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Medical Forum / General / Vision / June 2005

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When to start working out after strabismus surgery

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johnny_scorpio@hotmail.com - 08 Jun 2005 00:26 GMT
I had strabismus repair surgery about a month ago. I used to work out
at the gym before so when can I go back?

On related topic, does doing heavy exercises affect eyes in any way?
Neil Brooks - 08 Jun 2005 00:36 GMT
>I had strabismus repair surgery about a month ago. I used to work out
>at the gym before so when can I go back?

When the surgeon who performed the surgery gives you the green light.

That's not sarcastic.
johnny_scorpio@hotmail.com - 08 Jun 2005 00:38 GMT
She told me three weeks, is that the usual time frame?
Dr. Leukoma - 08 Jun 2005 02:17 GMT
Well, I was told NOT to exercise following surgery on my forehead.
This is primarily because the forehead is extremely vascular, and a
post-surgical hematoma could have disastrous cosmetic consequences.

On the other hand, I also suffered a severe groin strain that resulted
in quite a bit of bleeding, and probably was accompanied by some
avulsed bone.  The sports medicine doc told me that I couldn't resume
running for six weeks, because that is the time it takes for
cartilagenous structures like bones and tendons to heal.

In your case, muscles and tendons were cut and sewn.  I would think
that three weeks would be the minimum time frame, and perhaps six weeks
would be even better.  In my case, I used the time off to develop an
interest in road biking.  Perhaps you might do the same.

DrG
Dr. Leukoma - 08 Jun 2005 02:23 GMT
Once, after forehead surgery, I was told not to exercise for two weeks.
This seemed like an eternity.  The reason is that the forehead is
highly vascular, and exercise could result in an unsightly hematoma,
which would require that the surgery be repeated.

On another occasion, I suffered a severe groin pull, which damaged some
muscle, and also probably pulled away some bone.  The sports medicine
doc said no running for six weeks, because that is how long it takes
muscles and tendons to heal.  Your surgery likewise involved muscles
and tendons.

However, the silver lining was that during the time I couldn't run, I
developed an interest in something I could do right after my accident
-- road biking.  I know alternate run days with biking days, and I feel
much better for it.

DrG
David Robins, MD - 10 Jun 2005 05:06 GMT
On 6/7/05 4:38 PM, in article
1118187503.031416.96980@g14g2000cwa.googlegroups.com,

> She told me three weeks, is that the usual time frame?

Since the eyes are not involved in the physical work of the workouts, they
have little risk from exercise. Risk of bleeding is essentially gone by 1
week.

I tell my own patients about the same time.


David Robins, MD
Board certified Ophthalmologist
Pediatric and strabismus subspecialty
Member of AAPOS
(American Academy of Pediatric Ophthalmology and Strabismus)
Dr. Leukoma - 10 Jun 2005 12:40 GMT
Hmmm.  Now that comment came as a surprise, doctor.

I recall once a high school athlete who presented in my office with
bilateral subconjunctival hemorrhages, as well as a few scattered
retinal hemorrhages.  The cause?  The patient lost his balance while
doing competitive weight lifting.  One of the principal causes of
subconjunctival hemorrhaging is coughing, sneezing, or other valsalva
maneuver.

DrG
David Robins, MD - 11 Jun 2005 05:11 GMT
Sure, extreme Valsalva can cause subconj hemorrhage. However, at 3 weeks,
the muscles are well attached, and a subconj hemorrhage won't bother
anything. It is direct muscle trauma that can cause a problem, but exercise
won't do that.

By 3 weeks, the vessels are well enough healed that they should not spring a
leak like the capillaries of the conjunctiva or retina did in this case.

BTW, a large subconj hemorrhage even immediately after surgery generally
seems to have little effect on the attachment of the muscles. A case of
extreme vomiting postop, with just that happening to me, caused no adverse
outcome. (n of 1 in that case).

On 6/10/05 4:40 AM, in article
1118403623.392101.240440@g47g2000cwa.googlegroups.com, "Dr. Leukoma"
<drg@leukoma.com> wrote:

> Hmmm.  Now that comment came as a surprise, doctor.
>
[quoted text clipped - 6 lines]
>
> DrG
Dr. Leukoma - 11 Jun 2005 12:32 GMT
OK.  Thanks for that.  So, three weeks, then.  I was just trying to
come up with a rational basis, assuming the worst case scenario.

DrG
 
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