Parkinson’s and the Eyes

Parkinson’s is a condition that mainly affects movement, but some people can also experience difficulties with their eyes. These may become more common as the Parkinson’s progresses. The most commonly reported problems are blurred vision, double vision, excessive watering of the eyes and dry eyes, but sometimes the problems can be less specific, such as a general difficulty with reading. As with many other aspects of Parkinson’s, these problems may be exacerbated by fatigue.

While some eye and vision problems may be related to the Parkinson’s itself, others may be caused by anti-Parkinson’s medication. It is also important to remember that many problems with vision will not be related to the Parkinson’s at all and instead will have a different cause such as age-related visual problems, poor eyesight or perhaps some other co-existing condition. If you have any difficulties with your eyesight you should have them checked out.

Blurred Vision/Difficulty Focusing

Blurred vision in Parkinson’s can be caused by difficulty in moving the eyes, but it can also be caused by a side effect of anti-Parkinson’s drugs, particularly the anticholinergics. This group of drugs includes Cogentin and Artane. The problem of blurred vision often occurs when anticholinergic drugs are first taken, and it may improve in time. It can also occur when the drugs have been taken for a long time or when an adjustment has been made to the dose of drugs. If blurred vision persists or worsens, consult your doctor, who might suggest a reduction in the dose of antocholinergic medication. If you already wear reading glasses, a slight modification to these might improve blurred vision. Your ophthalmic optician should be able to advise you about this. Modifying reading glasses is probably more appropriate for people who are settled on a drug regime that suits them and which is likely to be relatively long-term.

Double Vision

Double vision in Parkinson’s is often caused by problems in moving the eyes and, in particular, by problems of tracking. ‘Tracking’ refers to the eyes moving in alignment from side to side: for example, moving across a page when reading, or up

and down. Impaired coordination and fatigue of the muscles that move the eyeballs can mean that the eyeballs do not move together in alignment. This can cause double vision. The problem of double vision is usually improved by the medication that is used to treat Parkinson’s. Resting the eyes when double vision occurs is sensible and should provide relief.

There can be other causes of double vision which are unrelated to Parkinson’s. If the problem persists, consult an ophthalmologist (doctor that specializes in the care of the eyes) so that further investigations can be carried out.

Dry Eyes

People with Parkinson’s often find that they blink less frequently. Blinking helps to cleanse the eyes, by removing dust and impurities. If the rate of blinking is reduced these impurities can build up, making the eyes dry or sore. Artificial tears, which are available from a pharmacy, can help reduce discomfort and dryness. Avoiding dry, hot and smoky atmospheres can also help. The reduced rate of blinking and build up of impurities may, on rare occasions, lead to conjunctivitis. The treatment for this is usually with antibiotics from the doctor.

Difficulty Moving the Eyes

This may be noticed as a difficulty in beginning a movement of the eyes or an inability to move the eyes quickly. It may be more evident when looking at a fast moving object such as in motor racing or watching a tennis match. Sometimes the smooth movement of the eyes is impaired and instead they move in a slow and jerky way. The inability to move the eyes quickly can have implications for activities such as driving. Advice should be sought from your doctor. Difficulties in moving the eyes are usually improved by Parkinson’s medication. Marked difficulties in moving the eyes up and down is characteristic of a condition called Progressive Supranuclear Palsy, which is a form of parkinsonism. If you are experiencing this problem, your doctor is the best person to offer further advice.

Involuntary Closure of the Eyelids

This problem is called is called blepharospasm. It can occur in people who have Parkinson’s, but it is very rare. Blepharospasm suggests a parkinsonism rather that idiopathic Parkinson’s—your doctor is the best person to offer advice.

4