Updated by Mike Rosco, MD on 3/23/23 at 1:03 PM
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 gel inside your eye 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, and so on.
After a PVD occurs, there are physical changes within the eye. The vitreous now occupies less space. Though it’s “detached,” it doesn’t separate completely from the retinal surface. As the eye moves back and forth, the vitreous remains tethered in certain areas. It’s in these areas where the retina can potentially 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 a 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, evidence shows that the retina hasn’t “healed” in any significant way.
During REM, the speed of the eye movements (think of what your eyes do when you reach the end of a sentence) approaches that of reading, however the extent to which the eyes move is more extreme than these reading movements. And it occurs for hours during a normal sleep.
Thus, every night your eyes sustain greater forces during REM than while you are awake.
As mentioned, 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 it does not make you my patient by merely reading this article), I’d advise you exactly as I’ve written here. I think my arguments allowing exercise are evidence-based and worthy of discussion with your own doctor.
Lastly, if you are at risk for developing a tear, wouldn’t you want it to occur during the time we are being extra vigilant?