I believe exercise after sustaining a posterior vitreous detachment (PVD) to be safe. Many doctors recommend a “no exercise” period after a PVD to decrease the risk of retinal tear and retinal detachment. This does not make sense to me.
PVD Causes Retinal Tear
A retinal tear may occur after a posterior vitreous detachment, but in my opinion, the chance of a tear occurring is the same whether or not you exercise.
The vitreous normally separates, or detaches, from the retinal surfaces with age. It happens to everyone as we get older. A PVD will occur earlier in life due to increased nearsightedness, previous eye surgery, certain trauma, etc. After a PVD occurs, there are physical changes within the eye.
The vitreous now occupies less space within the eye. The vitreous does not separate completely from the retinal surface and remains adherent in certain areas. The vitreous moves back and forth with eye movement, yet tethered to the retina in the areas which remain attached. This is where the retina can tear.
Statistically, a retinal tear will occur during the first six weeks of onset of a PVD.
Does Exercise Increase the Chance of Retinal Tear
The concern about exercise is related to increased motion/bouncing of the eye. The thought is that increased movement increases the chance of retinal tear.
This might be a valid concern except for two arguments; 1) each evening during REM sleep (a necessary stage of sleep), the eyes beat back and forth faster than any activity we perform while awake, and 2) after the six week period, there is no known “healing” of the retina.
REM (rapid eye movement) occurs every evening and involves continuous beating of your eye back and forth. While the speed of the eye movements (think of what your eyes do when you reach the end of a sentence) approaches that of reading, the extent to which the eyes move and the duration supersede these reading movements.
Thus, every night your eyes sustain greater forces during REM than while you are awake.
Also, there are no known physical changes to either the retina or vitreous after six weeks. For instance, the retina does not become stronger or thicker after a PVD, hence the chance of tearing should be the same.
Weightlifting is definitely safe.
What Does this Mean?
Remember, this is my opinion. If you were my patient (and I remind you that you are not my patient just by reading this article), I’d advise you exactly as I’ve written here. For the rest of you, I think my arguments allowing exercise are pretty valid and you should discuss with your own doctor.
Lastly, if we are at risk for developing a tear, wouldn’t you want it to occur while we are being vigilant?