My Eyes! My Eyes! Parkinson’s Vision Problems

I began to notice I was having some issues reading. It was okay for about 10 minutes or so and then I would get a headache, the page became blurry, and my eyes would water.

I started having more trips, falls, and running into walls and corners. The latter were more alarming as I, being a Parkinson’s alarmist, saw the falls and corner jamming as a sign of rapid progression of my Parkinson’s.

At my next neurologist appointment at the Movement Disorder Center, I mentioned the increased clumsiness. She responded with, "How are your eyes?" I was thinking ... "Can’t stay on topic." After she explained about Parkinson’s vision problems, she referred me to a new set of specialists.

More specialists on my team

My first appointment was with a neuro-ophthalmologist specializing in Parkinson’s vision issues. After some magic with prisms on a stick, she said lack of dopamine was causing the muscles that move my eyes to no longer work in synch. This caused the muscles that focus my eyes to work incorrectly.

Armed with my diagnosis of diplopia, strabismus, and intermittent amblyopia, I was off to see an opthamologist specializing in Parkinson’s vision issues. This ophthalmologist did an eye exam and explained that prisms could be fitted on glasses to correct my problems. She opened a drawer with about 400 lenses.

After an hour of better or worse lens choices, I had prescriptions returning my vision to 20/10 along with the warning my vision would continue to change. I also was instructed to use eye drops and to give my eyes a rest every 10/15 minutes while reading.

What is the connection?

One study found that patients with Parkinson's had a higher rate of vision symptoms such as blurry vision, dry eyes, and trouble with depth perception, compared to people without Parkinson's. The study also found that these symptoms often interfered with daily activities.¹

In patients with Parkinson's, vision issues - along with balance issues and instability from the condition - may increase risk of falls or fall-related injuries.¹

Types of eye movement

There are 3 fundamental types of eye movements: pursuit, saccadic, and vergence.

Pursuit eye movements - These allow the eyes to travel together in the vertical or horizontal direction to follow movement. In Parkinson's, double vision can occur as a result of medications or because the eyes have trouble working together. Special prism glasses can help correct this.^2,3

Saccadic eye movements - This type of rapid eye movement allows the eyes to quickly jump to a new target. For example, they help the eyes jump from one line to the next when reading. People with Parkinson's may have trouble reading when this type of movement is slowed or difficult to start, similar to freezing of gait.^2,3

Vergence eye movements - This type of movement is used when a target is coming towards or away from a person. If a target moves towards a person, the eyes converge together slightly in order to keep vision clear. Double vision may occur in Parkinson's when a person's eyes do not work together.^2,3

What can I do?

What do you and I have to do to keep our vision working? Schedule periodic eye exams and be aware of any vision changes. Report any issues to your neurologist or ophthalmologist as soon as possible.

An ophthalmologist familiar with fitting prisms related to Parkinson’s vision issues is essential to best treatment. Follow instructions for medications and keep eye exercises.