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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] > > ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn