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Retinal Detachment Risk due to Gravel Riding

Old 08-12-19, 07:56 AM
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richard.susanto
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Retinal Detachment Risk due to Gravel Riding

Hello Everyone,

I want to ask anyone input here related to the risk of retinal detachment caused by the constant vibration in gravel riding (especially gravel grinding races/events). I realize this topic is very specific and might not get many answers.

A bit of a background. My right eye retina detached about 10 years back because of trauma (long story). About 2 years ago, the vitreous gel in my retina started to shift and to move, a natural condition called PVD (posterior vitreous detachment) that affects people above 45 years old. The condition is usually non-sight-threatening but occasionally affects vision more permanently in the event of complication, such as retinal detachment (when the gel is too sticky and pulling the retina too hard causing it to detach). At this point in time, my PVD has not fully completed yet.

Does anyone know any retinal detachment incident caused by gravel riding? or maybe have experienced it themselves?

I've been wanting to ask this question for a while, but haven't found the right group for it.

Thanks,
Richard
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Old 08-12-19, 10:12 AM
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Ask a medical specialist. This is too important for discussion forum anecdotes.

Most retina detachment comes from blows to the head, usually impacting the eye directly even with the eyelid closed. It's common among boxers and other fighters, or anyone who's suffered a head blow from crashes, falling, etc.

Whether bike rides can aggravate the condition would depend on many factors, particularly the condition of the roads (unpredictable) and choice of bike, tires, suspension, etc. Since the latter is controllable, I'd choose the softest riding bike I could afford that still performed as desired. My personal concern would be my neck -- old C1 and C2 injury from 2001, re-injured when I was hit by a car last year. I've made lots of incremental changes to my bikes to reach a compromise between comfort and performance, and will probably need to do so for as long as I'm able to ride. I may need to switch to bikes with suspension or that can accommodate larger tires to reduce the impact and vibration.

But your vision is more critical than my comfort issues from neck and shoulder injuries. You really need to consult a specialist.
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Old 08-12-19, 10:16 AM
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You really should ask a Retinal -Vitreal specialist. I'm at some risk of a detachment and have been told to avoid all out efforts like lifting very heavy objects or running or biking at an all out effort. Gravel racing requires you to make an all out effort. I know that hard shocks to the head can cause retinal detachments, but I don't know about continuous vibrations. I guess its up to you decide how important is recing, and is it worth risking your eyesight.
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Old 08-12-19, 10:58 AM
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Hey guys, thanks for the feedback.

I have actually spoken with my Retinal Surgeon. She's not really familiar with the type of vibration experienced by riding on rough gravel road, but had made a recommendation that I play it extra safe, which is to avoid the activity due to the risk of having a PVD in the middle of a race. The thought behind her recommendation is when a PVD happens, it's critical to have the eye examined by a Retina Specialist right away to ensure that there is no retinal detachment.

I agree with everyone. Since the risk is involving eyesight, I'd rather play it safe and avoid joining any gravel grinding race in the near future (at least until the PVD completes and my surgeon gives me a green light to race).

Thanks,
Richard
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Old 08-12-19, 12:34 PM
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Very good topic, am monitoring this myself at this very moment. Going through lens implant, cataract evaluation and surgeries. Had a retinal tear in my left due to tennis ball accident fifteen years ago, had it lasered and 'welded'. Third week of this May, had my left eye's lens implant done. My Opthamologist, long term and avid road cyclist, also is the implant surgeon. I was cleared to road bike, spin class and backpack and climb. Caveat... make sure I don't fall and impact my head. The second month to fourth month is the 'critical' time when a retinal detachment could occur. Trust me when I say this, I am being overly cautious these days!

In October, I have the mapping of the right eye scheduled. Had the vitreous separation two years ago in the right eye. This actually benefits LOWERING the risk of a retinal detachment. Though, I will have to repeat the same cautiousness again, once the right eye's surgery is performed.

My Doc is a corneal specialist, AND... works with potential risks to retinal detachment. As mentioned, though I am very active, I am concentrating more in the spin class rather than riding outside or climbing the high peaks... to keep the vibrations to a minimal or the possibility of having a fall and detachment.

