Ask the Teacher is an advice column that connects Yoga Journal members directly with our team of expert yoga teachers. Every other week, we’ll answer an issue from our readers. Submit your questions here, or drop us a line at asktheteacher@yogajournal.com.

Are you able to advise me on glaucoma-safe asanas?

—Sandy in Silverdale, Washington

We sought the recommendation of Camille Palma, MD, RYT-200, is a retina specialist practicing within the Chicago-land area. She has been exploring meditation and the body-mind connection since she was an adolescent. A graduate of Stanford University and Baylor College of Medicine, she is on faculty at Cook County Stroger Hospital. In 2016, Palma accomplished a 200-hour training at Corepower Yoga. Since then, she has taught studio classes, in addition to individual classes for personal clients and her ophthalmology colleagues. Here’s her skilled advice. 

Glaucoma is a condition wherein abnormally high eye pressure causes optic nerve damage. The fundamental caution that we give patients who’ve glaucoma is you don’t want anything that’s going to potentially raise the intraocular pressure–the measurement of the fluid pressure contained in the eye. Inversions do put you in danger for increased ocular pressure because you’ve got more blood flow to the brain.

Know the Severity of Your Eye Condition

What you may do is dependent upon your level of glaucoma, too. If you’ve got very severe glaucoma, don’t do anything together with your head down, or anything where your blood rushes to your head. Meaning no Handstands, Headstands, and postures like that. There was a 2015 study that checked out the rise in intraocular pressure with a wide range of inversions, including Downward-Facing Dog and Forward Fold. After a minute in each position, there have been significant increases in intraocular pressure. It returned to normal inside two minutes of coming back to an upright posture. This sort of pressure rise may or might not be damaging to the nerve; it is dependent upon the severity of an individual’s disease.

Yoga practitioners with more advanced glaucoma should probably avoid all inversions and modify their practice accordingly. For instance, hold a Plank or Table Top as a substitute of Downward-Facing Dog. Those with less severe glaucoma can likely go through these postures as they move from one pose to a different in a yoga flow, but I wouldn’t recommend holding them.

Talk with Your Doctor About Healthy Exercise

If you happen to’re a yoga teacher, encourage your students to speak with their doctor to get a fuller understanding of their very own condition and be educated in regards to the risks attached to their personal glaucoma diagnosis. That way they’ll have an intelligent conversation with their provider about the best way to incorporate yoga into their routine.

As a health care provider who does mindful movement regularly, I spend plenty of time communicating about the best way to keep my patients as lively as possible. I like having patients feel empowered about what they’ll and may’t do.

Your eyes are a mirrored image of your general health. I do think that exercise on the whole—and in fact, yoga specifically due to all of its advantages—is not directly helpful to eye health. In case your body is healthier, your eyes are also going to be healthier. Within the case of glaucoma, tailoring your practice to suit your individual needs and risk profile can go a good distance in keeping your vision and your body healthy in the long run.

Got an issue about alignment in a certain yoga pose? Want to higher understand a side of yoga philosophy? Need advice on the best way to approach a difficult situation in your class? Submit your questions here or email us at asktheteacher@yogajournal.com, and we may answer it in an upcoming column.