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Dr. Dan B.
Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3141
Experience:  Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
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About five days ago I had laser surgery for three tears in

Customer Question

About five days ago I had laser surgery for three tears in my left-eye retina. I had noticed lots of floaters all of a sudden one morning, and (stupidly) waited two weeks before seeing the eye doctor. Two of the tears were fairly small, but the third one was larger and some fluid had started to leak in, as a prelude to detachment. The surgery was relatively painless on the first two tears, but quite painful for the larger tear.
I am very active in karate, and very nearsighted. In the doctor's opinion, the karate (even though I did have a large blow to the eye about 6 weeks ago) probably did not cause the tear, but rather just my nearsightedness and age (I am 44).
After the surgery, the doctor said no karate (or other similar exercise) for a week. I had a followup checkup and the doctor said the eye was healing normally. I could return to karate in the next few days, but I am quite nervous.
Do you think vigorous exercise is okay - karate entails lots of jumping around and rolls and whatnot, along with the occasional sparring. I am afraid of more tears, but don't want to give up karate. Also is one week really enough time for the eye to recover from the surgery? I have a followup in 6 months, but what if I have a problem well before that?
Since my floaters haven't gone away following the surgery (as the doctor said they wouldn't), how would I know if I have another tear. I already have so many floaters, that how would I recognize any new injury?
I'm really worried about the future of my eye(s) but if vigorous exercise is ok, would loathe to give that up, as it benefits me in an enormous numbers of ways (fitness, social, anger management, activity with my children, you name it...)
Submitted: 1 year ago.
Category: Eye
Expert:  Dr. Dan B. replied 1 year ago.

Doctor DanB : Hello and thanks for your question. Are you available to chat ?
Customer:

Hi Dr, yes I can chat for about 20 min

Doctor DanB : I tend to be a conservative ophthalmologist. I would probably have you avoid strenuous activities like karate for 3 to 4 weeks rather than just one, but I'm also not treating physician. Your ophthalmologist certainly knows more about your particular case then I do. Also you could know worsening eye condition or injury Buy a sudden worsening in your floaters or developing anyone suddenly, a significant change or increase in and out of flashing light so you see, new curtains veils or shadows that come over here vision that you cannot see light through, or Sutton and significant worsening of your vision. For these reasons you should seek help immediately, but if your doctor has pronounced your Tara stable, then I would take part in that statement.
Customer:

what do you mean by "Tara stable"? I guess the problem I have understanding is, if the laser surgery takes 5 days to set the scars properly, than what do you gain by waiting additional weeks before resuming activity?

Customer:

What happens in between the first week and the third or fourth week of waiting to resume?

Doctor DanB : Sorry. My phone's auto correct got the best of me, those words should say if your tears are stable... In my opinion, I don't think everyone forms scars and has exactly the same healing process as everyone else. For that reason I hesitate to put a 5 day count on exactly when you would be able to resume strenuous activities on the basis of theoretical scar formation. Ultimately, in the end...
Doctor DanB : your ophthalmologist knows your case better than I do and so if they've said they think you'd be safe to return to karate after 5 days, they must have a good reason for saying so, but if you were my patient and I knew as much about you as I do (which isn't nearly as much as your doctor knows about you) I would want you waiting at least two weeks
Doctor DanB : While scarring may happen earlier than 2-4 weeks, it is the settling down of tractional and dynamic shifting of the vitreous jelly that I would want to have settle down a bit before I would feel comfortable releasing you to strenuous activity and that can take a few weeks after the initial episodes (tears /floaters).
Doctor DanB : Does this make sense?
Customer:

One thing I am worried about is, how to tell if I have a re-injury once I resume exercise. I was alerted to this problem by the floating specs/cobwebs/"hair strands" in my eye. This was a big contrast to the clear vision of before. Initially I put it down to ocular migraines or something that would go away. Since the last surgery last week, I still pretty much have all these floating specs still (my doctor said that was normal). I'm concerned that if I reinjure my eye, causing more floating specs or strands, I wouldn't be able to notice because of the other junk already there. I am nervous about waiting six months to a checkup after resuming karate, but yet hate to give up exercising. In an ideal world, I would have my retina checked every few days but of course that's impossible in a practical sense. Do you think someone engaged in heavy exercise, who has had retinal-tear surgery, should be checked more often? Or is it up to me, to somehow notice any increase in floaters. By the way, I never did have any flashing-light symptoms.

Customer:

Yes, you make sense. After this period of rest/recovery, would I be able to go back to my normal exercise level, or I am now more sensitive to tearing and need to somehow find a way to be very cautious, if that's possible? I guess I am not sure, that if the laser surgery is successful, will I able to be able to go back to my former level of exercise and jumping around. I am nervous about it. My doctor seems to think I should be ok, but I wanted to hear another opinion - have you had patients who have reinjured themselves after retinal-tear surgery, by too much strain/exercise?

Customer:

I have even considered quitting karate, but for me that's a drastic step and I wouldn't want to do it, unless I was at significantly-increased risk for further retinal-injury trouble. By the way, this is the first such problem (with my eyes) that I have had. Except for my ever-present nearsightedness (I am -7 in that eye, and -6.5 in the other).

Doctor DanB : So I understand your anxiety about this. Another good reason for waiting to three weeks to resume vigorous exercise is that gives more time for the floaters you have now to dissipate and resolve and therefore if you do happen to have a sudden onset of new floaters or the floaters increase suddenly that will be easier to detect. Flashing lights are also another sign that you may have injured or have worsening of your condition. Flashing lights are usually quick and electrical in quality, Manifesting as a quick and small starburst of light or an arc of light. Both a sudden increase or sudden change in the amount of floaters, these flashing lights, and/or the onset of a curtain, veil, or shadow that comes over your vision that you cannot see through are all signs of reinjury or worsening of your condition, as is sudden and distinct worsening of the vision. These are the ways in which you would be able to detect worsening of your condition or injury to the retina. Most patients who give a certain amount of time after a procedure such as this do not have a reinjury because of the vigorous exercise. Once in a blue moon somebody has a reinjury or a worsening of their condition because that is what fate has handed to them. But I think your chances of having a reinjury or worsening of the condition are much less if you give it two-four weeks of rest first.
Doctor DanB : I think it is much more likely that your myopia has put you at risk for these tears then just the karate by itself. Ultimately as long as there's good scar formation around the tears and your symptoms are improving I think you should be able to return to your previous level of exercise intensity and will very likely not have significant problems from these by returning to do such activities. But you always have to be more cognizant and aware of these symptoms should get regular examinations at least yearly from now on.
Doctor DanB : Do you have any other questions about this?
Customer:

I think you have answered my concerns. Thank you.

Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3141
Experience: Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
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