Patients With Parkinson Disease At Increased Risk Of Vision Eye Issues Study Shows
Patients with Parkinson disease were found to be more likely to experience vision and eye issues, such as blurry vision, dry eyes, trouble with depth perception, and problems adjusting to rapid changes in light, compared with people without the disorder, according to study findings.
Patients with Parkinson disease were found to be more likely to experience vision and eye issues, such as blurry vision, dry eyes, trouble with depth perception, and problems adjusting to rapid changes in light, compared with people without the disorder, according to study findings published in Neurology.
In patients with PD , irregular eyesight can prove a chief issue, as ophthalmologic disorders combined with postural and gait instability from the disorder may increase the risk of falls and fall-related injuries, noted the study authors.
Risk of vision impairment is potentially common for PwP because PD is linked with retinal dopamine depletion and decreased dopaminergic innervation of the visual cortex, which can lead to visual problems such as diminished oculomotor control, contrast sensitivity, color vision, and visuospatial construction. PwP are also at increased risk for seborrheic blepharitis and keratoconjunctivitis sicca .
In PwP with ophthalmologic symptoms, 68% reported that it interfered with daily activities, compared with 35% of controls .
How Parkinsons Affects Your Eyes
Eye Movement Problems
There are three fundamental types of eye movements.
- Pursuit eye movementsallow the eyes to travel together to follow a moving target in the horizontal or vertical direction.
- Saccadic eye movements are the rapid eye movements that allow the eyes to quickly jump to a new target. They are important when reading as the eyes need to jump from the end of one line and to the beginning of the next.
- Vergence eye movements are used when the target is coming towards or away from a person. When the target comes towards a person for example, the eyes have to move slightly together, or converge, to keep vision of the target clear.
In PD, the saccades tend to be slow, which means reading can be difficult if the eyes are unable to find the correct place on the next line. If a person has Levodopa-induced dyskinesias, the saccades can become fast and erratic which can also be problematic.
Another common eye movement issue for people with PD is difficulty with vergence eye movements. In PD, the eyes are often not able to come together sufficiently as a target draws near. This is called convergence insufficiency, which can cause double vision, especially when focusing on near tasks. This problem can also affect a persons ability to read.
Eye movement solutions
In terms of complementary and alternative therapies, art therapy has been seen to alleviate some of the vision effects associated with Parkinsons disease.
Abnormalities of blinking
External eye disease
How Often Should I Get An Eye Test
If you have Parkinsons, its recommended that you have an eye test with an optometrist at least once a year. You should try to do this even if you arent experiencing any problems with your eyes.
You must tell the DVLA if you have any problem with your eyesight that affects both your eyes, or the remaining eye if you only have one eye.
For more information visit www.gov.uk/driving-eyesight-rulesor call 0300 790 6806.
For Northern Ireland visit www.nidirect.gov.uk/articles/driving-eyesight-requirements or call 0300 200 7861.
You can also speak to your GP, specialist or Parkinson’s nurse for advice.
Also Check: Parkinsons And Genetics
Difficulty Reading & Other Pd
The quick eye movements that allow the eyes to shift to a new vision target can slow down as Parkinsons disease progresses. Should this happen, it can be difficult for seniors with PD to follow words on a page as they go from one line to the next while reading. Older adults with Parkinsons may also experience other vision problems involving: The ability to follow moving targets in a side-to-side direction Blinking to change eye positionLevodopa, the most common PD drug, may help The ability to see a target coming right at the eyes Difficulty voluntarily opening/closing eyes possible solutions include doing eyelid crunches or having Botox injections
There are a variety of age-related health conditions that can make it more challenging for seniors to live independently. However, many of the challenges they face can be easier to manage if their families opt for professional home care services. Rhode Island families can rely on expertly trained caregivers to keep their loved ones safe and comfortable while aging in place. Trust your loved ones care to the professionals at Home Care Assistance. To create a customized home care plan for your loved one, call 284-0979 today.
Excessive Watering Of The Eyes
People with Parkinsons can experience this for several reasons, including infrequent blinking due to impaired reflexes. Infrequent blinking stimulates the lacrimal gland resulting in excessive watering. Irritation can also be a cause and this is often eased by using eye lubricants.
If the watering does not settle your neurologist may refer you to an ophthalmic surgeon. Botulinum toxin A injections into the lacrimal gland may also help.
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Types Of Eye Movements
There are three kinds of eye movements that can change with PD:
- Saccadic rapid eye movements direct us to gaze at a specific object or to read lines of print.
- Pursuit eye movements allow us to follow an object as it moves.
- Vergence eye movements allow us to move our eyes in different directions2
Changes to these eye movements due to Parkinsons can also result in different kinds of visual difficulties. The inability to control eye movements can lead to involuntary blinking, double vision and other motor issues that can affect visual acuity.
