With the recent storm in the media about the various “dangers” of yoga to the body, one thing caught my eye more than anything else, retinal tears were mentioned.
This is not the first time I have heard of retinal tears or detached retinas linked to yoga inversions. As I have a personal occurrence of this (twice) I thought my experience would be valuable to teachers and students alike.
What is it?
First a very amateurish explanation of a retinal tear – I am not after all an eye surgeon but having discussed this with three top ones I think I can explain it in laymans terms.
In it’s simplest form the eye is a round ball with jelly (called the vitreous) inside. The retina is a light-sensitive tissue lining the inner surface of the eye. The optics of the eye create an image of the visual world on the retina, which serves much the same function as the film in a camera.
In your sight everything is upside down so the TOP part of the back of eye represents your LOWER field of vision and vice versa. (this is important to understand)
People who are myopic (short sighted) with a HIGH NEGATIVE (-) numbered eyesight prescription have an increasing egg shaped eyeball which is less stable. The jelly can pull away from the sides of the wall (through head traumas, age, or other things) of the inner eyeball and sometimes tear pieces of the retina with it.
Signs of retinal detachment can vary from flashing lights, flickering or a distinctive “shadow” in the eye. It can tear slowly but requires quick action to save loss of vision. With today’s technology it can be fixed (several options depending on severity etc) If it is not rectified loss of sight will occur.
What Happened
My original retinal detachment in my belief was acerbated by a headstand workshop. In any teacher training prolonged inversions are a precaution or even a prohibition for people who have had this condition Having not had a detachment before and not knowing all the above stuff I didn’t think about my risks.
I will point out CLEARLY that I have a HUGE predisposition to this happening, here is why:
- My nearsightedness was over -13 in one eye (VERY shortsighted) giving me an egg shaped eyeball, less stable with loads of room for stuff to bump about in
- I had lens replacement surgery for vision as my eyes eventually rejected contact lenses which I had worn since I was 8 years old. This gives a higher risk for retinal detachment as its invasive.
- I’d had vitreal detachment that didn’t tear the retina years before (where jelly pulls away from the inner eye)
- I also did huge amounts of “headbanging” (eg to rock music) in my 20s and 30s eg shaking the jelly around as well as my booty!
So why do I think the headstand workshop acerbated this if there were so many other factors?
The symptoms were starting on the way home…slowly. It took me a week to see that it was happening and only then because I am very aware. They fixed it with a scleral “buckle” (external band aid if you will).
The tear was against gravity, the shadow in my eye was in the top of the field of vision, meaning the bottom part of my retina had been torn. So the jelly had pulled upwards (when I was upside down) This is my theory.
I have asked 3 top surgeons and they disagree but I just have a strong feeling about it. My strong feeling got me to the hospital quickly before the symptoms were really noticeable.
I had another tear next to the same site recently which required invasive surgery. The explanation was that the original buckle failed or became weak. Since the original tear I do not do prolonged inversions.
So what do I think now?
It would be very short sighted of me to blame headstands or indeed dismiss a possible link altogether. But I have no firm conclusion, just an experience to share.
Who knows, I’m not the only one to link this to prolonged yoga inversions. All I like to do is share the information and I DO think that teachers should be aware that people with very high myopia should be very careful with prolonged inversions.
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Excellent article-you write extremely well”
Thanks for your sharing your personal experience. I’m 29 but had a retinal tear in my right eye when I was about 13 years-old. I have 20/20 vision but see an eye doctor once a year since the tear was found. At last month’s visit, my doctor thought he saw a hole in my left eye (not the one with the tear) and sent me to a retinal specialist. Both doctors said my eyes were fine (it was just a pigment variation) but if I saw an increase in floaters or any flashes to call right away. I had been seeing tiny flashes for about a week (I didn’t follow directions completely) and decided last week to call my regular doctor. I went in and again, everything looked ok but he instructed that I call the specialist again just to see if he too wanted to see me. Today, I went in to see the specialist and he said I was fine but asked if I had been doing any increased activity. I’m a fairly active person but twice a week Vinyasa classes (90 mins each) is new for me. He thinks the inverted poses could be causing the “jelly” to pull on my retina. He instructed me to not even do down dog! Now I’m not even to shoulder standing yet but regardless, removing down dog from my practice seems a bit of a drastic measure. Then again, these are my eyes! My grandfather, a self-taught artist (among many things) had macular degeneration (he couldn’t see the center of his vision) so I don’t want to take this lightly. Do you still do down dog? What modifications have you made to your practice?
Thanks!
Gosh a tear at 13 with no predisposition? Seems strange. I have just returned to practise after last detachment where I had the gas bubble put in the eye to push and seal the retina back, successfully. The jelly is gone from that eye now but of course I always have the other which could pull. ALWAYS go if you see a shadow or flashing or more floaters, I went quickly this is why I have only a tiny blur in my peripheral vision now. You must trust your instinct, the specialist was surprised I even spotted mine but I stay very aware.
I am not able to advise medically but I do not do headstand ever now but I do forward folds which are inversions! I never stay in down dog for more than five breaths at a time. I have relaxed my Ashtanga practise so not as many dogs as less Vinyasas. It is very interesting this specialist is saying this as I do think there is something in it. You could do modified dog by keeping the head more up (looking at ground instead of back towards feet) but watch you don’t strain neck or scrunch your shoulders. Draw the shoulder blades down the back. When I was recuperating after 6 weeks off I did extended Childs pose to get the shoulder stretch. I know it’s incredibly worrying but there are lots of lovely postures that don’t invert fully.
All the very best of luck x
I saw your comment at Jennifer Repo’s blog at Huffington…and now this… Many thanks As more and more “elders” (60+) are taking interest in Yoga it is critical that teacher learn about the “hidden” dangers of people with myopia. (Holding breath, downward facing dog and other inversions, swinging the head in Cat/Cow, etc)
Doctors who are also encouraging us to “be active”, excercise, etc should also be more forthcoming with advice and percautions.
Thanks Myron, only too pleased to share my experience if it helps anyone at all, I was at a conference recently and none of the yoga teachers had heard of this at all but one had had a detached retina herself! Aside from the normal post-op advice she wasn’t given anything further. I’d love to research it further and properly rather than ad hoc anecdotal evidence but currently I do not have the time
I have no postures that I rule out – everyone is an individual, what is important assessing them as such.
I have had quite a lot of anatomy and physiology training aside from just yoga teacher training and my emphasis is always on safety. Having said that I had a wonderful experience recently with helping a young student who was completely ready and prepared to achieve her headstand
I recommend that you read my recent blog post cited below. One study gives pictures of a woman’s eye before she began “postural yoga”, after it, and then a year after she had stopped it. It is quite telling. More will be posted on the effects of several positions.
Having just had a retinal tear myself, making people more aware of the dangers of inversions is quite important. I have very high myopia and am therefore in a higher risk group for tears and detachments and have known this for a long time. But anyone can have these issues according to the ophthalmologists and retinologists (some are family and friends) that I have spoken to and consulted with. I have seen my children’s friends in their 20s suddenly, for no apparent reason, have a retinal detachment.
Inversions of any kind, and there are many in yoga, do pose a special elevated risk. I was fortunately never taught headstand, handstand, and other challenging asanas in India–they were not taught to anyone in a general raja yoga class and especially not to beginners. High impact yoga is relatively new and poses threats to joints and eyes as well. Now they are routine in classes across the US. We were aware of the limitations and contraindications of these positions. So I have never done them or taught them in 30 years of teaching yoga, meditation, and yoga therapy. Now I am not even allowed sun salutations for a couple of months, no bending forward from the waist, no squats, no asanas and no breath retentions. Downward dogs can pose an issue and certainly they cannot be held for more than 10 seconds. Doctors in the family are very knowledgeable about these issues. Consulting a knowledgeable doctor is important as every situation is different.
