Dear E of the Heady dress,

Actually this poster is more relevant..
H&K's again (I never tire of that)
Michel

----- Original Message -----
From: "Jacqueline Winterkorn, PhD, MD" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Thursday, July 13, 2000 11:59 AM
Subject: Vision Problems


> In response to recent requests for information about visual consequences
of
> PD, I have a document I prepared for an address to my colleagues in
> Neuro-Ophthalmology about a year ago on diagnosis and treatment of visual
> problems in PWP.  I would be glad to email it to anyone who requests it.
It
> was rejected by the LISTSERV because it is too long.
>
> Every few months, the discussion comes around to visual problems --
blurring,
> double vision or general discomfort are typical in PWP.  There is not much
> new to say.  Here is a message I posted a few years ago on the subject.
>
>  Some visual problems especially common in PD:
> 1. Drying of the cornea owing to infrequent blink, exacerbated by
autonomic
> dysfunction and medicines, causes eye pain and blurred vision. Treat by
> clearing up blepharitis with lid scrubs and applying non-preserved tears
> frequently. When vision blurs after reading for a few minutes, just try
> blinking four or five times [like running your windshield wiper on a dusty
> windshield -- need lots of liquid and lots of blinks].
>
>  2. Convergence insufficiency causes diplopia [double vision] at near [for
> reading].
>  3. Less often divergence insufficiency causes diplopia at distance
[driving].
>  Prism and/or translucent occlusion of one spectacle lens improves
function
> and comfort. Your local neuro-ophthalmologist can attach a Fresnel prism
to
> your glasses and in the meantime, just put a piece of scotch tape on the
> inside of your left spectacle lens to block the double image. You'll be
> surprised at how comfortable that can be.
>
>  4. Vertical gaze may be slowed or difficult to control. Upgaze may become
> slowed or absent in the elderly with PD.
> In "PSP" [progressive supranuclear palsy = Steele-Richardson-Olshewsky
> syndrome] downgaze is especially impaired and unstable fixation [i.e.
> "square-wave-jerks"] makes reading difficult. For these reasons - among
> others - bifocals are a bad idea and reading will be easier with separate
> glasses.
> Balance problems make bifocals -especially Varilux lenses without the
line --
> difficult to use and unsafe to walk in.
>
>  5. It is hard to read when your head is shaking or you can't hold a book
> still.  Try a music stand to hold the newspaper still.
>
>  5. Of course, having PD does not exempt us from the usual problems of
aging
> eyes--glaucoma, presbyopia, cataract, macular degeneration, ischemic
attacks
> causing visual loss or nerve palsies.
>
>      It sounds simple, but often takes some practical solution that is not
> offered by your local eye doc.
>  Just yell and I'll try to help.
>
>  Jacquie
> [Jacqueline M.S. Winterkorn, PhD, MD
> [log in to unmask]
> Neuro-Ophthalmology
> 900 Northern Blvd.
> Great Neck, NY 11021]
>
>

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