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Mountain biking after retinal surgery

Dear Dr. Hagan,
About a month ago, at the age of 60, I had a retinal detachment in my left eye, that involved the macula.  The surgeon used both a Scleral Buckle and the insertion of gas (C3F8), which should be there for two months until it is fully gone.  While in there, the surgeon also took out a cataract and put in a new lens.  The whole surgery lasted about 2 ½ hours.  This was my first real surgery ever. The surgeon (just saw him 3 days ago) is quite pleased with how things are going (he has now seen me 1, 7 and 28 days after surgery, with my next visit in 3 weeks). He also said my “good eye” looks great, with no signs of problems there. My question to you is, since i am a very avid mountain biker, will it be safe for me to go back to riding on rocky dirt trails in the mountains (which i used to do about 3 times a week)? I have to admit, as much effort as i put into good technique and safety, about 2-3 times a year i take a good fall (while riding about 6-12 miles an hour), and sometimes i land on a rocky surface. I wear an expensive top of the line full face helmet, goggles or sunglasses and lots of padding in all of the crucial places people tend to land (shoulders, elbows, hips, knees, hands, shins), but still there is a moment of impact. I continued riding within a minute after all of these events, and none of these falls led to more than a purple skin bruise (hip, shoulder, knee etc) that went away in the coming weeks. Still, these are my eyes, and i want to take care of them. If i am in danger of detaching my retina again, i don’t want to do anything that could cause that. Is it ok for me to go back to this sport, or does the potential more impact in falls make it too risky?  Could riding on dirt roads (where I have never fallen) through farm country (instead of on single tracks) be a safe or safer option that you could be comfortable with if you don’t love the single track idea?
Thanks very much in advance,
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233488 tn?1310693103
You do of course need to discuss this with your retinal surgeon.  So I'm going to speak in generalizations. If you were my patient I would recommend you stop mountain biking and all contact sports. The biggest risk factor for a retinal detachment (RD) is a RD in the other eye. So the risk of a RD in you 'good eye'  is probably 5-9%. I have spend many summers in the mountains around Jackson WY and watched many mountain bikers take some terrible wipeouts.  When I was younger I did 100 mile bike rides and competed in triathlons. I stopped riding after taking 2 bad bike accidents while out for street rides. It will be about 6-9 months before you know the visual acuity in the RD eye. Generally if a RD is 'macula off' the eye does not recover normal vision. Cover your good eye and see what life would be like if you had another RD. Ask your surgeon. Depends a lot on what risk you are ready to assume. Lots of people take the risks (base jumping, big mountain climbing, hang gliding, etc)
Helpful - 1
Dear. Dr. Hagen,

I will of course discuss this with my surgeon.  You often say that only the surgeon who looks into your eyes really knows what it is safe for you to do.

You said that it will be 6-9 months before i know the visual acuity in the RD eye, but i must tell you some great news:  Even with 1/2 the gas bubble still there, i can read letters only 2 inches high from 20 yards away in beautiful "living color."  It seems by your mention of 6-9 months, that, G-d willing, my vision should continue to improve.  Would you say that this is a good initial outcome for someone who has both a buckle and a gas balloon, and had RD with macula off?

I also looked at number of medical studies.  It seems they highlight age, diabities, lifting very heavy weights, obesity and other reasons people get RD.  But in terms of biking, the only similar risk they highlight is from injury to the eye (like a finger in the eye in basketball, or a tennis ball in the eye), but not from a general fall on say the hip, knee or elbow, while riding a bike or jogging.  Know that i will be riding with a full face helmet and protective goggles.  Shouldn't that protect me adequately since i can't take a direct hit to the eyes that way?  If you don't think so, could riding on asphalt or smooth dirt bike trails still with goggles and a great helmet, be ok?

Those are all my follow-up questions.  

Thanks and G-d bless you Dr. Hagen,

Seeing as well as you describe is way ahead of the curve,  fantastic.   You missed the important points on risks of RD; most important are  RD in fellow eye, family history of RD, high myopia, previous cataract surgery especially if complications,  weak spots in the retina (extensive lattice degeneration),  MAAJOR trauma to eye.   I have given you my answer, you obviously are not happy with it. I understand. Discuss with your surgeon.  As I said some people understand risky behaviors but do them anyway.
I am not a big risk taker when it comes to health.  I think i may take up swimming.  However, to answer your points re. risk:

There is no RD in the fellow eye (in fact surgeon confirms that in other eye there is no retinal tears, retinal holes, lattice degeneration, retinal detachment or anything else worrying, and he said that "good eye" looks great).  

There is also no family history of RD, no high myopia, no previous cataract surgery, and the only MAJOR trauma to the eye was this eye surgery.

Thanks again Dr. Hagen,

Daniel, I don't want to rain on your parade but when RD in one eye risk is 5-9% the rest of your life even if the other eye looks normal now. Report RD symptoms immediately to your ophthalmologist and have an annual exam. As for swimming I highly recommend it, I swim 3 times/week for an hour for 25 years, no aches/pains and exceptional flexibility.
Thanks again Dr. Hagan for all of your expert advice.

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