Swimming ( 30 minutes plus per session) head under water style after trabeculectomy.

[Cyclingalong]

I’m due to have a trabeculectomy in a few weeks. As a keen ( mainly open water) swimmer I have been told that I can’t swim for several weeks after the surgery. Online reading and the glaucoma UK trabeculectomy information booklet confirmed this. Having watched the latest Glaucoma UK online discussion on the post operative journey after trabeculectomy I was “alarmed “ to hear Professor Peter Shah say, due to the risk of infection, he, personally would never swim again if he had trabeculectomy surgery.

The Glaucoma UK booklet states there is a small, ongoing lifetime risk of infection and that infection can lead to further visual loss. It also references a paper saying the risk of serious infection is rare ( 1 in 250 which I would think was not that rare). I can’t access the full paper t read the breakdown of causes of infection.

Another paper I found gave a higher rate of infection in younger patients ( possibly because they are more active- my superficial interpretation).

With my initial early reading around the surgery I read that many people swam again ( wearing mask type goggles) a few months after trabeculectomy.

On deeper investigation today many of the people who say they swim after trabeculectomy surgery say they swim without putting their head under the water. I swim 1-2 miles a few times a week head under water style, outdoors April to September in the pool when it’s colder! Swimming head out of water doesn’t do my back any good because it’s a different position.

I will obviously check with my surgeon at the time of my surgery and if it’s too high a risk to swim regularly for longer sessions after my surgery I will change my habits and concentrate on other activities instead but I’m intrigued to know what others have been told as I have always told my consultant that I swim as well as cycling, hill walking etc. I’ve done lots of outdoor swims, swam between all the Scilly islands and have ambitions for future swims. I was not told to seriously consider not swimming again post op ( possibly because I wasn’t taken seriously about my swimming style and frequency).

[Hev02]

hello

It was me that posted the question on the webinar, and was very shocked to hear him say that he wouldn’t ever swim again

Like you, I am younger and I am pool and open water swimmer and longer distances, head down, front crawl. Please can you let me know the outcome of your discussions, as I have also done some reading and can’t find definitive advice.

I wish you luck for your surgery and hope your recovery goes well.

[Cyclingalong in reply to Hev02]

Thanks. I think possibly part of the decision about swimming after a trabeculectomy may come down to personal decision about the relative risk and how keen a swimmer you were before the surgery. If you aren’t bothered about swimming it’s a lot easier to say you would never swim again as you are aware that there is some risk ( of infection) involved. It could also depend on the healing ?

After listening to the webinar and searching this forum I realised that many of the people who say they have been allowed to swim several months post op don’t put their head under water.

My superficial discussion with my consultant a fairly long time ago certainly led me to believe I would be able to swim ( with mask type goggles) after the initial healing period. My consultant may not have realised my swimming style and as it’s not uncommon to swim distances head down I didn’t think to ask any further.

I will be asking for more information so I can weigh up the relative risk and will post again when I have discussed it with my consultant. It wouldn’t stop me from having the surgery but it’s a lot better to know in advance than suddenly find something may be better to be avoided altogether.

[Sorshup]

Including three needlings I have had six filtration "procedures" and don't recall any mention of swimming. The bleb formed by the trab just has a layer of skin over it and should gthis be punctured germs have immediate access to the anterior chamber (and if the trauma is great enough, presumably aqueous will escape with all the risks that brings on).

The significance of swimming is the germs in water - the chance of trauma to the bleb exists 24/7, and one could postulate that a tree branch, a chucked frisby, or a toy wielded by a grandchild is more likely than trauma while swimming! The other aspect is defensive medicine; the doc, understandably, doesn't want to be accused of not warning you.

[Cyclingalong in reply to Sorshup]

Thanks for your reply. I presume that the risk is due to bacteria in the water even with an intact bleb after the initial healing period. As you say there are many risks of trauma in day to day life ( for me , especially as I’ve lost a lot of vision in the upper half of my visual field in the eye that will be operated on). Branches and other objects can “ suddenly appear “ close by when I’m out and about or under trees so I’m always careful when gardening under trees. I have read that some people wear protective clear eyewear for gardening post trabeculectomy surgery.

It’s good to hear that you still swim. Enjoy the Thermae Bath Spa.

