Training Ciliary Muscles: Risks and Benefits for High Myopia - Ophthalmology

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Ciliary muscle training and retinal tears?


Hello, doctor.
A while ago, I went to an optical shop to get glasses, and I mentioned to the optometrist that sometimes things appear double.
The optometrist suggested that I could train my ciliary muscles by practicing convergence exercises.
Later, I heard that people with high myopia should avoid straining their eyes to prevent retinal tears.
I would like to ask if training the ciliary muscles is also a form of eye strain.
If so, why is it recommended? Or does this type of exercise indeed carry a risk of causing retinal tears?

Songshu, 20~29 year old female. Ask Date: 2024/04/12

Dr. Gao Pilin reply Ophthalmology


Hello: Ciliary muscle training is generally considered a safe and effective method for improving vision.
It can help relax the ciliary muscle, alleviate eye fatigue, and improve vision issues such as myopia and presbyopia.
However, there is some controversy regarding the suitability of ciliary muscle training for patients with high myopia.
Some ophthalmologists believe that individuals with high myopia have thinner scleral walls, making them more susceptible to retinal tears and detachments.
Therefore, they recommend that high myopia patients avoid activities like ciliary muscle training that may exert strain on the eyes.
Nonetheless, there is currently no conclusive evidence that ciliary muscle training directly causes retinal tears or detachments.

Strabismus training, or "cross-eyed" training, involves exercising the medial rectus muscle and the ciliary muscle, as the eyes converge when focusing on near objects, causing the ciliary muscle to contract and the pupils to constrict.
This method is often used to correct exotropic strabismus in children.
Generally, individuals can use strabismus training to adjust the tension of the ciliary muscle, as working at too close a distance can lead to muscle fatigue, while looking at distant objects can help relax and relieve eye strain.
Those with early presbyopia may try this training, but if it results in eye discomfort or fatigue, it should not be overdone.

Ciliary muscle training is a somewhat controversial vision care method.
For patients with high myopia, careful consideration should be given to whether ciliary muscle training is appropriate.
It is advisable to consult an ophthalmologist who can provide recommendations based on your specific condition.

Reply Date: 2024/04/12

More Info


Training the ciliary muscles, particularly for individuals with high myopia, is a topic that raises important considerations regarding both potential benefits and risks. High myopia, or severe nearsightedness, is a condition where the eyeball is elongated, leading to a higher risk of retinal complications, including retinal tears and detachments.
The ciliary muscles are responsible for adjusting the lens of the eye to focus on objects at varying distances. Exercises that involve focusing on near and far objects, sometimes referred to as "pencil push-ups" or "convergence exercises," are often suggested to strengthen these muscles. The idea is that by improving the function of the ciliary muscles, one might enhance their ability to focus, potentially alleviating symptoms like double vision or eye strain.

However, the concern arises when considering the implications of such exercises for individuals with high myopia. The ciliary muscle exercises do indeed require the eye to exert effort, which can lead to increased intraocular pressure and strain. For someone with high myopia, this strain could theoretically exacerbate existing vulnerabilities in the retina. Studies have shown that individuals with high myopia are at a greater risk for retinal complications, and any activity that increases the risk of retinal stress should be approached with caution.

Moreover, the practice of "cross-eyed" exercises, which involves converging the eyes, can lead to discomfort or fatigue, especially if done excessively. While these exercises may help some individuals improve their focus, they should not be performed without proper guidance, particularly for those with pre-existing eye conditions.

It's essential to consult with an eye care professional, preferably an ophthalmologist, who can assess your specific situation. They can provide personalized advice based on the degree of your myopia, the health of your retina, and any other underlying conditions. They may recommend alternative methods for managing symptoms, such as vision therapy or specific corrective lenses, rather than exercises that could pose a risk.

In summary, while training the ciliary muscles may offer some benefits for focusing and reducing symptoms of eye strain, it is crucial to weigh these benefits against the potential risks, especially for individuals with high myopia. Engaging in such exercises without professional oversight could lead to complications, including retinal issues. Therefore, it is advisable to seek a thorough evaluation from a qualified eye care provider before embarking on any eye exercises.

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