Friday, September 12, 2008

9.6 Diving and retinal breaks

Guo Jingjing is the Gold medalist of Women's 3-m springboard diving of the 2008 Olympics. She took up diving since age 7. And now at age 27, she is the most decorated Olympic female diver ever.

And the price she has paid as far as the eyes? Retinal tears or breaks:
They lead up to the more severe sight-threatening retinal detachment. Which was probably what has happened to Ms Guo. In 2002, a retinal break was discovered in her right eye. After a successful surgical repair, her vision or visual field dropped to 20% of normal anyway. In 2004, right before the Olympics in Athens, the retina apparently has re-detached. She went on to win two gold medals nonetheless. After the 2008 Games, both eyes now require surgery.

Sudden physical impacts or blunt trauma to the eyes in, e.g., boxing, car accidents, baseball or hockey games, can disrupt the retinal (and sometimes choroidal) structure. Even if there is no detectable blow-out detachment when the eyes are examined immediately after the injury, it does not mean that the patient is out of the woods. Unfortunately, the latency for retinal detachment is quite long, often in years. Diving apparently involves repetitive impacts on the top portion of the eye. In other words, when the diver's head enters the pool water, the contact force will have been transmitted to the eyeballs. And the latency of retinal detachment will have been considerably shortened. Even worse if there are other pre-disposing factors, e.g., high myopia and/or family history of retinal detachment.

Athletes in competitive diving should probably have their retinas examined at least once every 6 months.

20 comments:

BH said...

Wow! Never know about that diving is such a serious business.

I think the price is too high for her to get the gold medal.

What benefits one to gain the gold and lose his/her window of soul?

Thank you for the post!

EyeDoc said...

Unfortunately, she is not the only one to have this type of injury.

Kevin said...

Sarah Palin can't dive like that!!!

Adam Lee said...

It is sad to see people hurting their bodies in the name of sport. In fact someone dislocated their elbow in weight lifting as well (of course no-one saw that)

just search you-tube and you'll find it.

EyeDoc said...

There was a moment immediately after the last dive in 2008 Beijing when Ms Guo appeared to have some tears in her eyes. Mixed emotions, perhaps.

The lure of fame and fortune in competitive sports is simply too great for some to resist. Of course, it is not worth it for anyone to suffer debilitating injuries.

Sarah Palin shoots mooses quite expertly. Who knows, maybe she qualifies for rifle events.

Daisy said...

Ha! I like your last comment about Palin in Shooting events! I just saw this: jottings from Jersey's Do you really know Sarah? ...but then again we are taling about eye disorders here. So no wonder I'm not into these sports. I can't afford to lose my eyesight for medals and fame.

cube said...

Just popped in via BlogExplosion & read your post with much interest. I had no idea this was even possible. Thank you for enlightening me.

EyeDoc said...

Daisy:

Sarah Palin is also mother to a child with Down's syndrome.

There are many ways of looking at a politician. Good thing we live in a society where all views are tolerated.

Cube:

Thank you for popping in.

Let's not forget the impact force on the brain itself. Problem with the eyes may just be the proverbial tip of the iceberg.

cube said...

Is this kind of retinal damage mainly the result of high dives, or any kind of short dive? Just curious.

EyeDoc said...

Hard to say. In patients with retinal detachments, some do recall falling and hitting their heads on the ground. So it really does not take much for the retina to detach. Diving from any heights certainly involve even more force than a trip and fall. Plus the surface of water is actually quite hard. The predisposing factor, in most these cases, is probably an inherent structural weakness of the vitreous.

Rups said...

this really was an eye opener

EyeDoc said...

India has won one gold and two bronze medals in the 2008 Games; none in diving (yet). When planning for the future, please do not forget eye care for the athletes.

Velu said...

I never knew that swimmers suffered so much. I do recreational diving. Do i also face the same future?

Velu

EyeDoc said...

In grand rounds, when a professor asks you: what is the prevalence of a certain disease/condition in a certain population. And you have no idea what the answer is. Always reply: 5%. And you'd be right.

So you have 5% chance of developing retinal problems.

ohiit said...

OMG!! Wow I didn't know that diving is a serious sport that can wear and tear towards the eye. At least it give me an insight to why the divers didn't wear googles because of the reason it is suppose to wear without so they can perform well but at a disadvantage that it can tear the retina after exposure to competitive diving. Ahhh...

Retarius said...

Apart from just not diving, is there any protection against this injury? Like a compressible soft helmet for divers? And has anyone ever studied what sort of impact force these people are subjected to when they enter the water?

EyeDoc said...

The impact force obviously varies with each diver. A quick example is shown here:

For a diver weighing 50kg, entering water at 20m/sec and traveling into water for 2m, then the impact force (F) is:

F=(A x B)/C (Newton's 2nd Law)

Where A=body weight;
B=average speed (going from 20m/sec to zero when striking water)=(20+0)/2=10m/sec; and
C=time traveled 2m into pool water=2/10m/sec=0.2sec

therefore,
F=50x10/0.2=2500N

To streamline a diver, padded headgear may not be a good idea. You can aerate the pool water instead. This seems to soften the impact somewhat.

Also, the retinal problems have been assumed to be unique to Chinese divers. Tom Daley of the British team is now known to suffer the same; although the official version is that he has had some nasty "wipe-outs".

Dan said...

Can retinal detachment happen to a diver after only 2 years of diving?

I would love to begin diving, but I don't want to risk my eye sight!

EyeDoc said...

More important than the time spent diving is the structural integrity of the retina. For example, highly myopic eyes tend to be more susceptible to RD. And eyes with retinal holes and breaks are of course at even higher risk. Regular retinal exam is a good idea for all divers.

katty said...

Diving is the most exciting activity You can feel the immensity of the ocean. It's like traveling to another world. unexplained.This blog is amazing and vey interesting.
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