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.
I tried to attach a paper I presented to other Neuro-ophthalmologists this
March on how to diagnose and treat the visual problems of PWP, but the server
tells me it can't accept it because it is too long...
.
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.
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.
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] downgaze is especially impaired and
fixation instability [ 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.
[ While on the subject of glasses, astigmatic correction may be impossible to
tolerate and you may experience less blurring with the spherical equivalent.]
5. It's hard to read when your head is shaking or you cant hold a book
still. Try a music stand or a cookbook holder, and adjust the reading glasses
for the right distance.
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.
Just yell and I'll try to help.
Jacquie
[Jacqueline M.S. Winterkorn, Ph.D., MD
[log in to unmask]
Neuro-Ophthalmology
900 Northern Blvd.
Great Neck, NY 11021]
