Subject: Re: PD/neuro-ophth
From: Jacqueline M.S. Winterkorn, PhD, MD
Some visual problems especially common in PD:
1. Drying of the cornea owing to infrequent blink and 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. Blink whenever you think of it.
2. Convergence insufficiency causes diplopia at near [for reading].
3. less often divergence insufficiency causes diplopia at distance
[ diplopia=double vision] Prism and/or translucent occlusion of one
spectacle lens improves function and comfort.
4. Vertical gaze, especially upgaze, may become slowed or absent.
But must
discriminate this from the severe eye movement defects characteristic of
"PSP" [progressive supranuclear palsy -Steele-Richardson-Olzewsky syndrome]
in which downgaze is especially impaired or completely absent and together
with fixation instability [i.e. square-wave-jerks] makes reading difficult.
Lots of questions re PSP recently--it's not PD, doesnt respond to Sinemet,
has shor ter course of progression and unlike PD causes dementia. You dont
want to have this.
5. It's hard to read when your head is shaking or you can"t hold a book
still...Set the book down on a table or up on a cookbook stand.
5. Of course, having PD does not exempt us from the usual problems of aging
eyes-- Presbyopia [[Don't underestimate how distressing it can be for anyone
ages 45-60 to lose the ability to accommodate for near vision...] glaucoma,
cataract, macular degeneration
It sounds simple, but often takes some practical solution that is not
offered. Just yell and I'll try to help.
Jacquie
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