Suggestion. . TALK to YOUR Doc about YOUR specific condition! If you have to forgo excessive vibration and the possibility of taking a hard fall to the head, then I would sacrifice that to keep my retinas attached and in good condition.

I'm in the third month of the first lens implant at present and I take my Doc's advice and my actions seriously. You know, anything can happen and I pray that it doesn't. Good luck and safe riding!

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Old 08-12-19, 01:19 PM
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Sound advice from all. While the vibrations might be one concern, it would seem that a fall with a blow to the helmet could be a real problem. Most of the gravel we do is on fairly hilly routes with steep twisty descents. For me, I’d be so concerned about falling it would take most of the enjoyment out of riding. I could even see myself toppling over from riding so conservatively versus just letting the bike roll over the rough stuff. Just my two cents.
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Old 08-12-19, 01:50 PM
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Definitely N+1 :: suspension. Kirk Terraplane, Alex Moulton XTB, maybe a Specialized Roubaix or Cannondale Slate - or how about an ICE Adventure?


Fun fact: in the 1890s the League of American Wheelmen pushed road paving with their 'Good Roads' movement.

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Old 08-13-19, 05:07 AM
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Originally Posted by tcs View Post
Definitely N+1 :: suspension. Kirk Terraplane, Alex Moulton XTB, maybe a Specialized Roubaix or Cannondale Slate - or how about an ICE Adventure?


Fun fact: in the 1890s the League of American Wheelmen pushed road paving with their 'Good Roads' movement.

Which had the unintended consequence of permitting and promoting automobiles which have marginalized cycling. So we are back on unpaved roads.
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Old 08-13-19, 05:58 AM
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Sounds like caution is probably warranted in your case since you have had issues and your eye surgeon urges caution. When I was on a bike trip in New Zealand I did a bungee jump but two doctors on the trip refused, saying their were afraid of PVD. The bungee jump did not result in a jerk -- it was a gradual deceleration. And these docs were not eye specialists. I suspect they were no more knowledgeable about the actual risks than I was.
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Old 08-13-19, 07:52 AM
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Originally Posted by donheff View Post
Sounds like caution is probably warranted in your case since you have had issues and your eye surgeon urges caution. When I was on a bike trip in New Zealand I did a bungee jump but two doctors on the trip refused, saying their were afraid of PVD. The bungee jump did not result in a jerk -- it was a gradual deceleration. And these docs were not eye specialists. I suspect they were no more knowledgeable about the actual risks than I was.
Well, they were more knowledgeable about the risks than you were.
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Old 08-13-19, 12:30 PM
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First, I'm not an opthamologist so my 2 c worth here is worth even less. Having said that, about 3+ years ago I started seeing floaters with an occasional flash in my left eye. Floaters are pretty common, the flashing not so much. I immediately contacted my opthamologist and he had me come in that day as this condition could mean a retinal detachment (PVD) was close at hand. Turns out that wasn't a concern at that time. My condition was monitored for around 2 years for potential PVD and visual acuity . Slowly but surely over those 2 years my ability to see in that eye deteriorated to the point I couldn't focus on anything unless I was about a foot away... I saw the same amount of light as before but I just couldn't focus. I ended up having to have a vitrectomy going into it with the knowledge that if I got back 20/30 or 20/35 vision in that eye that would be great. AND also knowing that a cataract would probably develop within a year. They don't know why a vitrectomy speeds up/causes cataract development but it does. Anyway after the vitrectomy and 6 months later cataract surgery, I've got 20/20 vision in that eye with glasses... I'm very lucky.

The whole point of the above is that from one month to the next there were continual changes in the vitreous fluid ending up with a sort of scaring that needed to be removed. My thinking is the vibration from riding on gravel might be just fine one month but then as time marches on, things could change with the vitreous fluid along with potential more pulling of the retina and riding on that same gravel could be bad news for that eye. A good chance you wouldn't even be aware of or notice any changes. In my case, changes happened so slowly that it was hard to notice them. I enjoy cycling but I like my eyesight better so I'd probably give up riding on anything that wasn't smooth. Again, that's just my 2C worth.
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Old 08-13-19, 01:49 PM
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42mm tires like the Cmpass Babyshoe Pass or Gran Bois Hetres,, help smooth things out.
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Old 08-14-19, 07:19 AM
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Thanks for all the feedback here. I was actually hoping that there's a 40+ yo. Retina Specialist in this forum who is also a gravel grinder and can provide perspective. But, I'm not expecting much since it's such a specific case.

