Eye pressure, lifting, and Valsalva Eye pressure, lifting, and Valsalva

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Thread: Eye pressure, lifting, and Valsalva

  1. #1
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    Default Eye pressure, lifting, and Valsalva

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    I know this topic has come up before but I have some new experience to share and I知 anxious for more answers. I知 likely soon getting a vitrectomy to remove scar tissue (vitreous) in one eye due to lymphoma (and some minor retinal tears which have been treated). I値l hopefully know more early Jan.

    In the meantime, of the five surgical ophthalmologists I have been treated by, four have said lifting and Valsalva are NOT a problem as it does not increase interocular eye pressure and any blood pressure increase is transient. One said under no condition lift anything heavy, especially performing a Valsalva. Ever.

    I have found one reference that claims Valsalva increases risk of glaucoma (chronic pressure increase) and several that say it decreases the risk.

    My bad eye 吐eels lifting a little, but doesn稚 care about Valsalva or free breathing. I describe it as a tight feeling around that eye.

    My question is, does anyone here know anything about this? The recovery from a vitrectomy ranges from a week or so of rest to keeping your head face down for several weeks. TBD in my case but I really want to weigh risk and reward. I知 very unhappy.

    Thanks!

  2. #2
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    I know that lifting and valsalva have no effect on intraocular pressure, because of the anatomy. Look at it yourself. We'll ask about the rest.

  3. #3
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    Hi Barry, sorry to hear about the eye issues and your upcoming vitrectomy.

    Intraocular pressure is independent of blood pressure, and unlike blood pressure, there is some evidence that intraocular pressure can be influenced by valsalva manuever. However, the studies that I have seen that actually quantify the change generally show that it is a small change in pressure and is very transient, coming back to normal nearly instantaneously after conclusion of Valsalva. It would be very hard to believe that such a small amplitude, short duration increase in IOP would be of any consequence UNLESS you had severe preexisting pathology (i.e., advanced glaucoma). Not an issue in your case from what I can see in your initial post.

    Now, in terms of activity limitations post vitrectomy, a lot of it depends on what your vitreoretinal surgeon will actually need to do during the case, and he may or may not know until he actually gets in your eye during the surgery. You've already summarized a lot of it in your post, but if there is a retinal tear that needs treating or a small detachment develops, then they'll likely need to inject an isoexpansile gas into your eye, which comes with significant limitations on your activity ranging from a few days to several weeks after surgery depending on the location of the tear, type of gas used, etc. No lifting during that period due to the need for constant head positioning (failing to do so could lead to postoperative retinal detachment or failure of the hole/tear to close correctly). If no gas is needed you would likely be good to go back to the gym within a week or so.

    Best of luck to you,
    Mike

  4. #4
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    Quote Originally Posted by EyeMD View Post
    Hi Barry, sorry to hear about the eye issues and your upcoming vitrectomy.

    Intraocular pressure is independent of blood pressure, and unlike blood pressure, there is some evidence that intraocular pressure can be influenced by valsalva manuever. However, the studies that I have seen that actually quantify the change generally show that it is a small change in pressure and is very transient, coming back to normal nearly instantaneously after conclusion of Valsalva. It would be very hard to believe that such a small amplitude, short duration increase in IOP would be of any consequence UNLESS you had severe preexisting pathology (i.e., advanced glaucoma). Not an issue in your case from what I can see in your initial post.

    Now, in terms of activity limitations post vitrectomy, a lot of it depends on what your vitreoretinal surgeon will actually need to do during the case, and he may or may not know until he actually gets in your eye during the surgery. You've already summarized a lot of it in your post, but if there is a retinal tear that needs treating or a small detachment develops, then they'll likely need to inject an isoexpansile gas into your eye, which comes with significant limitations on your activity ranging from a few days to several weeks after surgery depending on the location of the tear, type of gas used, etc. No lifting during that period due to the need for constant head positioning (failing to do so could lead to postoperative retinal detachment or failure of the hole/tear to close correctly). If no gas is needed you would likely be good to go back to the gym within a week or so.

    Best of luck to you,
    Mike
    Thank you immensely! For the sake of preparation (prepare for the worst) how does a patient keep their head in one position for days or weeks shy of an induced coma?

    Thank you!!!

  5. #5
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    That potential recovery sounds like a macular hole surgery recovery... Is that correct?

    My mom had that done 20(?) years ago and it was major suckage for her.

  6. #6
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    Quote Originally Posted by mpalios View Post
    That potential recovery sounds like a macular hole surgery recovery... Is that correct?

    My mom had that done 20(?) years ago and it was major suckage for her.
    Mike EyeMd can answer better, but yes. Could be required for a macular hole repair or retinal reattachment.

    I also think their is a slight chance the vitrectomy can cause one of those. I don稚 know how much more major suckage I can take.

  7. #7
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    Quote Originally Posted by Barry Charles View Post
    Mike EyeMd can answer better, but yes. Could be required for a macular hole repair or retinal reattachment.

    I also think their is a slight chance the vitrectomy can cause one of those. I don稚 know how much more major suckage I can take.
    Positioning is required whenever a gas bubbles are used (you need to insure that the bubble remains in the correct position to support the retina). Its not clear that Barry will need one from his post, but the fact that you've been through five surgical retina specialists makes me think your eye has been through the wringer and I just wanted to lay out a worst case scenario in case one was needed.

    As to your question about how to cope with positioning, there are a few companies that produced chairs that are designed to support your body while positioning face down They can be found on Amazon and from medical supply websites. There are also companies that rent them, but the last time I checked the rental fee is close to what it costs to buy one.

  8. #8
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    Got vitrectomy today. No bubble required!! Tissue off to pathology. I値l update with any information if it could be interesting to others here. Otherwise looking forward to start training again soon!

  9. #9
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    Quote Originally Posted by Barry Charles View Post
    Got vitrectomy today. No bubble required!! Tissue off to pathology. I’ll update with any information if it could be interesting to others here. Otherwise looking forward to start training again soon!
    Great news Barry! Mend well.

  10. #10
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    starting strength coach development program
    I had to stop wearing contacts when lifting because they'd always tear during a heavy squat!

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