Each person who gets diagnosed with Parkinson’s experiences the disorder differently. Parkinson’s comes with a baggage of symptoms that vary from tremors, sleeping disorders, stiffness, and swallowing problems to vivid dreams and hallucinations. There are several underlying conditions that alter the progression of the disease. For example, the food we consume and our overall gut health influences brain function and how people cope with Parkinson’s.
Parkinson’s also has an effect on the person’s vision. To learn more about this, we spoke to Dr. Elfride Sanjana, an ophthalmologist. She discusses a series of effects and underlying conditions that influence or indicate a progression of the disorder.
Common conditions in people with Parkinson’s
Here are some of the common vision-related symptoms that people with Parkinson’s may experience:
Visual hallucination
When a person sees an object without it actually being present, it is known as a visual hallucination. It occurs due to dopamine agonists and can be extremely disturbing to the person. People with Parkinson’s may experience visual hallucinations due to medication or due to the worsening of the disorder.
Visuospatial orientation
Visuospatial orientation refers to our ability to walk in a room of people, furniture or other things without bumping into them. People with Parkinson’s may have a weakened visuospatial orientation due to the low levels of dopamine in their eyes.
Colour vision contrast sensitivity
When you walk from a bright room into a dim one or vice versa, your pupils adjust almost automatically to make it easy for you to see. However, reduced dopamine levels in people with Parkinson’s makes it difficult for them to adjust in a new lighting.
Blepharospasm
The eye lid can remain closed for an extended period of time if Parkinson’s reaches a critical level. Patients may require an injection of Botulinum toxin or artificial tear drops to treat this condition.
Blepharitis
Blepharitis is dandruff-like scales on the eyelashes. To reduce the symptoms mix 2-3 drops of baby shampoo with lukewarm water and use earbuds to lightly scrub the eyelashes at night with eyes closed. Accompany this with artificial tear drops, for at least a month to effectively reduce the discomfort. Visit an ophthalmologist in cases of redness, pain or irritation.
Gaze palsy
Gaze palsy causes the eye to remain fixed in one direction and the blink rate to slow down. This can be caused by PD, and is accompanied by tear evaporation, dryness, and reflex tearing. Furthermore, age can weaken the muscles that pump tears, resulting in increased tearing.
Why do people with Parkinson’s find it hard to read?
Blurring vision makes it difficult for people with Parkinson’s to read. However, there are several other underlying conditions that may contribute to this problem:
Dry eyes
The ocular surface can be affected by a decrease in dopamine levels in the eyes, resulting in a decrease in blink rate. This can lead to an increase in evaporation of the tear film, reduced tear secretion, burning sensations, and the sensation of dust in the eyes.
Colour vision and contrast sensitivity
Colour vision is the ability to differentiate between different shades and hues of colour. However, with Parkinson’s, if an object has low contrast in comparison to its background, it can be difficult to spot. This issue is known as contrast sensitivity and can even make reading difficult. Fortunately, Neuro physicians can help by adjusting the PD prescription.
Convergence insufficiency
Due to a dopamine deficiency, the eye muscles don’t work together, leading to convergence insufficiency. People with PD find it hard to fix and focus on a particular point. One method to tackle this is to take short breaks instead of reading continuously. closing one eye and reading, or using separate glasses for reading and distance.
Loss in saccadic movement
Saccadic slowing down causes difficulty when shifting the focus from one part of the visual field to another. While adjustments to PD prescriptions may provide some relief, it can be difficult to achieve a complete cure.
How to manage vision-related conditions?
Here are some ways that may help bring relief to people with Parkinson’s experiencing vision-related issues:
Alter PD prescription
Vision-related issues may rise due to PD medication. Work with your neurophysician to understand its effects and alter the medication. An ophthalmologist cannot change the medication prescribed by a neurophysician.
Check for Glaucoma
Glaucoma is a condition that leads to an imbalance in eye pressure. The condition is not caused due to PD. It is vital to communicate this condition to your neurophysican as anti-cholinergic drugs cannot be prescribed to Glaucoma patients. Sharing your full medical history will help determine the best course of medication.
Other underlying conditions
Not all vision-related issues rise due to Parkinson’s. Some patients may have issues like cataract, diabetes, hypertension or ARMD (Age Related Muscular Degeneration). A vision problem rises over several weeks or months. It is vital to regularly get your eyes checked and take the necessary course of action.
Day-to-day changes
Avoid dusty environments or use glasses if such environments are unavoidable. Artificial tear drops can be effective in comforting the eyes and must be accompanied with wet hygiene. Avoid making changes to your house settings as adjusting to new environments may be difficult. Lastly, use separate spectacles for reading and distance.