I ride the Canyon Grail, with a suspension seat post and 40mm tires. In addition, the handlebar (Canyon calls it Hoverbar) also helps with softening the overall vibration felt when riding on really rough road. Still, I can feel the constant vibration all over my body when riding in a long distance.

Thanks again, everyone.
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Old 04-20-22, 03:52 PM
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Hi, recovering from detached retina surgery with the buckle. Now in both eyes. Last time doctor said i could go back to normal that buckle made it less likely i was going to have more problems, go ride and live life, but i wish there was an opthalmologist who rode to chime in. I do gravel rides and Mt bike. I like the long stuff 6 hours in the saddle and some races. Thinking hard about of its worth it
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Old 04-21-22, 11:27 AM
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If you go see three retina specialists, then you will have three different very good answers. We want medical science, but most of it is medical arts.
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Old 04-24-22, 12:34 PM
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Originally Posted by blacknbluebikes View Post
If you go see three retina specialists, then you will have three different very good answers. We want medical science, but most of it is medical arts.
That's why doctors practice medicine.

I am very interested in this thread because my -7 diopter myopia puts me at increased risk of retinal detachment, because of the elongation of the eyeballs. I did have a retinal tear about 12 years ago, and my ophthalmologist, who specializes in lens and cornea, referred me to a vitreo-retinologist, who performed an emergency successful cryogenic repair that same day. (Many of you already know this, but if you experience flashes and floaters, get thee to an eye doctor post haste.) I use my mountain bike (no suspension, but 26 x 1.95 tires for shock absorption) on gravel or multitrack dirt. I don't have the coordination for single track technical work, anyway, so my off road riding is pretty tame.
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Old 04-24-22, 11:18 PM
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My left retina detached 6 years ago and completely losing vision was a frightening experience . Luckily I had access to an expert retinal surgeon who laser tacked it back together again. After years my vision is about 85% in that eye which sure beats where we started. Being a mountain biker at the time, I asked about continuing to continue to do the rough and tumble sport. He said take a year off and road bike instead, which I did. After that year I resumed mountain biking with all the bumps and roots and drop offs with zero issues. Pre-COVID I had 6 month progress visits where my vision only improves. I still mountain bike on a limited basis with more impacts than you willl ever encounter gravel riding unless you are extreme.

This is a very long way of saying that I would have zero concern about gravel riding (which I did yesterday - 20 miles) but if you are still concerned visit your retinal expert and get their OK.
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Old 04-26-22, 11:12 PM
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Coincidentally, I experienced a posterior vitreous detachment in 2020, a year after this thread began. I noticed the symptoms during a nighttime bike ride, when there were distant thunderstorms, far enough away to be barely visible in the far western sky. But on my return trip home I continued to notice what appeared to be lightning flashes from the outer corner of my left eye, which at this time was facing east, away from the thunderstorms.

By the time I got home I realized it was my left eye. A few hours later the vision was cloudy and grainy in the left eye. The next morning I phoned for an ophthalmology appointment and was fortunate to get in a day later. This was early in the pandemic, before in-person non-emergency medical appointments were very difficult to get.

The ophthalmologist (dressed head to toe in hazmat-quality PPE, including a surgical mask over an N95-type mask with an exhalation vent, which was all they had available) said it was probably just age-related (I was 62 or 63 at the time) and did not appear to be related to my bicycling or exercise routines. Unfortunately, he said it will probably be a recurring problem and there isn't much they can do to prevent or treat it, but it shouldn't need medical intervention.

