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List Members: Here is the post that Camilla was referring to about vision problems. It is the one that was so helpful and we copied and took in for Rob's appointment. Also at this time, we would like to say a great big THANK YOU ! to Dr. Winterkorn, and the List for helping us in so many ways ! DL, CG for Rob (56/52/36) ----- 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