Data suggests the benefits of exercise may be far-reaching for ocular health
Michael Cymbor, OD, of Nittany Eye Associates, talks about the benefits of exercise and movement for ocular health, which he presented at the 2024 American Academy of Optometry Annual Meeting.
Michael Cymbor, OD:
It was great to present “Exercise and Eye Disease” at the Academy. The Academy, year in and year out, is just a fantastic meeting. The beginning of the meeting is the Optometric Glaucoma Society, which is always just so much fun for me. But I was really pleased to be able to present “Exercise and Eye Disease.” This comes out of this growing realization that lifestyle factors are so very important. Where we’re at when it comes to exercise and eye disease, we’re just beginning to understand it. The parallel that I’ll make is that, when I graduated optometry school, when it comes to using vitamins for macular degeneration, you would absolutely be laughed off the stage.
But now we realize that, yeah, that’s really important in the treatment of macular degeneration. There is some really good research now that suggests that regular exercise lowers the incidence of so many different systemic diseases: hypertension, diabetes, depression, the list goes on and on and on. But now it’s working its way into eye care, and we’ve got some really good studies that says that, whether it’s macular degeneration or glaucoma or diabetic retinopathy or dry eye or even myopia, exercise, regular exercise, can have a real profound effect, lowering the chances of conversion and progression pretty much across the board. For most eye care providers, counseling diabetics is what comes naturally. We’ve been doing that for a long time, and I think the data certainly is most compelling in that topic range. We’re really used to saying to our patients, “Hey, medication is important. Diet is important. But what’s also really important is kind of getting out there and moving your body.”
Sometimes we use the term exercise, which is kind of a discretionary type thing. But sometimes we’ll just say physical activity, because there are a lot of, my patients in particular, they just love to go out and garden. Most people wouldn’t consider gardening as exercise, but yet it still is a physical activity. They’re out there moving their muscles, they’re burning glucose, they’re doing things like that. In the field of diabetic retinopathy, we’re used to having these conversations. I think what’s just starting to emerge is maybe how important these conversations can be with patients with glaucoma, with patients with macular degeneration. There are really compelling studies that look at patients who exercise regularly versus not, and it really is protective against both macular degeneration and glaucoma conversion and progression.
Very compelling data as well as in the dry eye arena. Certainly, as it relates to diabetic retinopathy, it is accepted, and the data is beyond question. I would say in the field of macular degeneration and glaucoma, even though the research is compelling, it’s still kind of more in its infancy. Part of the reason that I’m doing this topic is to kind of raise awareness, kind of saying, “Hey, this …” Because many optometrists aren’t even aware, really, that there is really good data out there. Part of what I’m trying to do is just raise that level of awareness by saying, “Let’s look at this data, and I hope you find it as compelling as I do.” I started off this talk last year concentrating on diabetic retinopathy, macular degeneration, and glaucoma. But I have since added dry eye and myopia, and there’s really some compelling research in that area.
I think we are on the precipice of this going mainstream. I can envision a time 5 years from now where we are across the board recommending exercise almost regardless of the eye condition that they have. Two important questions arise, and one is, what is the magic number? How much exercise, really, do I need? I think the data kind of suggests that 150 minutes; 150 minutes is something that I see over and over and over. If you can get 150 minutes of mild- to moderate-intensity workouts a week, that is going to have some protective effects. If you can even get 240 in, that’s kind of next level, and the rates of disease conversion and progression go down even further. The second question really is, why? Why does it work? What we’re beginning to realize is, when we exercise, we create all of these things in our body like micro tears in our muscles, and the body wants to fix those things.
How does it fix those things? Well, it releases adult stem cells from our bone marrow, and then these adult stem cells kind of go throughout our body, and they go and heal all these micro tears. But they overcompensate, meaning they release more stem cells than are what’s really needed to fix that particular problem. You have these excess stem cells floating around, and they are going to go look for things that aren’t working. That’s why we think it can be really effective in so many conditions, but including all of the eye conditions that I named. It really is an exciting time when it comes to this research. It’s fun to be kind of out in front, kind of exposing our colleagues to this great information.