[Sorshup]

I should have added that I have swum recreationally in both pools and sea, but not vigorously underwater. In three days time I wll be in the water at the Thermae Bath Spa !

[NewCardinal]

Surely The only question to ask yourself is which is the most important to you - your eyesight (which once compromised might be lost) or a method of exercise (which can still be done but differently) …. .????

[Cyclingalong in reply to NewCardinal]

Yes, As I said if the consultant’s advice is against my style of swimming I will stop and concentrate on other activities instead.

I can’t swim effectively or efficiently for a distance with my head out of water and it doesn’t do my back or neck any good either, it’s not a streamlined position. There’s still a risk of getting splashed with “ dirty” pool or lake water and thus get an infection. I may become a cold water dipper with goggles and a bobble hat instead!

Luckily I cycle and hill walk and Nordic walk so I can still get my exercise and fresh air.

I’m fairly risk averse so wouldn’t want to take a chance with risking an infection that could lead to total loss of my eyesight by doing something that could be avoided.

The reason for my question was that from previous discussions pre surgery and reading information leaflets I had been led to believe that after a few months of healing swimming should be absolutely fine ( wearing mask type goggles). Nothing I had seen or read cautioned about swimming styles or not swimming (and swimming head down is not an unusual style) . Obviously the professor has a personal opinion which could be partly based on his knowledge and patients experiences etc. but his opinion has certainly made me question the general advice that’s out there and I will be asking my consultant for his advice when I see him at the time of my surgery.

Most of us on here know that for people with glaucoma yoga positions with head below heart are to be avoided but I haven’t heard or been told that freestyle or other swimming strokes done with head under water may be recommended to be avoided for ever more post trabeculectomy surgery. The Glaucoma UK information booklet just says to avoid strenuous activity including swimming during the early post operative period. It doesn’t say it may be recommended or advised that you don’t swim again or don’t swim any swimming stroke that involves submerging your head. By implication it seems that swimming will be fine after the early post operative period.

Professor Peter Shah said he would not swim again after trabeculectomy surgery. I understand that’s a personal opinion and I’m sure he would discuss pros and cons and relative risk with individual patients.

My point is that there’s quite a wide gap between those two statements ( booklet information and webinar comment). Neither statement makes any qualifying comment about swimming style. For all we know the professor could have been including swimming with your head always out of the water when he said wouldn’t swim again post trabeculectomy surgery. Having read more around the subject I’m starting to see why but it’s not what I was led to understand by discussion with my health professionals or reading advice sheets and booklets.

That is why I posed the question, to see what others had been advised on a case by case basis. Hopefully that makes sense.

[Olivertwist24 in reply to Cyclingalong]

I read your posting with dismay on the fact of the advice not to ever swim again . I was a member of David Lloyd fitness club where I swam in outdoor pool before my first trab surgery . I have paused my membership and will not restart until after 2nd op which is hopefully early in the new year. I was going to buy mask goggles and I normally swim breast stroke so mainly with head out of water. I will check with my consultant again on my next appointment just after Christmas . But like you was going on the written advice post trab surgery. My first op has to date gone very well and I certainly would not want to jeopardise my recovery with going swimming if this is a a complication that could lead to infection but if necessary to prevent this then sadly I would have to give up swimming . But definite advice would be helpful to making decision . As I enjoy swimming very much & being in my 70’s is an overall exercise I feel I benefit from a great deal . My late father always swam all his life even when he had his lower leg amputated due to diabetes so set me good example in the benefit of swimming.

[Cyclingalong in reply to Olivertwist24]

I’m glad your recovery is going well. Best wishes for your second surgery next year. It may be that the advice depends on healing and other factors, let’s see what our consultants say.

[Olivertwist24 in reply to Cyclingalong]

Thanks for your wishes and hope your recovery goes well 🤞for swimming safely

[GlaucomaMe]

I have had a trabeculectomy in both eyes some four years ago. I swam yesterday for over 30 minutes: crawl, breaststroke and backstroke, with my face in the water as necessary for the stroke. I wore large format goggles. I took some time to make sure that they fitted well before entering the water and no water entered the goggles during the swim. I think that I am much more at risk in the garden, but I also garden. Exercise and fresh air are really important for eye and mental health. I just am more careful with eye protection and hygiene.

