Straining, coughing and high myopia

[vieux_rose_marjolaine]

Hello Dear Doctors,

Can straining, such as from constipation, heavy lifting and harsh coughing be caused retinal holes, tears or RD if person has high myopia?

Thank you.

[flossy93]

I don't know about whether the activities you mentioned can cause tearing or detachment in the retina.  

I do know that there is a condition called Valsalva Retinopathy in which bleeding can result from the activities you mentioned in patients who have thinned or delicate retinas (high myopes), or already have CNV or other blood vessel proliferation in the retina (wet AMD), or are on blood thinners.

In Valsalva Retinopathy there is a localized increase in blood pressure in the head caused by the heavy lifting or straining while holding one's breath.  The blood pressure increase in the head can cause delicate blood vessels in the retina to break open, and bleeding can follow.

So, to the extent possible it's a good idea for high myopes to avoid these activities.  I try not to even do prolonged head-down positioning in yoga and do not use gravity boots or an inversion table, all for the same reason - they increase the local blood pressure in the head.

[John C Hagan III, MD, FACS, FAAO]

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