Exercising After Cataract Surgery: Everything You Need to Know (From a Doctor)

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If you’ve had cataract surgery, you may have been told that you need to take a break from exercise afterwards, but why, how long should that break be and does it vary depending on the exercise you want to do?

We wondered too and so we asked Consultant Ophthalmic and Oculoplastic surgeon, Dr Elizabeth Hawkes of The Cadogan Clinic for her advice on exercising after cataract surgery.

Before we get into that though, let’s start with the basics

What is a Cataract?

‘A cataract is the name given to what happens when the lens of your eye becomes cloudy,’ says Ms Hawkes. ‘This most commonly occurs as a result of ageing and as the lens starts to become frosted, like glass, our vision becomes limited. They are also common in people who smoke, individuals with previous eye injuries, or those who have spent significant time in the sun.’ 

What Happens During Cataract Surgery?

‘Cataract surgery involves removing the cloudy lens inside your eye and replacing it with an artificial one made of silicone,’ Ms Hawkes explains.

‘It’s the most common operation performed in the UK and has a high success rate of improving eyesight.

If you’re having cataract surgery you’ll receive local anaesthetic drops to numb the eye, and possibly an oral sedative to help you relax.

The ophthalmic surgeon will then remove the clouded lens with an ultrasound machine, a process called phacoemulsification, and a clear intraocular lens is implanted. It usually takes 4-6 weeks to fully recover from this type of surgery.’

Why Does This Affect Exercise?

After all, your legs are at the opposite end of your body to your eyes!

There’s actually a few different reasons – the most obvious is that exercise that involves any impact like running or aerobics will jolt the body and, while the lens is firmly implanted, you still want to keep it stable while the stitches and tissue around it heal.

The second is that some exercises where you lift things or positions that invert the body, or, holding your breath when you do any other type of move, can increase the pressure behind the eye which could also affect healing.

Lastly, sweat or other substances getting into the eyes when you workout could lead to irritation and infection – and you want to avoid both during your recovery.

So, now you know why you need to take a break from activity after cataract surgery – so, now let’s find out how long it needs to be for.

When Can You do Cardio Exercise After Cataract Surgery?

Not the day after that’s for sure! In fact, the day after you should avoid doing anything active, even just bending forward, to give the eye the optimum chance to heal.

You might also find your eyesight is still a bit blurry the day after surgery and so walking outside, let alone any faster activity, could be riskier than normal so just take the day off doing anything and let your body recover. You’ll then normally go back to your surgeon the next day to check everything is fine.

After this appointment, Ms Hawkes says that light walking should be fine (although always ask your surgeon). ‘And most people will be able to return to cardio exercise within three weeks of surgery.’ That means running, cycling, tennis and golf – while the walking in golf might be gentle, you can put a lot of force into your swing so it’s best to wait three weeks to play golf after cataract surgery.

If that long a break makes you a bit concerned about your fitness level, don’t panic – we spoke to fitness trainer Julia Buckley in another article in this series and she told us a few weeks off isn’t going to make a huge difference to the average exerciser -especially as you can go for gentle walks. If you want to see her advice in full, you’ll find in this piece – just skim all the way down to the end.

What About Swimming After Cataract Surgery?

‘Swimming can be risky following cataract surgery and consequently should be avoided for at least 4 weeks, goggles or no goggles. 

Whilst the incisions are only 2.2mm and are sealed fully by hydration at the end of surgery you must keep the eye dry for 4 weeks after your operation to reduce the risk of infection,’ says Ms Hawkes.

The NHS advice goes even further and suggests you might want to stay out of the water for up to six weeks.

At this point, you might be wondering whether it’s safe to wear swimming goggles after cataract surgery – I know when I had surgery on my retina, I was really nervous about anything pressing around the area for a long time as I was concerned it might cause pressure on my healing eye!

Don’t worry! Once your eye is healed you don’t need to worry, but if you are like me…

Research has shown that wearing goggles can temporarily raise the pressure behind the eyes but this study looked directly at whether the size of googles made a difference as to how much. And found that it did.

It determined that the bigger the goggle the lower the pressure generated – and that goggles with an internal diameter of 52mm or above caused no pressure change at all.

So, if you do feel nervous about pressing around the area, then bigger goggles are the way to go.

How About Yoga?

You might think yoga would be gentle enough to do fairly soon after cataract surgery but in a small study by German researchers looking at the risk of injury in yoga, 12 per cent of injuries involved eyes. Specifically, damage to the veins of the eyes or worsening of existing glaucoma (again due to the rise in pressure inside the eye that damages the optic nerve).

The reason for this is that inverted poses like headstands or shoulder stands – or even less advanced moves like Downward Facing Dog – raise pressure levels in the eye and this might be a risk if you go back to yoga after cataract surgery before you’re ready.

‘There are no specific time-limits for avoiding things that lead to pressure on the eye like yoga inversions, however, I’d suggest that for many people waiting a minimum of two weeks is essential,’ says Ms Hawkes. ‘After that, I would advise checking with your ophthalmic surgeon in order to make sure that the eye has healed well enough for you to put additional pressure on it.’

Weight lifting can also raise pressure and so Ms Hawkes says ‘ Bending, lifting, and picking up weights should also be avoided for at least 2 weeks.’

Contact sports like boxing or rugby should be avoided for at least six weeks.

Outside Exercising After Cataract Surgery

There are a few things that mean that outside activity after cataract surgery might be a bit riskier.

For starters, there might be more exposure to irritants like pollen outside, ‘and it’s important to avoid rubbing your eyes after surgery,’ says Ms Hawkes. She says you also shouldn’t wear make-up, moisturiser or sunscreen as this can result in irritation and introduce harmful bacteria to the area.

What you do need to wear though are sunglasses. Damage by UV light is one of the main contributors to the development of cataracts, but also a condition called age-related macular degeneration and so you should always protect your eyes from sun exposure when you are outside.

‘After cataract surgery, you’ll be given a clear cartella shield to protect the eye that must be worn for the first 2 weeks. You will usually be advised to wear UV-protection sunglasses, even though your intraocular lens has a special UV coating,’ says Ms Hawkes

Also remember that if you normally drive to your outside exercise spots, you shouldn’t drive for at least two weeks after surgery. ‘Exactly how long depends a lot on pre-operative vision and contralateral eye visual acuity,’ says Ms Hawkes.

The Surgical Fitness Boost

All of the above advice can help with a safe, speedy recovery from your cataract surgery – but what you might not realise is that having the surgery could also have a knock-on effect for your fitness.

When researchers in Western Australia looked at how much activity people who had cataracts in both eyes did after their surgery, they found they moved over 50 per cent more after having both eyes treated than they did before surgery when their vision was impaired. Which is a good thing for your health.

It’s easy to see why – when you see more clearly you might be more confident to go out more; to walk on uneven surfaces like country paths, or to start running. Not to mention the effect of better vision on your golf game or tennis skills! Apparently, you’ll be able to see a golf ball in flight much better after your surgery!

It might also be a good idea to encourage your family and friends to move more too. While pretty much everyone develops some level of cataract formation with age, people who exercise regularly have a 10 per cent lower risk of developing cataracts than those who don’t – and every hour of jogging or cycling reduced risk by around 2 per cent found a study published in the International Journal of Ophthalmology.

The theory is that exercise increases levels of antioxidants in the body that neutralise the free radicals associated with the formation of cataracts.

As you may know, a cataract in one eye normally has a friend in the other eye that may need treatment too! The paper didn’t discuss whether exercise can slow down cataract progression – but considering how many health benefits come from exercise, it definitely won’t hurt!

Just make sure you wear your sunglasses!

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