Excercise After PVD is Safe

Retinal Detachments and Retinal Tear

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?

Randy

Randall V. Wong, M.D.
Ophthalmologist, Retina Specialist
Fairfax, Virginia
www.TotalRetina.com
www.RetinaEyeDoctor.com

 

 

 

 

Comments

  1. Hani Barakat says:

    Dear Sir.
    I had a retina surgery 4 months ago.This was done because of some halls in the retina.The eye surgeon used sikicon oil and laser in the operation.Can you tell me when the silicon oil should br removed.The doctor says the the retina is good now.
    Best regards.

  2. Miguel Matias says:

    Hello Doc. Randall,

    Excellent info as usual.

    Your point on this makes perfect sense. I believe there are too many “myths” out there regarding health.

    Please keep doing your webinars about all of these subjects, i’m sure they will carry many bits of wisdom and common sense into this “think inside the box” World we live in.

    I greatly enjoyed your vitreous floater webinar, learned a lot, passed the message to many people and will continue to do so.

    Thank you once again for being so generous while expecting nothing in return.

    Miguel Matias

  3. m j thakoor says:

    My left eye R.D surgery two years ago right eye pvd more than two years back vitreous floters seen from same date for last two months in right eye I see transient flashes superioly MY doctor examined me every three months & say peripheral retina is normal so what precautions shoud I take & what are the chances of retinal tear in right eye pleae guide me

  4. Dear Hani,

    Hard to know without examining you, but silicone oil can often stay in the eye for a long time. I usually prefer to remove the oil in my patients after several months.

    Your doctor may feel the same way.

    Randy
    Randall V. Wong, M.D.
    Ophthalmologist, Retina Specialist
    Fairfax, Virginia

    http://www.TotalRetina.com
    http://www.RetinaEyeDoctor.com

  5. Dear M J,

    You are doing everything correctly. Getting examined regularly.

    I am guessing, but I’d say the chance of getting a tear in the right eye is about 10%.

    Randy
    Randall V. Wong, M.D.
    Ophthalmologist, Retina Specialist
    Fairfax, Virginia

    http://www.TotalRetina.com
    http://www.RetinaEyeDoctor.com

  6. Doug Pribble says:

    Dr Wong-
    I had a diagnosed PVD in my left eye in Sept. 2012 – this is after having a retinal tear/detachment in my right eye in July 2012. The RD was repaired with buckle/vitrectomy with no real complications.

    However, my left (PVD) eye continues to experience some flashes, which seem to come in ‘clumps.’ I’ll not notice anything for weeks, then I’ll see 15-20 flashes over the space of a day.

    To the point of your article – I noticed that after an especially vigorous swim workout, I seem to experience an increase in flashes for the rest of the day. Would this be indicitive of those tenacious vitreous fibers pulling on the retina during exercise, then the retina remaining somewhat stimulated for the rest of the day?

    I’m 48 and very nearsighted; my retina doc tells me my vitreous separated earlier (because of nearsightedness) and therefore is still ‘tougher’ and less liquified than most PVD patients’. Would this put me at greater risk for a tear in the PVD eye? If so, what could I do to lessen that risk?

    Thanks for all your great info.

  7. Dear Doug,

    Not really sure. Curious that the flashes are more apparent after a vigorous swim…maybe that’s just the issue, they are more apparent.

    I would say you are at greater risk only because you’ve already had a detachment, not necessarily because you had a PVD “earlier.”

    To me, your PVD is probably age appropriate given the refractive nature of your eye and that fact that the other eye already sustained a PVD.

    I know nothing to lessen the risk except get examined and follow your retina doc’s advice.