Returning to swimming after the trabs was discussed with my surgeon and the advice was to wait until all stitches had been removed.

I hope that your surgery goes well.

[Cyclingalong in reply to GlaucomaMe]

Thanks for your reply. It’s good to hear that you were given the all clear to swim after your surgery.

[Olivertwist24 in reply to GlaucomaMe]

Many thanks for your advice very helpful and for your wishes & yes agree exercise good for mental health . My stitches are still in after having my op in October so hopefully out soon on my next visit

[Lovearoastdinner]

Hi, I had a trab in June. I'm a golfer. I had two months of doing very little. No lifting, bending, driving, gardening, or housework.I did walk but nothing strenuous. At end of Aug I was back on golf course.

My advice is do as you are told. I think you could go swimming again, but I would wear good quality goggles. I still don't touch or rub my operated eye! Also, now wear glasses on golf course to proect eyes from glare etc. My eye is good. Pressure acceptable, and grateful to my surgeon. Angela

[Cyclingalong in reply to Lovearoastdinner]

Thank you for your reply and it’s good to hear that your recovery has gone well. I think we do hear more about post operative complications rather than all the good news stories. It’s going to be a quiet few months. I’ll do as I’m told and look forward to the spring when hopefully I’ll be able to be more active again.

[Olivertwist24 in reply to Lovearoastdinner]

Many thanks for your advice very helpful

[Lovearoastdinner]

I concur !! It's not easy. I hated having to be sensible, but paid off longterm. Angela

[Cyclingalong]

Well I had my trabeculectomy surgery in December. That seems to be settling ok so far.

When I asked my consultant about swimming he said that 6 weeks after the surgery I would be ok to swim in a swimming pool wearing mask type goggles. He said that swimming in the sea would be ok but not lakes due to risk of infection. Obviously the sea can be unsafe ( from an infection viewpoint) if there are sewage discharges and not all lakes are the same, but that was his advice- not a “no swimming” at all but there’s always going to be some infection risk.

[Roundearther in reply to Cyclingalong]

Hi there, just to say I had a trab in my right eye in December, so we are on a similar timeline.

I'm 35 and was very active, running and football - loved staying fit and throwing myself into things. If you ever want to message and compare progress etc, please let me know - I'm feeling pretty isolating with the lifestyle changes and what info to trust etc.

[Cyclingalong in reply to Roundearther]

Yes, being active it’s hard to rest and not do much at all during the initial recovery period. Christmas and New Year have helped break up the days and I’ve been going for leisurely level walks as well. With the ice and snow I’ve not missed cycling but I’m starting to look forward to being allowed to do a bit more after the initial recovery period.

[Teg252 in reply to Cyclingalong]

Hi, just joined and saw your post, hope all is going well. I had trabs to both eyes in Feb & May 2023. I enjoy swimming, plus variety of sea watersports. Speaking purely from my own experience, my consultant highlight trabs make us more susceptible to eye infections, but was happy for me to continue my watersports as long as I used the mask goggles, (standard goggles with the individual eyes can impact eyes pressures). He also recommended an over the counter antibiotic eye cream for when I go on holidays just for piece of mind. It may be worth asking your consultant for a similar recommendation to have in your first aid kit.Happy swimming 🏊

[Teg252 in reply to Teg252]

Ps found Sutton Prescription goggles good 👍

[Cyclingalong in reply to Teg252]

Thanks. My trabeculectomy seems to be working well, pressure down to 9 around which is where my consultant wanted it . Getting some inflammation each time I reduce the steroid drops ( as per instructions) but had a check each time and the team are happy with it. I was waiting for the check up before replying.

Saw my consultant again last week, he’s happy for me to swim in the pool ( and when pressed said sea should be ok too) as long as I wear mask type goggles which I have for a few years anyway. With the inflammation flare ups I had postponed re starting swimming but went back to the pool this morning. Now I need to build up some fitness again. I have done some leisure kayaking so I need to try out goggles for that ( incase of an unplanned swim), Thanks for your input. I was thinking lubricant ointment pre swim ( as a bit more of a barrier). I’ll look into the antibiotic cream too.