Parkinson's and Vision

        Yesterday I went to see an Ophthalmologist  for an eye exam and check up.  I have been having double vision lately. I think it is from the Gabapentin that I take for Sciatica pain. I am trying to lower my dose.

I had never gone to this eye doctor before.  I needed new glasses. I usually just went anywhere convenient, I went to Walmart or Lens Crafters, etc.  My retina specialist told me that I should also have a regular ophthalmologist in addition to him. I am rules oriented so I did what he told me and I went to see the eye doc.  She was really nice.  She told me that most people with PD don't wear bifocals or progressives. I have never been able to wear those types of glasses. Glare bothers me at night so that may be from my cataracts.  I have just had glare reducing regular prescription glasses. And I use readers that I usually buy at the dollar store or at TJ Maxx.  She wants me to get my cataracts out, I told her that I wanted to talk to my retina specialist first! I am falling apart here!! I went and filled my prescription at Walmart.  Below are vision changes that may be due to PD.
     
   Tomorrow I work with my speech therapist.  I really like her, I think we are almost finished with the  in home sessions.  We are almost finished with the SPeak Out program. I really wish I could go back to the Parkinson's Boxing class. I really enjoyed it but my sciatica pain was sky high when I participated in the class.  I am intending to go try again next week.
        Whenever I go somewhere, I have to remember to stand straight and NOT lean forward! I tell myself to stop leaning forward but I don't always LISTEN to myself!!! Now I have to remember to SPEAK UP because my speech therapist told me that I am not loud enough!
    I have so many blog readers that I am not going to post this on all of the PD sites any more.I'll continue to post it this week and occasionally on PD sites on other days here and there. Please follow my blog(www.positivewithparkinsons.blogspot.com) or read it on People With Parkinson's Facebook page or on my Facebook page!

• Double vision can occur due to medications or because the eyes have trouble working together, (convergence insufficiency). Special prism glasses can correct this.
• PD can cause dry eyes and decreased blinking.
• PD medication, especially anticholinergics, can cause blurry vision. There is a relationship between anticholinergic medication (trihexyphenidyl ― formerly Artane® or benzotropine ― Cogentin®) and dementia.
• Trouble reading, because eye movements necessary to follow the lines of a page are slowed and have trouble starting (similar to gait freezing in the legs).
• Blinking to change eye position. Levodopa can help.
• Trouble voluntarily opening the eyes, known as apraxia (treated with "lid crutches" or botulinum toxin injections).

Some people with PD notice as the disease progresses their vision loses sharpness. Difficulties related to the eyes and vision often progress alongside other PD symptoms. 
  Tips for Managing Vision Changes

• Regularly see your ophthalmologist for an eye examination.
• Get two pairs of glasses, one for distance, one for reading. This may be better than bifocals. Ask your ophthalmologist if prescribing prism glasses can help.
• Apply warm moist compresses or ointments for eyelid irritation.
• Use artificial tears to moisten dry eyes.
• Consider adding a neuro-ophthalmologist to your medical care team. This is a specialist, either an ophthalmologist or a neurologist, who has additional training in diagnosing and treating eye and vision problems associated with PD and other neurological diseases.

Uncommon Vision Conditions

It is not common for people with PD to experience involuntary closure of the eyes, but it does occur in some cases. This phenomenon is known as blepharospasm . Blepharo refers to the eyelid, and spasm is defined as an uncontrollable muscle contraction. 

PD causes a loss of retinal cells in the eye that rely on dopamine to process and perceive color. Parkinson's may also impact the eyelids. People with PD blink less frequently, which can lead to dryness, irritation or burning of the eyes. Sometimes it even causes blurred vision.