You may not want to answer this, but if you, knowing what you know, were diagnosed with this, what would you do vis a vis working out? Would you quit load-bearing exercise altogether? change your weightlifting to bodyweight exercises only? change to aerobic exercise? What bothers me is that everything that I am reading seems very tangential a representative of potential problems that aren’t well-represented in the studies (possible raised arteriole pressure during exercise but no clear studies about that; raised perfusion pressure but no clear connection between that and AION because all studies are done on intraocular pressure with respect to glaucoma, etc). And while the stakes are very high - my vision - working out under loads is not just a pass time; at my age it’s kind of essential too (for maintaining mobility, for combating the eventual dissolution of posterior chain strength and the impact that would have on mobility, and not least for combating the other debilitating impacts on strength and mobility of growing older).
Sorry to sound petulant; I am frustrated: I haven’t found any other ophthalmologists in the area that take load-bearing exercise very seriously. And not many other doctors seem to know much about AION at all.[/quote]
Non-ophthalmologists generally know very little about the eye, and trust me when I say there’s a lot to know. (The medical literature in ophthalmology is second in size only to that of Internal Medicine.) This is why there are ophthalmologists in the world.
As for what I would do…The fundamental issue is one of risk stratification and amelioration. First, the risk factors for another event must be identified. Then it must be determined what intervention (if any) can potentially ameliorate each risk factor. Finally, a cost-benefit decision needs to be made re each potential intervention; ie, it must be decided whether the resulting risk reduction is worth the cost of the intervention itself.
From what you’ve shared here, your risk factors may include:
- History of NA-AION; ie, it’s already happened to you. This is the #1 factor putting you at risk for a second event. Unfortunately, until/unless a time machine is invented, this factor is not modifiable.
- Age; gender. (Ditto)
Then there are the modifiable ones:
- PGE-5I (Cialis) use
Other potential modifiable risk factors include diabetes, hypertension, hypOtension, hyperlipidemia, sleep apnea, hyperviscosity, and others.
So here’s what I would do. I would create with my doc(s) an itemized list of my NA-AION risk factors. For each, we would come up with an estimate of how significant a risk factor it is. Then, for each modifiable factor we would determine what interventions might be undertaken to reduce the risk, and how much the risk would be reduced. Once this is done, a decision can be made regarding which interventions are worth undertaking.
Recall that the medical literature indicates the baseline risk of a second NA-AION event is 15% (at a minimum). So that’s your risk ‘floor,’ in that no intervention can take you below that number. The issue becomes, how high that number climbs when your other risk factors are tabulated.
This discussion is likely to require you to make some difficult, life-altering decisions. I hope it all works out for you.