Progression of glaucoma associated with the Sirsasana (Headstand) yoga posture

University of Texas at Dallas, Richardson, Texas, United States
Advances in Therapy (Impact Factor: 2.27). 11/2006; 23(6):921-5. DOI: 10.1007/BF02850214
Source: PubMed


This article reports a case of progressive glaucomatous optic neuropathy and visual field loss that occurred in a patient who practiced the Sirsasana (headstand) yoga posture on a daily basis for many years. Visual field analysis was performed through standard automated perimetry. Intraocular pressure (IOP) was measured through pneumotonometry in the sitting position and in the head-down position. Stereo-optic disc photographs were obtained. IOP increased significantly in the head-down position. Optic disc evaluation revealed a new disc hemorrhage in the left eye. Visual field analysis over a period of 2 y showed progression of a superior arcuate defect in the left eye. Transient increases in IOP associated with the yoga headstand posture may lead to progressive glaucomatous optic nerve damage and visual field loss.

56 Reads
  • Source
    • "Regarding specific yoga postures, the headstand (Sirsasana) was practiced in 10 cases [25], [27], [28], [32], [35], [37], [38], [46], [52], [53], the shoulder stand in 3 cases [36], [39], [52], variations of the lotus position (Padmasana) in 3 cases [26], [47], [56], forceful breathing techniques in 3 cases [40], [41], [55], voluntary vomiting (Kunjal Kriya) in 2 cases [27], [48], and postures that included putting 1 or 2 feet behind the head in 2 cases [34], [50]. Kneeling posture (Vajrasana) [31], locust pose (Salabhasana) [36], bridge pose (Setu bandha) [49], seated forward bend (Paschimottasana) [57], and downward-facing dog (Adho mukha savasana) [58] were practiced in 1 case each. "
    [Show abstract] [Hide abstract]
    ABSTRACT: While yoga is gaining increased popularity in North America and Europe, its safety has been questioned in the lay press. The aim of this systematic review was to assess published case reports and case series on adverse events associated with yoga. Medline/Pubmed, Scopus, CAMBase, IndMed and the Cases Database were screened through February 2013; and 35 case reports and 2 case series reporting a total of 76 cases were included. Ten cases had medical preconditions, mainly glaucoma and osteopenia. Pranayama, hatha yoga, and Bikram yoga were the most common yoga practices; headstand, shoulder stand, lotus position, and forceful breathing were the most common yoga postures and breathing techniques cited. Twenty-seven adverse events (35.5%) affected the musculoskeletal system; 14 (18.4%) the nervous system; and 9 (11.8%) the eyes. Fifteen cases (19.7%) reached full recovery; 9 cases (11.3%) partial recovery; 1 case (1.3%) no recovery; and 1 case (1.3%) died. As any other physical or mental practice, yoga should be practiced carefully under the guidance of a qualified instructor. Beginners should avoid extreme practices such as headstand, lotus position and forceful breathing. Individuals with medical preconditions should work with their physician and yoga teacher to appropriately adapt postures; patients with glaucoma should avoid inversions and patients with compromised bone should avoid forceful yoga practices.
    PLoS ONE 10/2013; 8(10):e75515. DOI:10.1371/journal.pone.0075515 · 3.23 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The authors describe a case of progressive optic neuropathy in a patient with congenital glaucoma who had routinely practiced the Sirsasana (headstand) yoga posture for several years. Ophthalmic examination included best-corrected visual acuity, anterior segment examination, indirect ophthalmoscopy, ultrasound pachymetry for central corneal thickness, and intraocular pressure before, during, and after maintaining the Sirsasana posture for 5 minutes. Intraocular pressure increased significantly during the Sirsasana posture. Transient elevation in intraocular pressure during yoga exercises may lead to progressive glaucomatous optic neuropathy, especially in susceptible patients with congenital glaucoma.
    Ophthalmic Surgery Lasers and Imaging 07/2008; 39(4):339-40. DOI:10.3928/15428877-20080701-03 · 1.32 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Regular exercise is a healthy lifestyle choice with numerous benefits to general health. Ophthalmologists may face questions of the benefits or risks of exercise to eyes. Here the effects of acute exertion and regular physical activity on ocular physiology and disease are reviewed. Intraocular pressure is transiently reduced by dynamic exercise. For the great majority of patients exercise is beneficial to the eyes by reducing risk of central retinal vein occlusion and neovascular age-related macular degeneration, and by improving control of systemic hypertension and diabetes. Ophthalmologists should be advocates of regular exercise with appropriate eye protection.
    Survey of Ophthalmology 05/2009; 54(3):349-55. DOI:10.1016/j.survophthal.2009.02.005 · 3.85 Impact Factor
Show more