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.

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    • "Yoga is deeply rooted in Indian philosophy and has been a part of traditional Indian spiritual, philosophical, and psychological practice for around 3 000 years (Feuerstein, 1998). While the ultimate goal of yoga has originally been described as uniting mind, body, and spirit, it has now become a popular means to promote "
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    • "on of cases from the CHIRPP database relied on key - word recognition , there may be an underestimation of the true number of cases if the keywords used were not included in the narrative . In addition , several studies indi - cate that certain yoga postures pose a higher risk of injury ( Dacci et al . , 2013 ; Ferreira & Galvez - Jimenez , 2013 ; Gallardo et al . , 2006 ; Le Corroller et al . , 2012 ; Penman et al . , 2012 ; Walker , Meekins , & Hu , 2005 ) and unfortu - nately , the yoga pose performed at time of injury was not collected in this data - set . Pertinent injury information including the type , style , or school of yoga practised , level of experience of the practitioner , and previous hi"
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    • "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. "
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    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.
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