    Randy

    Randall V. Wong, M.D.
    Retina Specialist
    Fairfax, Virginia
    http://www.RetinaEyeDoctor.com

  8. Hi,

    I saw my eye doctor yesterday for an annual exam and she indicated that I had a suspicious spot on my retina, possibly a hole or tear. I had noticed a large floater in the past few weeks in the same eye. I am nearsighted, 55 years old and my father had a history of a retinal tear. Does vigorous activity, such as road/mountain biking increase the risk of retinal tear/detachment? Is there a relationship between blood pressure and retinal issues? Should I avoid vigorous activity until after being treated?

    Thanks much.

  9. Gregg,

    I do not believe road/mountain biking or other vigorous activity will cause a retinal tear. Yes, there is a relationship between blood pressure and vascular occlusions or optic nerve swelling, but not with retinal tears.

    I’d recommend staying following your doctors’ advice as they’ve examined you, but you won’t cause a tear by exercising in my opinion.

    Randy
    Randall V. Wong, M.D.
    Retina Specialist
    Fairfax, Virginia
    http://www.RetinaEyeDoctor.com

  10. Dr. Wong,

    I had LASIK surgery in 2007. Now after 6 years I got -1.25 glasses.

    They say my retina is thin. It is not safe to lift heavy weights. Is it SAFE for me to do gym exercises?

    Please help me Sir.

    Thanks a lot.

  11. Prasad,

    Please exercise. It’s good for you and not bad for your eyes. I’ve never seen a patient get a retinal detachment from lifting weights or exercising…thin retina or not.

    Randy

  12. I’m 26 years old with high blood pressure. I like doing the elliptical trainer to bring down my blood pressure. But 2 months ago, I was poked in the eye. Two weeks ago, I started seeing flashes in my peripheral vision in the eye that was poked. An eye doctor examined my eye, said there was no retinal tearing or damage, but didn’t exactly diagnose me with PVD either. She said, “It could be.” But just to be safe, I stopped exercising. Naturally, blood pressure is now up. Wife is unhappy… Am I REALLY being silly for not exercising?

  13. Miles,

    Get back to exercising. Reread the part about REM sleep. You need to exercise. If you develop a problem with the retina, it won’t be because you exercised.

    Randy
    Randall V. Wong, M.D.
    Retina Specialist
    Fairfax, Virginia 22031
    http://www.TotalRetina.com

  14. 1 week ago, I noticed some new “C-shaped” flashes of light in the extreme left portion of the field of vision in my left eye. I then noticed a new, string-like floater in the same eye. This concerned me, my brother had a detached retina when he was about my age, and I have been learning of warning signs of potential detached retina. I had been lifting weights earlier that same day (I’ve been working out for years and I love it).I met with my Ophthalmologist on 7/18/13 who diagnosed my condition as a PVD. The Doctor said I had no evidence of retinal detachment or tear, but that I was a high risk for a retinal detachment over the next 6 weeks. She advised me to
    take it easy” on the weightlifting. I asked her if there were any way to continue lifting weights safely. She advised me to “lay off a couple days, then watch your breathing when you lift (she explained about the internal pressure effect from holding your breath when you lift). Since then I have been thinking about developing a safe way to continue lifting, but I really don’t want to take a risk with my vision (thus I plan to proceed with caution). Thanks for your viewpoints regarding this issue.

  15. Hi,

    I think your information here is great. I especially appreciate the exercise advice as it is confusing. I noted my own challenges about exercise in a blog post.

    posteriorvitreousdetachment.tumblr.com

    Thanks again

  16. George,

    Best of luck. Practical information is best! Thanks for your input.

    Randy
    Randall V. Wong, M.D.
    Retina Specialist
    Fairfax, VA 22030

    http://www.TotalRetina.com

  17. Patrick,

    Sorry for the long delay. I thought I answered you already.

    Anyway, I would say that following a PVD, you are higher risk, but not high risk as most people do not get a retinal detachment following a PVD.

    Weightlifting, in my opinion, does not affect your chances of a retinal tear, monitoring your breathing or not monitoring your breathing.

    Go lift!

