# Acute intraocular pressure responses changes during dynamic resistance training in primary open-angle glaucoma patients and age-matched controls

## TL;DR

This study found that moderate-intensity resistance exercises like leg extensions and bicep curls cause only small, clinically irrelevant increases in eye pressure for people with glaucoma, making them a safe option for improving fitness.

## Contribution

The study is the first to compare IOP responses to dynamic resistance training in glaucoma patients versus controls, showing that patients have a blunted IOP increase likely due to their eye drop treatment.

## Key findings

- POAG patients showed significantly smaller IOP increases during moderate-intensity resistance exercises compared to controls.
- IOP increases during low- to moderate-intensity resistance exercises in POAG patients are clinically irrelevant.
- Ocular perfusion pressure remained stable during the exercises in both groups.

## Abstract

Physical exercise has been proposed as a feasible strategy for preventing and managing glaucoma by modulating intraocular pressure (IOP) and ocular perfusion pressure (OPP). The primary objective of this cross-sectional study was to assess the IOP and OPP responses to dynamic resistance exercises (leg extension and biceps curl).

Twenty-six patients with primary open-angle glaucoma (POAG) (age = 68.9 ± 8.1 years) and 18 healthy age-matched controls (age = 69.6 ± 5.9 years) were recruited. Participants performed one set of 10 repetitions of both exercises at low- (light bar) and moderate-intensity (15RM). IOP and blood pressure were measured at baseline and after 1 and 5 min of passive recovery. Additionally, IOP was measured during training after each of the 10 repetitions.

Our data showed a progressive IOP increase throughout the sets of leg extension and biceps curl exercises when performed at moderate intensity (p < 0.001). Remarkably, POAG patients showed a smaller IOP increase compared to controls (p = 0.048). The between-group differences for IOP changes were higher during the 10 exercise repetitions at moderate-intensity for both leg extension (average IOP rise: POAG = 0.3 ± 0.6 mmHg vs. control = 2.3 ± 0.7 mmHg) and biceps curl (average IOP rise: POAG = 1.4 ± 0.6 mmHg vs. control = 3.4 ± 0.8 mmHg) exercises. No changes in OPP were observed.

The findings of this study suggest that moderate-intensity dynamic resistance training is a safe intervention for potentially improving physical fitness in medically treated POAG patients.

The online version contains supplementary material available at 10.1007/s00417-025-06814-9.

Although physical exercise has been proposed as a strategy for glaucoma prevention and management, resistance exercises, especially when performed at high intensity, lead to an acute increase in intraocular pressure.

Although physical exercise has been proposed as a strategy for glaucoma prevention and management, resistance exercises, especially when performed at high intensity, lead to an acute increase in intraocular pressure.

The intraocular pressure increases during low- to moderate-intensity dynamic sets of leg extension and biceps curl in POAG patients is clinically irrelevant, meanwhile ocular perfusion pressure remains stable.The better intraocular pressure response to dynamic strength exercises in POAG patients in comparison with controls could be associated with the effectiveness of the eye drop treatment (prostaglandin analogues or a combination of prostaglandin analogues and beta-blockers).Moderate-intensity dynamic resistance training appears to be a safe strategy and should be considered by trainers and eye care specialists working with POAG patients on eye drop treatment.

The intraocular pressure increases during low- to moderate-intensity dynamic sets of leg extension and biceps curl in POAG patients is clinically irrelevant, meanwhile ocular perfusion pressure remains stable.

The better intraocular pressure response to dynamic strength exercises in POAG patients in comparison with controls could be associated with the effectiveness of the eye drop treatment (prostaglandin analogues or a combination of prostaglandin analogues and beta-blockers).

Moderate-intensity dynamic resistance training appears to be a safe strategy and should be considered by trainers and eye care specialists working with POAG patients on eye drop treatment.

The online version contains supplementary material available at 10.1007/s00417-025-06814-9.