That particular bout with PVD cleared up within a couple of weeks. It recurred occasionally to a much lesser extent for the next year. No problems in several months.
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Old 04-28-22, 11:42 AM
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Originally Posted by canklecat View Post
Coincidentally, I experienced a posterior vitreous detachment in 2020, a year after this thread began. I noticed the symptoms during a nighttime bike ride, when there were distant thunderstorms, far enough away to be barely visible in the far western sky. But on my return trip home I continued to notice what appeared to be lightning flashes from the outer corner of my left eye, which at this time was facing east, away from the thunderstorms.

By the time I got home I realized it was my left eye. A few hours later the vision was cloudy and grainy in the left eye. The next morning I phoned for an ophthalmology appointment and was fortunate to get in a day later. This was early in the pandemic, before in-person non-emergency medical appointments were very difficult to get.

The ophthalmologist (dressed head to toe in hazmat-quality PPE, including a surgical mask over an N95-type mask with an exhalation vent, which was all they had available) said it was probably just age-related (I was 62 or 63 at the time) and did not appear to be related to my bicycling or exercise routines. Unfortunately, he said it will probably be a recurring problem and there isn't much they can do to prevent or treat it, but it shouldn't need medical intervention.

That particular bout with PVD cleared up within a couple of weeks. It recurred occasionally to a much lesser extent for the next year. No problems in several months.

Interesting -- thank you for sharing. I was 58 years old, and I started seeing lightning flashes in the upper left corner of my field of vision, followed by floaters. Two days later (Monday morning) the vitreo-retinologist painstakingly scanned my left retina, finally finding a tiny matrix tear in the lower right (from my side) corner, which would of course correspond to the flashes in the upper left corner of my vision field. Because of my high myopia, he was not able to perform the standard laser treatment to prevent a detachment, so he had to go with cryotherapy instead, apologizing the whole time for "the additional discomfort to the patient." The residual impairment is miniscule, and the brain easily fills in for the small peripheral blind spot, but I still have the floaters 12 years later. No big deal, easy to live with, and of course things could have been much worse, as some of you have experienced. Next ocular adventure will probably be cataract surgery in a few years ... .
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Old 04-28-22, 09:45 PM
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Originally Posted by rsbob View Post
My left retina detached 6 years ago and completely losing vision was a frightening experience . Luckily I had access to an expert retinal surgeon who laser tacked it back together again. After years my vision is about 85% in that eye which sure beats where we started. Being a mountain biker at the time, I asked about continuing to continue to do the rough and tumble sport. He said take a year off and road bike instead, which I did. After that year I resumed mountain biking with all the bumps and roots and drop offs with zero issues. Pre-COVID I had 6 month progress visits where my vision only improves. I still mountain bike on a limited basis with more impacts than you willl ever encounter gravel riding unless you are extreme.

This is a very long way of saying that I would have zero concern about gravel riding (which I did yesterday - 20 miles) but if you are still concerned visit your retinal expert and get their OK.
What caused it to detach?
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Old 04-29-22, 02:44 PM
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I don't do gravel, MTB, or cyclocross, but I had a retinal tear just before the COVID pandemic began. I noticed a sudden batch of 'floaters' in my right eye, went to my Primary physician, who referred me to an opthamologist down the hall, who immediately referred me to a nearby retinal specialist, who did an in-office laser treatment to seal the tear before it turned into a detachment (which would have required invasive surgery ). It wasn't in the focal point (macular area?) of my eye, so no noticable vision issues. I had not had anything hit my head, nor do I frequent roller coasters (he mentioned those can create tears/detachments, too) but the doctor mentioned it happens frequently as you get older, so if you're +50 and have any sudden appearance or sudden increase in 'floaters' get it checked out ASAP.
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Old 04-29-22, 07:55 PM
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Originally Posted by ColonelSanders View Post
What caused it to detach?
Three factors. Am extremely myopic which is already a risk factor which contributed to so many floaters my vision was compromised. Had a surgical procedure which removed the fluid inside my eye along with the floaters, replaced with saline. The result was crystal clear vision, but a risk for detachment in a small percentage of the population. Another risk of the fluid swap is the premature development of cataracts. And yes it started at age 55, 8 years after the procedure. So I had the cataract removed and replaced with a new lense, which is yet another risk factor of detachment. About 1 year after the cataract procedure - bingo! So can’t pinpoint the exact cause, it was probably a combination of factors. It was not caused by mtn biking because I was on a business trip for a week when it occurred.

