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Ametropia is one of the leading causes of visual impairment. This study describes epidemiological and clinical aspects of ametropia as part of a free medical care program in Kinkala, Republic of Congo. Patients and Methods: We conducted a cross-sectional study from August 25th to September 24th, 2019; patients presenting complaints suggestive of ametropia were evaluated. The ametropia was determined by the objective method under cyclopentolate eye drops according to the following protocol: 3 applications of one drop every 5 minutes, followed by auto-refractometry at least 45 minutes after the first instillation. The auto-refractometer gave us the objective refraction. An anatomical examination was performed in order to eliminate any organic pathology. Results: Of the 2352 patients received, only 137 patients were included in our survey. Of the 137, 14 were emmetropic. Astigmatism was the most common ametropia. Its axis reversed with age, with more than 65% of direct astigmatism before age 40. There was nearly 65% of reversed astigmatism at 60 years and over. In spherical equivalents, hyperopia accounted for more than 80% of ametropia. Conclusion: Ametropia in Kinkala is dominated by astigmatism. Spherical equivalent, hyperopia represents more than 80% of refractive error.

Valsalva retinopathy is caused by a sudden increase in intra-thoracic or abdominal pressure, following forced expiration, with mouth and nose closed (Valsalva maneuver). We report a case of Valsalva retinopathy in a pregnant woman. A 36 years old patient, pregnant at 24 weeks of amenorrhea, who consulted for sudden visual acuity decrease of the left eye, evolving since 24 hours after Valsalva maneuvers to calm down her panic and control her breathing. The refraction has demonstrated a decrease of visual acuity in the left eye to "can see a hand moving", while the visual acuity remained normal in the right eye. Spontaneous evolution was marked by a fast and progressive reduction of hemorrhage and progressive recovery of vision in the left eye. Valsava retinopathy was first described in 1972 by Thomas Duane. Physical activity is usually found before it occurs. Many situations are usually associated to this occurrence among which: pregnancy, vomiting, weightlifting or trauma. Regression of this hemorrhage without sequelae is usual. But sometimes, we need a Nd:Yag laser treatment or surgery to evacuate the blood.

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