Dry eyes can be treated with drops or ointments, warm wet compresses, but are not generally cured. The blink reflex can be impacted by PD. This manifests as either a slowing of the reflex, appearing as inappropriate staring, dry or burning eyes and by reduced vision. Blepaharospasm and apraxia are two common eyelid motion issues. Blephararospasms are eyelid spasms that cannot be controlled, cause eyelids to squeeze, and can be relieved with Botox injections. Apraxia is a condition that makes it difficult to open eyes. There are specialized lid crutches and cosmetic tape that can be applied to hold the eyelids open.2
What Are The Surgical Treatments For Parkinsons Disease
Most patients with Parkinsons disease can maintain a good quality of life with medications. However, as the disease worsens, medications may no longer be effective in some patients. In these patients, the effectiveness of medications becomes unpredictable reducing symptoms during on periods and no longer controlling symptoms during off periods, which usually occur when the medication is wearing off and just before the next dose is to be taken. Sometimes these variations can be managed with changes in medications. However, sometimes they cant. Based on the type and severity of your symptoms, the failure of adjustments in your medications, the decline in your quality of life and your overall health, your doctor may discuss some of the available surgical options.
Also Check: Parkinson’s Medicine Side Effects
Screening Tests And Recommended Treatments
We recommend starting the examination by excluding severe visual impairment. This can be done by briefly testing the near visual acuity . This is an excellent screening test since it is easy to administer and because only few significant disorders leave visual acuity unaffected. Above the age of 45, appropriate reading glasses are required for normal near vision. Reading acuity as well as reading speed are good predictors of everyday visual function . Moderate vision impairment can be defined as < 6/24 on the visual acuity test and severe vision impairment as < 6/60 . Dopaminergic medication may influence visual acuity, causing refraction changes during the medication cycle. Therefore, some patients may need adapted glasses depending upon the medication phase. Referral to an ophthalmologist is advised in case of significant vision impairment.
Difficulty Moving The Eyes
You may have difficulties when starting to move your eyes or when trying to move them quickly. This might be more noticeable when looking at fast-moving objects, such as cars. Sometimes, instead of a smooth movement, your eyes move in a slow and jerky way. Difficulties in moving the eyes up or down are more common in progressive supranuclear palsy than Parkinson’s.
Increased Urination Urgency And Frequency
Bladder problems are a common occurrence in people with Parkinsons, occurring in 30-40 percent of people with the disease. The most common urinary symptom is a frequent and urgent need to urinate even when the bladder is empty, as well as trouble delaying urination.
Trouble emptying the bladder is a less common feature of Parkinsons urinary dysfunction. It may be caused by difficulty in relaxing the urethral sphincter muscles that allow the bladder to empty.
How Is Blurred Vision Treated
The cause of your blurred vision will be diagnosed using various eye tests and a physical examination of your eyes. If an underlying medical cause is suspected, you may also have a blood test.
The treatment of your blurred vision will depend on the cause. It might include eye drops, laser surgery or medicines.
If you have blurred vision, you may need to wear glasses or contact lenses.
Recommended Reading: What Are Early Warning Signs Of Parkinson’s Disease
Common Causes Of Dizziness And Vertigo In Parkinsons And How To Treat Them:
In people with early Parkinsons disease , the dizziness has in many cases linked to a lower Montreal Cognitive Assessment score raising the possibility that dizziness may be a non-movement symptom associated with cognitive decline .
Dizziness or vertigo can be tied to many causes and is not unique to Parkinsons. Symptoms can be caused by medications, low blood pressure, anxiety, cold, flu, dehydration, heart conditions and more. Tell your doctor immediately if you regularly experience dizziness or vertigo.
Page reviewed by Dr. Michael S. Okun, Parkinsons Foundation Medical Director, Professor and Chair, Department of Neurology, Executive Director of the Fixel Institute for Neurological Diseases a Parkinson’s Foundation Center of Excellence.
Parkinsons Awareness Month And Your Vision
The Parkinson’s Foundation has announced this years theme: #KeyToPD and Parkinson Canada advocates the same involvement. What is the key to living a high quality of life while living with Parkinsons? Patients, doctors, caregivers, and families are encouraged to use this hashtag on social media to give of their knowledge and experience.
In order to successfully manage the disorder, its essential to understand the disease, symptoms, and treatments. After all, knowledge is power.
Also Check: Is Parkinsons Deadly
What Is Parkinsons Disease
Parkinsons disease is a nervous system disease that affects your ability to control movement. The disease usually starts out slowly and worsens over time. If you have Parkinsons disease, you may shake, have muscle stiffness, and have trouble walking and maintaining your balance and coordination. As the disease worsens, you may have trouble talking, sleeping, have mental and memory problems, experience behavioral changes and have other symptoms.
Ocular Motor And Sensory Function In Parkinson Disease
The purpose of this paper is to evaluate the effect of dopaminergic medication and deep brain stimulation on ocular function in Parkinson Disease and to measure vision-elated quality of life in subjects with PD. The conclusion is that convergence ability is significantly poorer in PD subjects in both on and off states compared with controls, but significantly improves with systemic dopaminergic treatment. Ocular motor function in PD subjects fluctuates in response to treatment, which complicates ophthalmic management. PD subjects have a significant reduction in vision-related quality of life, especially near activities, that it not associated with visual acuity.