The scary part was when the retina 3/4 detached and looking through that eye was like through a burlap sack. Could only see vague shapes and bright lights. When I flew home I immediately saw my optometrist who just about flipped out when he saw my eye and personally called the retina center and sent me over the next day for emergency surgery. Lying face down for two weeks with a bubble in my eye was no picnic but had books on tape and rented a chair where I could hang my head down with a mirror down below which allowed me to watch TV and movies.
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Old 04-29-22, 09:09 PM
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Originally Posted by rsbob View Post
Three factors. Am extremely myopic which is already a risk factor which contributed to so many floaters my vision was compromised. Had a surgical procedure which removed the fluid inside my eye along with the floaters, replaced with saline. The result was crystal clear vision, but a risk for detachment in a small percentage of the population. Another risk of the fluid swap is the premature development of cataracts. And yes it started at age 55, 8 years after the procedure. So I had the cataract removed and replaced with a new lense, which is yet another risk factor of detachment. About 1 year after the cataract procedure - bingo! So can’t pinpoint the exact cause, it was probably a combination of factors. It was not caused by mtn biking because I was on a business trip for a week when it occurred.

The scary part was when the retina 3/4 detached and looking through that eye was like through a burlap sack. Could only see vague shapes and bright lights. When I flew home I immediately saw my optometrist who just about flipped out when he saw my eye and personally called the retina center and sent me over the next day for emergency surgery. Lying face down for two weeks with a bubble in my eye was no picnic but had books on tape and rented a chair where I could hang my head down with a mirror down below which allowed me to watch TV and movies.
Damn
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Old 05-29-22, 06:51 PM
  #24  
dpellillo
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My experience

I am 66 years old myopic with previously -5.75 vision.

On February 15 I underwent cataract surgery on my left eye. Then on March 1 I repeated the surgery on my right eye. Both lenses were replaced with a multi focal lense. My surgeon is a personal friend and is a very capable cateract specialist.

Things were going great and my vision was 20/20 and no need for reading glasses.

after the required healing process I resumed my normal activities. I am an avid cyclist, hiker, fly fisherman and pickle ball player. BTW. I’m retired.

I began training for an 80
mile gravel ride in July.

I had ridden a few rides without any issue. Then after a 35 mile gravel ride I came home to notice floaters in my left eye. Since my surgeon is a close friend, I called him immediately and he wasted no time and referred me a retinal specialist who did a laser procedure to repair a vitreous haemorrhage. I was back on the bike after 3 weeks. On week 4 after another 35 mile ride, the exact thing happened to my other eye. Same thing, visited my friend then had the laser. Now I’m sitting around for 2 more weeks trying to decide if I should ever ride gravel again or for that matter do anything.

I will be meeting with my retinal doc in a week but his first reaction was that there was no causality. The next time I ask him however, I need to be sure he understands the nature of my riding.

this has been my experience. I hope no one else has this issue.

thanks for starting this feed.
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Old 05-30-22, 12:34 PM
  #25  
John E
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When I experienced the retinal tear and resulting flashes and floaters, the retinologist who examined my eye announced, "That's like looking into a dirty fishbowl!" He was highly competent, experienced, sympathetic, and a lot of fun to work with, and I was disappointed to learn of his subsequent retirement. Fortunately, my regular ophthalmologist has given me contact for one of his former associates, whom he says is "even better than he was." At this point, I am just living with the floaters and my developing cataracts, because neither has caused enough impairment to worry about ... yet. (I do fail one very subtle component of a comprehensive color vision test, because the yellowing of the cataract compromises the ability to resolve near-green blues from near-blue greens.) I greatly appreciate all of the information provided in this thread.
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Capo: 1959 Modell Campagnolo, S/N 40324; 1960 Sieger (2), S/N 42624, 42597
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Last edited by John E; 05-30-22 at 12:37 PM.
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