hemorrhage at fovea the patient underwent a complete hemogram , basic coagulation profile and peripheral blood smear , which revealed no abnormality . he underwent a general physical check up and imaging to rule out cardiac or neurological abnormalities , which turned out to be normal . follow up , a near total resolution of hemorrhages with bcva 20/20 , n6 in both eyes was noted , which confirmed our diagnosis . od colour fundus montage at two weeks follow up showing relative reduction in the hemorrhages os color fundus montage at two weeks follow up showing relative reduction in the hemorrhages od color fundus montage at one month follow up showing near total resolution of hemorrhages os color fundus montage at one month follow up with near total resolution of hemorrhages and a dilated stq vein high - altitude retinal hemorrhages ( harh ) were first described more than four decades ago by singh , et al . autoregulation in response to hypoxia , increase in venous pressure secondary to raised intra cranial pressure and variations in hematocrit levels have been described . hypoxia , due to deficient oxygen at a high altitude , induces various compensatory mechanism in the retinal vasculature , which leads to retinal hemorrhages . choroidal circulation does not exhibit autoregulation ; hence , the occurrence of hemorrhages is more in the superficial retina than at a deeper level . this is a usually a self - limiting condition which does not require any active intervention .
high altitude retinopathy is a condition often seen among mountain climbers or among persons who reach high altitudes rapidly . in this report 
 , we describe a case of a 57 year old healthy gentleman who presented with diminution of vision in both the eyes associated with retinal hemorrhages and the spontaneous resolution of the same .