    Randy
    Randall V. Wong, M.D.
    Retina Specialist
    Fairfax, VA 22030

    http://www.TotalRetina.com

  18. Thank you so much for this article!

    I was diagnosed with PVD in my right eye two months ago. Both my doctors told me that I was basically limitless in what I could do, with regards to my PVD. Coming across this article just reaffirms what they have told me and has made me more confident in what I can do.

    Cheers

    Sean.

  19. Sean,

    Glad you found some agreement!

    Move forward!

    Randy
    Randall V. Wong, M.D.
    Retina Specialist
    Fairfax, VA 22030

    http://www.TotalRetina.com

  20. Thank you Doctor Randall,

    Its quite nice to see you debunking another myth and then helping to remove another excuse in the name of fear for not to exercise and to lead a sedentary lifestyle ,, No wonder people become chronically ill as I have to search for this website to get a proper sensible explanation to the reason behind the retina detachment. thank you Doctor.

    In 2006 I was diagnosed with CSR and they treated with laser after condcuting an angiogram in my eyes to detect the ruptured cells. Later several occasions i had these type of attacks and i resorted to natural healing changing my life style. At present my line of vision is blurred almost 70% in my left eye. Can u please suggest a long term remedy for this..

    with lot of regards
    Hafiz

  21. Hello,

    I was assessed yesterday with a retinal tear with laser treatment scheduled for next week. The ophthalmologist said it seems to be stable and looked as though it wasn’t recent. He didn’t give a time frame, and didn’t see any urgency for immediate treatment. It was a very busy clinic. I’ve been training hard for a marathon over the past 15 weeks and noticed flashing black dots (along with the usual floaters which I’ve had for as long as I can remember. I’m 58) during a long run. These seemed different to me, so had them assessed. Also, I had/have flashes of white light to the upper left of my left eye. The marathon takes place in just over 3 weeks, which would be 15 days after the laser treatment.
    Do you advocate that I continue exercising, even intensely, before the laser treatment as well as after the treatment and then run the marathon?

    Thanks for your insights (pardon the pun)

    Michael

  22. How about inversions? Hand stand push ups or simply staying inverted for a minute? Would you not recommend these kind of activities to extremely severe myopic people? (my left eye is -16 and was told has PVD on that eye) I asked my doctor regarding this but only got a vague answer. Thank you Dr. Wong!

  23. Hafiz,

    I really can’t recommend anything without examining you. It’s really tough, but I’d only be guessing.

    Sorry.

    Randy

    Randall V. Wong, M.D.
    Retina Specialist
    Northern Virginia
    Fairfax, VA. 22030

    http://www.vitrectomyforfloaters.com

  24. Michael,

    If you were my patient, I’d advise you run the race. I’m a big believer that most tears occur during REM sleep, not while awake. Also, I’ve had very, very few patients (fewer than 5?) over 23 years of practice sustain retinal tears from boxing/martial arts.

    Just my thoughts. Good luck.

    Randy

    Randall V. Wong, M.D.
    Retina Specialist
    Northern Virginia
    Fairfax, VA. 22030

    http://www.vitrectomyforfloaters.com

  25. Ann,

    If you can, and want, to do hand stand push ups or remain inverted….go for it! It doesn’t matter if you are highly myopic.

    Have fun!

    Randy

    Randall V. Wong, M.D.
    Retina Specialist
    Northern Virginia
    Fairfax, VA. 22030

    http://www.vitrectomyforfloaters.com

  26. Chen Hau Hau says:

    Hi, Dr. Wong,

    I experienced my first retinal detachment (RD) about two years ago which is caused by rubbing my right eye too rigorously. During the incident, I dislocated my IOL (from a cataract surgery) and tore my retina at the same time. I am in my early 40s. I had a cataract surgery on the same eye about 10 years ago. I believe this cataract is caused by a trauma to the head due to sport injury.

    My surgeon fixed the RD successfully with a buckle but decided to wait to get the dislocated lens fixed. I finally got the IOL repositioned about 8 weeks ago. Two weeks after the surgery, I had another RD in the same eye. This was fixed with a vitrectomy. This is also a successful surgery.

