People with high myopia (severe near-sightedness) are at a significantly increased risk of retinal complications throughout life. Recent expert warnings and epidemiological evidence have renewed attention on a lesser-known but potentially vision-threatening trigger in this group: heavy weight lifting and strenuous physical exertion. While resistance training is generally considered safe for the eyes, individuals with high myopia represent a distinct anatomical and clinical risk category.
High myopia typically refers to a refractive error of −6.00 diopters or greater. In these individuals, the eyeball is elongated, causing the retina, the light-sensitive inner lining of the eye to be stretched thinner than normal. This structural thinning makes the retina more fragile and prone to tears, holes, and detachment.
High myopia is already a well-established independent risk factor for:
Retinal tears
Posterior vitreous detachment (PVD)
Rhegmatogenous retinal detachment
Myopic macular degeneration
Any additional mechanical or pressure-related stress on the eye can further increase this risk.
During heavy lifting, especially when straining, people commonly perform a Valsalva maneuver, holding the breath while exerting force. This action causes a sudden rise in:
Intrathoracic pressure
Venous pressure
Intracranial pressure
Intraocular pressure (IOP)
These pressure spikes are transmitted directly to the eye. In a normal eye, this transient rise is usually tolerated. In a highly myopic eye with a stretched retina, however, this sudden pressure surge can exert traction on already weakened retinal tissue.
Dr. Sanskriti Ukey, an ophthalmologist recently shared a case where a patient suffered a retinal detachment after avoiding warning about heavy weight lifting.
A detailed epidemiological and mechanistic analysis published in Occupational and Environmental Medicine 2 proposes two main hypotheses explaining how lifting may increase the risk of retinal detachment.
Brief but intense increases in intraocular pressure during heavy lifting may trigger retinal tears, particularly during or shortly after posterior vitreous detachment (PVD), a common age-related process where the vitreous gel separates from the retina.
In this scenario:
The vitreous pulls unevenly on the retina
A sudden pressure spike acts as a mechanical “tug”
Retinal tears may occur during a vulnerable time window of weeks following PVD
Repeated episodes of heavy lifting over months or years may cause recurrent IOP spikes, accelerating:
Vitreous liquefaction
Vitreoretinal traction
Structural weakening of retinal adhesion
Under this hypothesis, retinal tears and detachments are more likely after a long history of strenuous lifting, rather than from a single event.
Both mechanisms are biologically plausible and supported by observed associations between occupational lifting and retinal detachment risk.
In high myopia:
The retina is thinner and less elastic
Peripheral retinal degeneration (such as lattice degeneration) is common
Vitreoretinal adhesions are often abnormal
When sudden pressure increases occur, the retina may fail at its weakest points, leading to:
Retinal tears
Fluid entering beneath the retina
Progression to full retinal detachment
Retinal detachment is a sight-threatening medical emergency that typically requires urgent surgery. Even with treatment, permanent vision loss can occur.
People with high myopia should seek immediate ophthalmic evaluation if they experience:
Sudden flashes of light
New or increased floaters
A curtain-like shadow in vision
Sudden blurring or distortion
These symptoms may indicate a retinal tear or early detachment.
High myopia significantly alters the structural integrity of the eye, making the retina more vulnerable to pressure-related stress. Awareness, preventive behavior, and individualized medical guidance remain central to preserving long-term vision in people with high myopia.
Gauchard, G. C., et al. “Occupational Lifting, Physical Effort, and Retinal Detachment.” Occupational and Environmental Medicine 66, no. Suppl 1 (2009): A99. https://pubmed.ncbi.nlm.nih.gov/18854710/.
David Kriebel, Stefania Curti, Rebecca DeVries, Andrea Farioli, Mattioli, Susan Sama “Heavy Lifting and Retinal Detachment in Occupational Settings.” Occupational and Environmental Medicine 74, Suppl. 1 (2017): A36.3. https://oem.bmj.com/content/74/Suppl_1/A36.3.
Bashir, Shajan, and Thomas C. Shen. “Associations of Physical Activity with Intraocular Pressure: A Systematic Review.” Journal of Sport and Health Science 2, no. 3 (2013): 178–187. https://www.sciencedirect.com/science/article/pii/S2093791112310081