On my blog, http://www.yogamedblog.wordpress.com, I have just posted “Headstand Inversions And Glaucoma” which cites and links to clinical studies that clearly indicate the potential danger to the eye with sirsasana. I will be posting more on the eye, retinal tears and detachments. Our local yoga centers pay no attention to these issues, do not teach this important information in teacher training programs, and this is a serious issue. Teachers and yoga practitioners in my experience have repeatedly pooh-poohed, ignored, been a little disdainful about the cautions/contraindications of a whole range of asanas and pranayamas when they are clearly pointed out–but people do so at their own peril. Retinologists routinely ask their patients if they have been practicing yoga and inversions because of the number of problems they see resulting from them. Ditto for physical therapists who routinely see patients due to yoga injuries to the back, shoulders, neck, and hip.
Thank you for this information and I am glad to see serious study on the issue. Three top eye surgeons disputed it could have anything to do with my two tears but I still maintain my position about the risks. Thank you again for the information.
Hi, my name is spiros and I am 51 years old. I am myopic since a very young age.
I am also very fit. I was doing handstands for 15 min and when I finished I saw a on the top of my left eye. I immediatelly realised that I had damaged my retina and I self admitted myself to the EYE & EAR HOSPITAL IN MELBOURNE.
I had an operationon 7 September 2012 and now I am fine. I completely agree with you that prolonged inversions might cause these type of problems
Thank you very much Spiros for your information, despite surgeons disputing this when I bring it up I still believe it to be true and just want to warn practitioners and teachers of the risks especially if they are myopic, I do not believe there has been formal study on the linkage. Thanks again and I hope you are to resume and enjoy your practise with adaptations. I am still very careful after a second tear in one eye which required the insert of the gas bubble to rectify (10 days of lying in the same position is not fun but to save your sight it was a miracle), I do know I am very predisposed.
I would like to thank you as well for developing such a site where we can all share our knowledge/experience. Thank you also for your wishes for a quick recovery. In actual fact, I have already recovered mainly because I did not use the 3 different described medical eye drops which are full of serious side effects and they can even cause blidness. You can confirm this by googling side effects of the name of the eye drops.Naturally, I had to prepare my own drops. Your predisposition can be also reversed by some lifestyle changes. If you want to learn more, please feel free to conact me on 0408 532 914, for free. I am a lifestyle coach and I teach people how to live a balanced life free of drugs and other addictions. Take care, Spiros
Note that nearsightedness (myopia) are at a higher risk of retinal tears and detachments due to the possible thinning of the retina.
I am so very pleased to have found this site. I am 49 year young beginner to yoga. I had been going every day for about a month to “hot yoga”, as well as strength training with a personal trainer at the gym. Two weeks ago I had a detached retina. I asked EVERYONE I could if my inversions (downward dog, forward fold, rag doll, etc) had anything to do with my detachment. They all said NO. I have the gas bubble in my eye and is almost gone (now the size of a regular contact, if I look down). I would be SO very disappointed if yoga was the cause of my detachment. I actually thought blowing up many balloons might have been the cause. (I work with kids and use them to entertain them). That might have been a factor. I am so in love with my yoga practice, and love the hot yoga classes. I look forward to everyone’s thoughts regarding this.
Namaste,
Hi Val I am really very sorry to hear this, I know how stressful it can be and the bubble surgery requires longer healing. I cannot categorically say if yoga was the cause – but as I mentioned I quizzed some serious eye surgeons and doctors – they all passed it off – but I have had it twice and one after a headstand workshop – I encountered this more often from talking to people and recently met yet another yogi who got one after an intensive. However Just as I will not say this caused it, I think it is irresponsible for anyone to say it doesn’t.
It’s your sight after all, and we are really lucky these days there are options to save it.
I have gone back to downward dog without holding my head up (I faced the floor so head was level for a while which strained my neck!), I don’t hold forward folds too long nor anything inverted too long – you can still practise – I do every day.
Think about your prior risk factors (if any)
Good Luck
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