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When Double Vision Is An Emergency
Seek immediate treatment in the emergency room or call 911 if double vision symptoms are accompanied by:
- Memory loss
- Loss of sensation or movement in your arm or leg
- Loss of consciousness
- Inability to move one or both eyes
- Vision loss
- Blood appearing just beneath the surface of your eye
- In rare cases, double vision can be a symptom of a brain injury, tumor, or skull fracture
Treatment For Parkinsons Disease
There is currently no cure for the disease itself, but there are options to treat the symptoms of PD. A combination of medications, physical and/or occupational therapy, support groups, and of course, top-quality vision care can give a PD patient relief for some of their symptoms and tools to help cope with the condition.
Research and clinical trials are continuing as doctors and others in the medical community work towards the goal of finding a cure for PD.
No two patients are alike, and each can experience PD differently from the other, so finding what works for you or your loved one is key. During this Parkinson’s Awareness Month, share your #KeyToPD and give your loved ones hope for a healthy and high quality of life.
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How Is Parkinsons Disease Treated
There is no cure for Parkinsons disease. However, medications and other treatments can help relieve some of your symptoms. Exercise can help your Parkinsons symptoms significantly. In addition, physical therapy, occupational therapy and speech-language therapy can help with walking and balance problems, eating and swallowing challenges and speech problems. Surgery is an option for some patients.
Ocular And Visual Disorders In Parkinsons Disease: Common But Frequently Overlooked
This literature search covering 50 years reviews the range of ocular and visual disorders in patients with PD and classifies these according to anatomical structures of the visual pathway. It discusses six common disorders in more detail, reviews the effects of PD-related pharmacological and surgical treatments on visual function, and offers practical recommendations for clinical management.
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How Does Parkinson’s Cause Vision Issues
Parkinsons is characterized by a loss of dopamine producing cells in the substantia nigra portion of the brain. The reduction of dopamine can affect the visual cortex. So Parkinsons can impair mobility of the eyes just like the limbs. There are several kinds of visual disturbances that may be experienced by people with Parkinsons. Many who experience changes in vision or eye mechanics seek out a consultation from a neuro-opthalmologist, someone who specializes in visual problems associated with neurological disease.2
There Are Many Types Of Professionals Who Can Help
While there are no proven ways to prevent most ocular conditions from developing, routine visits with an eye care professional can lead to early recognition and treatment of eye issues before they harm your quality of life. Between you, your neurologist, and an ophthalmologist, most visual complaints can be handled. However, when symptoms remain unchanged and unexplained, consultation with a neuro-ophthalmologist is probably warranted.
A neuro-ophthalmologist is either a neurologist or an ophthalmologist with fellowship training in neuro-ophthalmology. Neuro-ophthalmologists have a unique appreciation for the intersection of the eyes and the brain and perform comprehensive testing in the office to determine where a visual or eye movement problem could originate. Once the location of the disturbance is identified, diagnostic testing , treatments, and therapies can be customized depending on the individual and their concerns.
While your eye care professional may not be aware of common ocular symptoms that people living with Parkinsons experience, explaining the kinds of situations and triggers that bring on eye symptoms is usually enough for your physician to know where to look during the examination . Keeping a journal or diary of symptoms can also be helpful for both you and your physician.
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Vision: More Than Meets The Eye Tricks To Aid Pd Patients
Retired neurologist and young onset Parkinsons patient, Dr. Maria De León reminds us that vision is integral to our quality of life and safety, especially with respect to driving. She lists 11 common eye problems with PD, and a few uncommon ones. They may be helped by adjusting medications, with special lenses, or artificial tears. See your doctor to find out.
Coping With Vision Problems From Parkinson’s
Despite the struggles caused by this degenerative disease, there is hope. Talk to your eye doctor. He or she may recommend medicated ointments or drops, injections, therapeutic lenses, visual aids, vision therapy, or a combination thereof. Additionally, a Neuro-Optometric Rehabilitation doctor can provide comprehensive eye care specifically designed for neurological disorders like PD.
Vision Problems May Be Common In People With Parkinsons Disease
The American Academy of Neurology is the world’s largest association of neurologists and neuroscience professionals, with 36,000 members. The AAN is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer’s disease, stroke, migraine, multiple sclerosis, concussion, Parkinson’s disease and epilepsy.
What Causes Parkinsons Disease
Parkinsons disease occurs when nerve cells in an area of the brain called the substantia nigra become impaired or die. These cells normally produce dopamine, a chemical that helps the cells of the brain communicate . When these nerve cells become impaired or die, they produce less dopamine. Dopamine is especially important for the operation of another area of the brain called the basal ganglia. This area of the brain is responsible for organizing the brains commands for body movement. The loss of dopamine causes the movement symptoms seen in people with Parkinsons disease.
People with Parkinsons disease also lose another neurotransmitter called norepinephrine. This chemical is needed for proper functioning of the sympathetic nervous system. This system controls some of the bodys autonomic functions such as digestion, heart rate, blood pressure and breathing. Loss of norepinephrine causes some of the non-movement-related symptoms of Parkinsons disease.
Scientists arent sure what causes the neurons that produce these neurotransmitter chemicals to die.