My journey with vision loss began in early childhood, later complicated by a glaucoma diagnosis in my 20s. Over the years my vision declined, necessitating lifestyle adjustments like giving up driving and certain sports. Despite these hurdles, I sustained a 30-year career in health and fitness as a coach, educator, and author, adapting to stay active and engaged. Remaining active is crucial in my life, keeping me physically and mentally healthy amidst an evolving visual landscape.
Navigating vision loss
The progressive nature and diverse symptoms of glaucoma present varying challenges. Alongside my extreme myopia, it began with peripheral vision loss, light and contrast sensitivity, and cloudy, patchy central vision. These symptoms often manifested in disorientation, dizziness, instability, and transient disruptions in spatial awareness. These challenges significantly impact my life, affecting mobility, balance, confidence, and independence. However, staying physically active is an important part of daily life, and specific exercise modifications help me navigate daily living, and have also mitigated some of these challenges.
Unlocking the power of exercise
While there are many ways to exercise, I focus here on three important approaches – cardiovascular, strength, and mobility/flexibility training – all of which have well-documented benefits for general health. For those living with glaucoma, these approaches offer benefits, and when combined with proprioceptive training, they can address some challenges associated with vision loss. Proprioception, our body's ability to sense our position and movement in space, becomes increasingly important when visual cues are compromised.
1. Elevate your heart health – the power of cardiovascular training
Regular cardiovascular exercise, such as brisk walking or cycling, effectively lowers intraocular pressure (IOP), a key factor in glaucoma management. Increased cardiovascular fitness buffers against the challenges of vision loss by improving endurance, stamina, and psychological well-being. This enhanced capacity reduces fatigue, promotes independence, and improves resilience. Cardiovascular exercise also offers numerous health benefits, including a reduced risk of systemic diseases that can exacerbate vision loss, such as diabetes and hypertension, and improved blood flow to the eyes. “As a runner and cyclist myself, I understand and appreciate the ‘de-stress’ effects of exercise,” says Dan Lindfield, Consultant Ophthalmic Surgeon Glaucoma Director at the Royal Surrey County Hospital in Guildford, UK. “Exercise has a positive impact on recovery, leading to improved heart rate variability, blood pressure and, importantly, ocular perfusion.”
Proprioceptive boost: hearth health
Cardiovascular activities can be modified to enhance balance, coordination, and non-visual cues. For example, treadmill walking can be varied by occasionally closing the eyes (while holding the hand rails), to challenge balance and spatial awareness. Outdoor activities like hiking naturally incorporate uneven terrain, demanding adjustments and improving positional sense. Even going barefoot (when possible) increases awareness of foot position and contact, enhancing balance, and stability.
2. Build a foundation – strength training for stability
While high-intensity strength training may cause transient pressure increases, resistance exercises contribute to overall fitness, supporting healthy blood flow. Strength training, particularly focusing on basic movements like squatting, pushing and pulling, helps improve stability in individuals managing vision loss. Exercises that emphasise midline stability, such as loaded carrying, engage core muscles crucial for maintaining posture and balance. Strengthening the hips and legs through movements like lifting and lunging improves lower body strength, vital for balance and mobility.
Proprioceptive boost: strength training
Using kettlebells in your training adds a unique stability challenge. For example, holding a kettlebell in front of you while walking can improve core strength. Performing kettlebell swings significantly improves stability and enhances the body's ability to sense position and movement without relying on visual input.
3. Move with freedom and ease – mobility and flexibility training
Flexibility and mobility exercises, including stretching, promote physical ease and can alleviate tension, potentially optimising circulation around the eyes. Mobility and flexibility training enhance balance and control of movement, crucial for navigation, especially when visual cues are limited. These methods also offer psychological benefits, including improved mood and reduced anxiety. Increased flexibility and mobility allow for more efficient movement patterns, reducing strain and improving physical function.
Proprioceptive boost: mobility and flexibility
Yoga and Pilates, and less well-known movement systems such as the Feldenkrais Method and Animal Flow, are inherently proprioceptive, with a focus on controlled breathing and mindful awareness of body position - further enhancing non-visual feedback and movement efficacy. Professor Lindfield adds, "One of my frustrations is hearing the effects of exercise misquoted. Yes, during certain yoga positions/holds, or immediately after an intense workout session, we may see very transient rises in intra-ocular pressure, but the effects are hugely offset by the long-term benefits in blood flow and optic nerve perfusion."
Finding fitness in your daily life
Integrating exercise and physical activity into your life doesn't require dedicated gym time; these activities can be woven into your daily routine. For example, improve balance by standing on one leg while washing dishes, or enhance stability by walking the dog on uneven ground. Gardening and household chores can also contribute to your activity goals. If you're interested in sports, organizations like British Blind Sport (BBS) and the Royal National Institute of Blind People (RNIB) offer activity finders, adaptive sports information, and inclusive fitness guides.
Nurturing a healthy mind through exercise
Exercise and physical activity not only benefit the body but also play a crucial role in maintaining mental well-being, which is particularly important for individuals with vision loss. Regular physical activity is known to boost mood, reduce anxiety and depression, improve cognitive function, increase confidence and self-esteem, promote social inclusion, and aid in stress management. Engaging in adaptive programs, focusing on balance and coordination, and recognizing the social and emotional benefits of physical activity are unique considerations for visually impaired individuals.
Embracing an active life
Physical activity offers benefits for individuals managing glaucoma, complementing medical treatment by potentially lowering IOP and improving circulation, ensuring oxygen and nutrient delivery to the optic nerve. While exercise cannot reverse existing vision loss, its impact on well-being and quality of life is profound. Regular physical activity, especially when modified to include proprioceptive elements, can enhance balance, coordination, and spatial awareness, directly addressing some challenges associated with glaucoma-related vision loss, such as disorientation and instability. Exercise also improves mood and reduces anxiety, while promoting a greater sense of control.
Considering how physical activity might fit in with glaucoma care from an ophthalmologist's perspective, Lindfield adds", "With a shift from a purely IOP paradigm toward increasing optic nerve support, it makes logical sense to suggest exercise be part of a holistic approach to glaucoma management.” It's important for individuals with glaucoma to consult their ophthalmologist before embarking on any exercise program. By making physical activity a cornerstone of their lifestyle, they can actively contribute to managing their condition and embrace a healthier, more fulfilling life.
