At 11:20 am 02/07/97 -0400, Val Parnell wrote:
>My dad 65/10 is having a lot of problems getting new glasses and I
>think it might have something to do with PD. I remember reading somewhere
>about double vision and other eye related problems but can't remember
>where!!!!
Hello Val,
I was looking for and found information about vision problems for
our resource centre a while ago, so am sending a couple now. I also have
articles about Dry Eye Syndrome, Blephoraspasm, and others. If you are
interested, e-mail me privately and I will gladly send them to you. :)
Judith Richards <[log in to unmask]>
June 1997
VISION PROBLEMS
(excerpts from PARKINSON'S DISEASE - THE COMPLETE GUIDE FOR
PATIENTS AND CAREGIVERS)
- by Abraham N. Lieberman M.D. and Frank L. Williams
The sense of sight is controlled by tiny muscles and nerves,
some of which may be affected by both PD and drug therapy.
Parkinson's disease itself does not cause loss of vision or
blindness. If there are marked difficulties with eye movement,
a diagnosis other than, or in addition to PD should be
considered.
Patients with PD report difficulty reading, blurred vision
when looking closely at objects, and occasionally double
vision. A decrease in night vision also occurs in some cases.
In many PD patients, the eyes move with a kind of cogwheeling
rigidity similar to the abnormal tone that is felt in the
muscles of the limbs of patients with PD. The patient has to
work hard to make out the sequence of letters and words and
moving down the page to the next line. The problem is impaired
co-ordination of the muscles that move the eye. The eyes also
freeze, festinate, and travel slowly across the printed page.
In addition to being affected by the disease itself, vision
may be disturbed by some of the anti-Parkinson medications,
including anticholinergics. They will cause the pupils to
widen slightly, resulting blurry vision. Double vision may
result when the muscles don't control the eyes well enough and
they look at two different points in space.
Parkinson's disease patients may also develop bloodshot,
irritated eyes which feel crusty and may burn and itch,
commonly known as conjunctivitis. This occurs because the
normal blinking-wetting activity of the eyelids diminishes.
TREATMENT
Vision problems caused by PD are usually alleviated with
Sinemet therapy: otherwise a reduction of anticholinergics may
be in order. If conjunctivitis occurs, a physician can
recommend a brand of artificial tears or another wetting
solution available at a pharmacy. If vision problems make
reading difficult, listening to books on cassettes might be
considered. These are available at most libraries and
bookstores.
VISUAL SYMPTOMS OF PARKINSON'S DISEASE
PD does not affect the optic nerves, the nerves that receive
visual impressions. Because PD can affect the muscles that
move the eyes, however, some patients complain of having
reading difficulty. In addition, some drugs that are used to
treat PD, particularly the class of drugs called
anticholinergic agents, may constrict the pupils , causing
blurry vision. A decrease in the number of times per minute
patients blink their eyes may lead to other
vision-related problems. The normal "windshield wiper effect"
of blinking - the wiping away of debris such as dust, smoke,
or other irritants - is lost. Conjunctivitis (inflammation of
mucous membrane that covers the front eye and lines the inside
of the eyelids) may result.
