Retinal Detachment: Concerns and Questions for Patients

Retinal issues?

I am a patient with high myopia, with both eyes having a refractive error of -1200 diopters (female, currently 34 years old).
I had sexual intercourse from September 20 to September 23, and on the evening of September 27, I felt a headache, so I went to sleep.
When I woke up on September 28, I could not see out of my left eye.
The doctor diagnosed me with a retinal detachment due to a tear and I underwent surgery on September 29, which included laser treatment, vitrectomy, air tamponade, and scleral buckle.
Currently, I have been following my doctor's instructions to maintain a prone position in my daily life for almost a month.
During this month, I have had several follow-up appointments, but the doctor has been very busy, and each visit lasts less than two minutes, so I have been unable to clarify some of the doctor's statements or ask my questions.
I would like to seek help from the doctors regarding the following concerns:
1.
Could my sexual activity from September 20 to September 23 have caused the retinal detachment? (I forgot to mention this to my doctor during the visit due to nervousness.)
2.
The doctor mentioned that I should avoid lifting heavy objects, but how should I define what constitutes a heavy object? Am I not allowed to lift heavy objects for the rest of my life?
3.
Once I have fully recovered, will I be able to fly internationally?
4.
The doctor said my retina is thinner than average, so I should avoid vigorous exercise.
However, there are many types of exercise; how can I determine whether the activities I want to do are suitable for me? (I categorize them broadly as swimming, driving back to my hometown in Wuling, which is at a higher altitude, and sexual activity.)
5.
The doctor mentioned that an increase in intraocular pressure could raise the risk of retinal detachment, but I am not sure how to recognize the sensation of elevated eye pressure.
How can I determine if my eye pressure is rising in the future?
6.
Does pregnancy increase the risk of retinal detachment?

Bai Bai, 30~39 year old female. Ask Date: 2018/10/31

Dr. He Jianxian reply Ophthalmology

1.
You should be fine unless you engage in very vigorous activities.

2.
Heavy weights that significantly increase abdominal pressure are typically those over 5 kilograms; this issue is not permanent and can be managed by gradually increasing the weight as long as the retina remains stable.

3.
You can fly on an airplane.

4.
Vigorous exercise usually refers to activities that can cause a noticeable impact on the retina, such as head shaking, diving, long jumping, high jumping, and spinning movements.

5.
What is being referred to is actually a temporary change in intraocular pressure caused by an increase in abdominal pressure, similar to point 2.

6.
Theoretically, straining during labor can lead to an increase in abdominal pressure, so it is possible.

Reply Date: 2018/10/31

More Info

Understanding retinal detachment, especially in the context of high myopia, is crucial for patients who have undergone surgery for this condition. Your concerns are valid, and I will address each of your questions based on medical knowledge and experience.

1. Could sexual activity have caused my retinal detachment?
While it is understandable to wonder if recent activities could have contributed to your retinal detachment, there is no direct evidence linking sexual activity to this condition. Retinal detachment is often associated with high myopia, trauma, or other underlying eye conditions. The stress or strain from physical activities, including sexual intercourse, is unlikely to be a causative factor. It is more probable that the detachment was due to the structural weaknesses in your retina associated with high myopia.

2. What constitutes "heavy lifting"?
After retinal surgery, it is essential to avoid activities that could strain your eyes or increase intraocular pressure. Heavy lifting typically refers to lifting objects that are significantly heavy or awkward, which could strain your body and potentially affect your eyes. As a general guideline, if you can lift an object without straining your back or feeling discomfort, it is likely safe. However, your doctor may provide specific weight limits based on your recovery progress. It’s important to listen to your body and avoid any activities that cause discomfort.

3. Will I be able to fly after full recovery?
Flying is generally safe after retinal surgery, but it is crucial to wait until your doctor gives you the green light. Changes in cabin pressure can affect your eyes, especially if there are any residual issues. Once your retina has healed and your doctor confirms that your eye health is stable, you should be able to travel by air without problems.

4. How do I determine which exercises are safe for me?
Your doctor’s advice to avoid vigorous activities is based on the risk of increasing intraocular pressure or causing strain on the retina. Low-impact exercises such as walking or gentle stretching are usually safe. Swimming can be acceptable, but you should avoid diving or activities that involve rapid changes in pressure. For driving, as long as you feel comfortable and your vision is stable, it should be fine. Always consult your doctor about specific activities you wish to engage in, especially if they involve elevation changes or physical exertion.

5. How can I recognize elevated intraocular pressure?
Many people do not feel symptoms of elevated intraocular pressure until it reaches a critical level, which can lead to acute glaucoma. Common symptoms of high eye pressure may include blurred vision, headache, eye pain, or seeing halos around lights. However, these symptoms can vary widely among individuals. Regular eye check-ups are essential to monitor your intraocular pressure, especially after retinal surgery. If you experience any unusual symptoms, contact your eye care provider promptly.

6. Does pregnancy increase the risk of retinal detachment?
Pregnancy can lead to various physiological changes in a woman’s body, including hormonal fluctuations that may affect the eyes. While there is no definitive evidence that pregnancy increases the risk of retinal detachment, women with high myopia or a history of retinal issues should be monitored closely during pregnancy. It is advisable to discuss your plans for pregnancy with your eye doctor, who can provide personalized recommendations based on your eye health.

In conclusion, while your concerns are understandable, it is essential to maintain open communication with your healthcare provider. If you feel rushed during appointments, consider preparing a list of questions to ensure all your concerns are addressed. Your recovery and long-term eye health are paramount, and understanding your condition will empower you to make informed decisions about your lifestyle and activities post-surgery. Always prioritize follow-up appointments and adhere to your doctor's recommendations for the best outcomes.

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