physician University of Pennsylvania Pleasanton, California, United States
Case Diagnosis: Patients with cervical degenerative changes, cervical radiculopathy and h/o diabetic retinopathy and recent cataract surgery. What special precautions should be taken when there are coexisting eye pathology?
Case Description: 62 year old patient came to clinic with acute onset neck pain with right upper extremity radicular pain. He has medical history of diabetes mellitus c/b diabetic retinopathy, hypertension, coronary artery disease, glaucoma and retinal detachment who underwent right eye cataract extraction one week prior. On examination, no sensory motor deficits in extremities noted. He was referred to physical therapy for cervical traction program along with isometric neck and upper back exercises. 2) 59 yr old female patient with cervical spondylosis with recent cataract surgery is requesting to continue his yoga sessions and acupuncture for pain control.
Discussions: Although regular exercises benefit vision health, routines should be modified in the post-operative period for many ocular surgeries. Patients should avoid heavy lifting, straining, bending, or high impact exercise for at least two weeks after routine cataract surgery in order to avoid accidental injury, risk of infection, or risk of increased eye pressure. Other procedures, such as retinal detachment repair, may involve placement of a gas bubble in the eye which requires face down positioning for upwards of a week and any strenuous activity runs the risk of a re-detachment. Even in those who have not undergone surgery, but have other ocular conditions, special exercise considerations may be required. For example, while yoga is a popular and often recommended exercise practice, prolonged head-down positions can raise intraocular pressure and be dangerous in those with severe glaucoma.
Conclusions: We will discuss precautions that should be taken during prescription of therapeutic physical modalities and rehabilitation including complimentary modalities like yoga and acupuncture, when there are coexisting opthalmic-conditions.
