Valsalva haemorrhagic retinopathy is an uncommon clinical entity that can severely affect visual acuity. Valsalva haemorrhagic retinopathy is caused by a sudden increase in intrathoracic pressure, which reduces venous return to the heart and increases cephalic venous pressure, and may cause a sudden rise in intraocular venous pressure and spontaneous rupture of the retinal capillaries. This report is of a patient with a large macular pre-retinal haemorrhage that was managed conservatively.