Does Weight Training Increase Risk of Macular Issues in Myopic Patients?

Q: Does Weight Training Increase Risk of Macular Issues in Myopic Patients?

Hello： 1) Retinal white spots and thinning are common complications of high myopia. <br>Retinal white spots are caused by the atrophy or detachment of retinal pigment epithelial cells and usually do not affect vision. <br>However, if retinal thinning is severe, it may lead to ret

Does strength training cause macular tears?

Hello, Doctor Gao.
I am a patient with high myopia, with both eyes around -1300 diopters.
I have been undergoing fundus examinations every six months at the clinic.
In 2018, the doctor noted white spots and thinning of the retina in my right eye and suggested laser treatment to prevent retinal detachment, but I did not undergo the procedure and continued with regular check-ups.
In February 2023, I was diagnosed with macular abnormalities and was referred to a retinal specialist at a hospital.
At that time, my vision was still 1.0.
I later consulted two other hospitals, where the doctors recommended monitoring the situation.
During the follow-up period, my vision decreased to 0.8 and now stands at 0.5.
During my follow-up on February 27, the doctor indicated that my condition had worsened (macular splitting) and suggested a vitrectomy.
My questions are as follows, thank you for taking the time to respond:
1) Can white spots or thinning of the retina lead to macular issues?
2) For patients with high myopia, can weight training cause problems with the retina or macula? Although all three doctors said it was okay to continue weight training, I have been concerned that my macular issues may be related to it, as I started weight training in November 2022 and was diagnosed with macular abnormalities in February 2023.
3) Can I continue to exercise normally before the surgery? Will it accelerate the deterioration of my condition? I regularly engage in weight training, aerobic dance (90 minutes each session), yoga, running (5-8 km each session), and hiking (with a load of about 3 kg).
4) After exercising, does using a foam roller pose any risk of damaging the retina for patients with high myopia?
5) If my recovery after surgery goes well, how long should I wait before safely resuming the aforementioned activities?

Ms. Chen, 50~59 year old female. Ask Date: 2024/03/04

Dr. Gao Pilin reply Ophthalmology

Hello: 1) Retinal white spots and thinning are common complications of high myopia.
Retinal white spots are caused by the atrophy or detachment of retinal pigment epithelial cells and usually do not affect vision.
However, if retinal thinning is severe, it may lead to retinal tears or detachment, which can subsequently cause macular issues.
2) High myopia itself is a risk factor for retinal problems, but weight training typically does not directly trigger retinal or macular issues.
However, it is important to maintain a reasonable exercise intensity to avoid increasing ocular pressure.
3) Before surgery, you can continue to exercise normally, but it is advisable to avoid high-intensity activities to reduce eye pressure.
Exercise should not accelerate the deterioration of the condition, but it is best to avoid extreme activities, especially weight-bearing and high-intensity exercises, prior to surgery.
4) Generally, using a fascia gun does not cause direct harm to the retina, but be mindful of the force and technique used to avoid applying excessive pressure directly to the eye area.
5) After surgery, you need to follow your doctor's instructions for rest and rehabilitation.
Generally, it is recommended to avoid vigorous exercise or high-intensity weight training for the first six weeks post-surgery.
After six weeks, you can gradually resume exercise, but be cautious to increase the intensity progressively and have regular ophthalmic check-ups.

Reply Date: 2024/03/04

More Info

Weight training and its effects on eye health, particularly in myopic patients, is a topic that requires careful consideration. As a patient with high myopia, you are already at an increased risk for various ocular complications, including retinal issues. Let's address your questions systematically.

1. Do retinal white spots or thinning lead to macular issues?
Yes, retinal white spots and thinning can be indicative of underlying retinal pathology, especially in high myopia. These conditions can increase the risk of retinal tears or detachments, which can subsequently affect the macula. The macula is crucial for central vision, and any compromise in its integrity can lead to significant vision loss. Regular monitoring by an ophthalmologist is essential to catch any changes early.

2. Does weight training pose a risk for retinal or macular issues in high myopia patients?
While weight training itself is not directly linked to the development of retinal or macular issues, it can lead to transient increases in intraocular pressure (IOP) due to the Valsalva maneuver, which is often employed during heavy lifting. This pressure spike could potentially exacerbate existing retinal vulnerabilities, particularly in individuals with high myopia. However, if your ophthalmologist has cleared you for weight training, it may be safe to engage in moderate resistance training, provided you avoid extremely heavy weights and maintain proper breathing techniques to minimize IOP spikes.

3. Can I continue exercising before surgery?
It is generally advisable to maintain a regular exercise routine, as long as it does not involve high-impact activities or heavy lifting that could strain the eyes. Activities like yoga, light aerobic exercises, and moderate weight training can be beneficial. However, if you notice any worsening of your symptoms or vision, it would be prudent to consult your ophthalmologist immediately. They may recommend modifications to your exercise regimen based on your current eye health status.

4. Is using a foam roller or massage gun safe for my eyes?
Using a foam roller or massage gun is unlikely to cause direct harm to the retina. However, caution should be exercised to avoid any sudden movements or excessive pressure that could lead to an increase in IOP. Always ensure that your body mechanics are sound while using such devices, and avoid any movements that could strain your neck or head, as these could indirectly affect your ocular health.

5. When can I resume my regular exercise routine after surgery?
Post-operative recovery varies by individual and the specific procedure performed. Generally, after retinal surgery, patients are advised to avoid strenuous activities for at least 4 to 6 weeks. This includes heavy lifting, high-impact sports, and any activities that could increase IOP. Once cleared by your ophthalmologist, you can gradually reintroduce your exercise routine, starting with low-impact activities and slowly increasing intensity as tolerated.

In conclusion, while weight training and other forms of exercise can be beneficial for overall health, they must be approached with caution in the context of high myopia and existing retinal issues. Always prioritize communication with your healthcare providers, and do not hesitate to seek their guidance regarding any changes in your exercise routine or symptoms. Regular eye examinations and monitoring are crucial in managing your eye health effectively.

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