---------- Forwarded message ----------
Date: Wed, 21 May 1997 23:05:38 -0400
From: [log in to unmask] (Bob & Joy Graham)
Subject: Re: Problem keeping eyes open.
Hi William,
You write:
>My Wife Doris has had PDplus for approx eight years now. In the last several
>months she has had periods when she cannot open her eyes. The lids just
>refuse to open. I am just wondering if any of the folks on this list have
>ever had this problem and if so what were they able to do about it..Any help
>with this would be appreciated.
One of my friends with PD plus has had this problem and has been helped
with Botox injections into the eyelids (I think into the eyelids). You
might ask at your neurologist or the neurology clinic about this. Perhaps
our neuro-opthalmologist on the List J Winterkorn may like to help you with
this one too.
I just found these old postings in my "eye problems file"
I will copy them for you below. I hope it's okay to do this???
Sincerely
Joy Graham
.............................................................
From: "Jacqueline Winterkorn, PhD, MD" <[log in to unmask]>
Subject: Ray cant keep eyes open
Comments: To: [log in to unmask]
Inability to open eyes in a PWP is typically caused by 1) apraxia of eyelid
opening, 2) blepharospasm, 3)diplopia avoidance, 4) dry eyes/blepharitis.
The first two can be treated with BOTOX injections. Diplopia can be
minimized with Fresnel prism or translucent occlusion of one spectacle lens;
4 requires artificial tears and lid scrubs. This is unlikely to be
caused by ptosis[droopy lids] since PWP are more likely to show lid
retraction than ptosis.
J WINTERKORN MD
Date: Sat, 22 Feb 1997 23:58:02 -0500
From: "Jacqueline Winterkorn, PhD, MD" <[log in to unmask]>
Subject: Re: blepharospasm
Comments: cc: Madge Hislop <[log in to unmask]>
Madge Hislop <[log in to unmask]>
Subject: Eye problems
Lane suffers from blepharospasm--forced eyelid closure. Recently he
has increasingly long periods when his eyes are clenched close and will not
open. I have found very little about this condition in the literature from
the American Parkinson Disease Association.
If any of you have experienced this problem would you tell us about
it. Have you found any helpful ways to eliminate the problem or alleviate
it?
Thanks,
Madge c/g for Lane 64/4
Madge:
Blepharospasm is a tight closure of the eyes that can interfere with seeing,
driving, reading, and functioning socially. Although it can be in reaction to
pain, dry eye, a foreign body in the eye, and other local phenomeona, it can
also result from an underlying neurologic problem, e.g. a facial dystonia ,
often progressive over time to involve the lower face as well as the eyes.
Blepharospasm and apraxia of eye opening are both reported in conjunction
with PD and I have seen patients with each of these. [Even pubished a paper
on the subject].
When blepharospasm is reactive, i.e. from dry eyes, lots of non-preserved
tears and punctal occlusion can help. [Of course, if one eye is closed, it's
likely diplopia avoidance and not blepharospasm.
For essential blepharospasm, the treatment of choice is Botulinum Toxin
[BOTOX or OCULINUM] injected into the eyelids. This is done right in my
office examining chair, takes only a few minutes, is reasonably painless,
and is marvelously effective. Unfortunately, it must be repeated every 3-4
months.
Since essential blepharospasm is a movement disorder, your PD specialist
should be able to treat it If not, there is a Blepharospasm society and
they can provide more info as well as the name of a treating physician in
your area.
Jacquie Winterkorn
