Exercise-induced visual loss associated with advanced glaucoma in young adults

Purpose To highlight the phenomenon of exercise-induced visual loss associa ted with advanced glaucoma and to discuss the possible underlying mechanism s. Methods Three young adult patients with congenital or juvenile-onset glauco ma presenting with visual loss which occurred during exercise underwent oph thalmic examination. In 2 cases, visual function parameters, including visu al fields (Humphrey full threshold perimetry) were measured before and afte r exercise. Results All patients clearly described visual loss during exercise. In the 2 cases in which data were available, significant impairment in central vis ual acuity and reduced foveal sensitivity and mean deviation on visual fiel d analysis occurred during exercise of mild to moderate intensity with comp lete or near complete recovery of visual function upon cessation of exercis e. Conclusion Young patients with advanced glaucomatous optic neuropathy shoul d be questioned regarding exercise-induced visual disturbance. We hypothesi se that a 'vascular steal' is the likely mechanism underlying this phenomen on. Patients should be advised to limit activities which induce their sympt oms, and therapeutic measures to promote ocular blood flow should be consid ered.