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Practicing Yoga Despite Glaucoma

A key principle of yoga emphasizes that one’s yoga practice is very personal and should be tailored to meet individual needs.  This notion serves the glaucoma patient well, as some yoga poses are not safe for them.  Of particular concern are postures that can increase intra-ocular pressure (IOP).  IOP is the pressure of the aqueous humor (fluid) inside the eye. Nevertheless, by adhering to a few simple guidelines, most people with controlled glaucoma can continue to practice yoga safely.

The underlying rule for yoga practitioners with glaucoma is this: Do not assume positions that elevate pressure in the veins of the neck, as increased venous pressure can increase IOP.  The risky positions are primarily the inverted poses.  Inversions are sometimes further classified as mild or full.  Mild inversions elevate the heart above the head, and full inversions in addition elevate the feet above the heart.

It is usually acceptable for a glaucoma patient to assume mild inverted positions such as the Downward Facing Dog and Forward Fold poses as long as they are part of a flow and are not held for extended periods of time. Assume that extended as used here translates to roughly longer than a minute. If practicing yoga in a class setting when mild inversions are maintained for longer periods of time, you can always substitute a modified pose or retreat to one after about a minute.  Continuing to breathe in these poses is particularly important to help keep venous pressure at normal levels. Here are a few examples of safe modifications for mildly inverted poses.

 

MILD INVERSIONS   

ACCEPTABLE MODIFICATIONS

Downward facing dog   

   

Dolphin pose

 

Forward fold

 

Bridge pose

 

Wheel pose

   

(same modification as for bridge)

Fish pose

 

Head stand, shoulder stand, and plow are examples of full inversions, and these should be avoided completely by glaucoma patients.  If practicing yoga in a class setting when full inversions are being practiced, one safe alternative is a legs up pose, as illustrated here.

FULL INVERSIONS   

ACCEPTABLE MODIFICATIONS


Plow pose
 

 

A good yoga instructor can suggest other alternatives once educated about your specific needs, and you may also devise your own variations. Some find it helpful to use aids, such as blocks, to modify poses, as illustrated below for a safer version of wide forward fold pose.

   

This discussion should convince you that safe adaptations of standard poses are not rigidly defined.  The main idea is to keep venous pressure at normal levels by keeping your heart and lower extremities below your head, with the exception of allowing mild inversions for short periods of time.  


Individuals who have undergone trabecuelectomy or other glaucoma surgery should not attempt even mild inversions until their doctors have cleared them for these activities, approximately 12 to 16 weeks post surgery. Consult with your glaucoma specialist to determine how this rule about dealing with inversions applies to you.
    

Prepared by Deborah D. Levinson, Ph.D. with guidance from John R. Samples, MD.

 
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Western Glaucoma Foundation
Yoga and Glaucoma
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