    With a history of two RD’s, I am really paranoid of doing any sport. Prior to my second RD, I used to be really active. I do weight lifting, running, and high intensity cardio exercise. If you’re familiar with programs like P90x and insanity, that’s what my routine looks like.

    With two RD’s under my belt, should I switch to a lower impact exercise such as swimming and cycling? What is your opinion on the effect of body resistance type of exercise (pushups, pullups, plyometrics) to the risk of having an RD?

    Many thanks for your input in advance. As you can see, I found your website because I’ve been searching high and low for the answers to this question.

    Hau

  27. Hi dr wong, thank you so much for this info. i’ve had a laser retinopexy done for a small retinal tear in the superior temporal side of my retina. Now i’m 5 days post laser. Would you reccomend that I continue my intense weight lifting? I work as a fitness model and the gym is basically my source of income. Thank you so much fr your rely.

    Also? Does exercising imcrease the intr occular pressure and is tht why doctrs don’t reccomend exercsisng post laser?

  28. Aj,

    I personally feel that non-contact physical activity, such as weight lifting, has no effect whatsoever in causing a retinal tear. The eye pressure high or low, would not cause a retina tear.

    I have no idea why a doctor would recommend against exercise after laser.

    Makes no sense to me.

    Randy

  29. Hau,

    I personally don’t view non-contact exercise as any riskier than sleeping with regard to retinal detachment and retinal tear formation. During REM sleep, your eyes beat back forth faster and harder than P90…..What do you think?

    Randy

  30. Chen Hau Hau says:

    Hi, Dr Wong,

    It makes sense. I have never read any articles on the web that say weight lifting causes retinal detachment as well. Although some people say that holding your breath while doing it has the risk of detaching the retina. Again, I have never found any studies done on this subject anywhere.

    Many thanks for your response. By the way, I just found this article from Cornell University related to the potential benefit of drinking coffee (since it contains chlorogenic acid) to preventing retinal degeneration. I think they just published it last week. You might already know this.

    http://news.cornell.edu/stories/2014/04/cup-coffee-day-may-keep-retinal-damage-away

    Thanks,
    Hau

  31. Chen,

    I don’t believe the item about holding your breath.

    Coffee – always beware of news releases not based upon good evidence based medicine.

    Could be true, but we really don’t know.

    r

  32. Hello, dr. Wong.

    I just got retinal detachment 3 months ago, and now still have the silicon oil in my eye, to be scheduled for evacuate in next 2 months. What I want to know is, how to prevent this to happen again in the future (for PVD patient and those who never got PVD)? I heard that miopia increases the chance to have PVD, since the retina is thinner. But that’s not something we can avoid of. :D

    Thanks, doc, I found this article when I Google “gym and retina tear”. :)

  33. Aaron,

    Thanks for the keyword tip (gym and retina tear).

    Myopia does increase the chance of having a PVD earlier in life. Everyone gets a PVD at some point. Myopia increases the chance of PVD because the eye is slightly larger, therefore the volume of the eye is greater.

    The only thing you can do is to get examined if you ever notice a sudden increase in floaters or you start to lose your peripheral vision.

    Randy

  34. I think I will be seeing you in 6 weeks. Today I was diagnosed with Posterior Vitreous Detachment by Dr. Dressler. I am 53 years old and usually go to 5 pretty intense step classes a week that do involve some jumping moves, plus weightlifting classes and some Pilates. I would like to continue this activity because I am afraid that if I stop doing this for 6 weeks I will have difficulty getting back in shape. However, if the activity is unsafe I will obviously not do it. Do you have a recommendation? Thank you so much.

  35. Robin,

    In my opinion, you should continue exercising. The physical activity you describe comes nowhere near the forces generated in the eye during REM sleep.

    If you ask me, keep exercising.

    Look forward to meeting you.

    r

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