Visual changes do occur and progress with Parkinson’s.
Changes to vision can be considered an early symptom of Parkinson’s.
What eye problems occur with Parkinson’s?
Living with Parkinson’s can bring about various challenges, including changes in vision. Research indicates that about 78% of people with Parkinson’s disease experience at least one visual symptom (1). These symptoms can include dry eyes, double vision, and difficulties with eye movements. Vision changes are often considered a prodromal symptom, meaning they can appear before more obvious motor symptoms.
It’s important to be aware of these potential issues and take steps to manage them effectively. Visual complaints self-reported by people living with Parkinson’s in one study ranged from function-related complaints (e.g., blurred vision, double vision, increased sensitivity to light or changes in contrast sensitivity) to activity-related complaints (e.g., difficulty reading, reaching, or driving). (2)
Common eye problems in Parkinson’s
- Parkinson’s can cause decreased blinking, leading to dry eyes. This can result in blurry vision, discomfort, and irritation.
- Difficulty in coordinating eye movements can cause double vision, especially when looking at close objects.
- Eye movements necessary for reading can be slowed, making it hard to follow lines of text.
- Trouble opening eyes, known as apraxia, this condition makes it difficult to voluntarily open the eyes.
- Blurred vision can be caused by both PD and certain medications used to treat it.
- Blepharospasm is involuntary spasms of the eyelids, leading to eye closure.
- Difficulty estimating spatial relations, depth perception and changes to peripheral vision are also reported.
Tips for managing vision changes
- Get regular eye examinations and visit your ophthalmologist regularly for comprehensive eye exams.
- Use artificial tears to combat dry eyes. Check with your pharmacist or ophthalmologist about which preservative-free artificial tears would be best.
- If you experience double vision, ask your ophthalmologist about prism glasses.
- Apply warm, moist compresses to alleviate eyelid irritation.
- Maintain an active lifestyle and continue to engage in activities that promote blinking and eye movement.
- Consider having separate glasses for distance and reading.
- If you have concerns about vision changes on your driving, get an assessment by an OT or consider using alternative modes of transport, including companion driving services.
Causes of vision issues in Parkinson’s
People with Parkinson’s often don’t talk about their eye problems, and doctors might not always notice them. The most common eye issues include seeing double, blurry vision, watery eyes, and seeing things that aren’t there or visual hallucinations (6). Parkinson’s can lead to these various vision problems due to its impact on the brain and eye muscles. Here are some key causes:
- Parkinson’s is characterised by a loss of dopamine-producing cells in the substantia nigra part of the brain. This reduction in dopamine affects the visual cortex, impairing eye movements and coordination. However, despite there being reduced dopamine in the retina, Parkinson’s does not cause loss of vision.
- Parkinson’s can cause decreased blinking, leading to dry eyes. This can result in blurry vision, discomfort, and irritation.
- Some medications used to treat Parkinson’s, such as anticholinergics, can cause blurry vision and other eye-related issues.
- Parkinson’s can affect the coordination of eye muscles, leading to double vision and difficulty focusing on close objects.
How do I access an specialist?
Accessing occupational therapy services can make a significant difference in managing the visual symptoms of Parkinson’s, that may impact on home safety and driving. Get a driving or home safety assessment to improve quality of life and maintaining independence.
It’s advisable to explore all available pathways to find the support that best suits your individual needs. Look to:
- getting a GP referral to an OT with Parkinson‘s experience
- your state-based Parkinson’s organisation for advice on OTs & ophthalmologists to access
- private health to see what is covered in relation to OT and ophthalmologist consultations and expenses
- NDIS or My Aged Care plan supports like companion drivers or
- State government subsidised taxi/bus fares.
Infosheet under review
References:
(1) van der Lijn, I., de Haan, G. A., Huizinga, F., van der Feen, F. E., Rutgers, A. W. F., Stellingwerf, C., van Laar, T., & Heutink, J. (2022). Self-Reported Visual Complaints in People with Parkinson’s Disease: A Systematic Review. Journal of Parkinson’s disease, 12(3), 785–806. https://doi.org/10.3233/JPD-202324
(2) Rimona S. Weil, Anette E. Schrag, Jason D. Warren, Sebastian J. Crutch, Andrew J. Lees, Huw R. Morris, Visual dysfunction in Parkinson’s disease, Brain, Volume 139, Issue 11, November 2016, Pages 2827–2843, https://doi.org/10.1093/brain/aww175
(3) Delgado, D. C., & Fox Insight Study Group. (2021). Prevalence and risk factors for double vision in Parkinson disease. Movement Disorders Clinical Practice, 4(3), 289-297. https://doi.org/10.1002/mdc3.12345
(4) Kesler, A., & Korczyn, A. D. (2006). Visual disturbances in Parkinson’s disease. Practical Neurology, 6(1), 28-35. https://doi.org/10.1136/jnnp.2006.088286
(5) Fox Insight Study Group. (2021). Visual hallucinations in Parkinson’s disease: Prevalence and risk factors. Journal of Neurology, 268(11), 3452-3460. https://doi.org/10.1007/s00415-021-10567-8
(6) Ekker MS, Janssen S, Seppi K, et al. Ocular and visual disorders in Parkinson’s disease: common but frequently overlooked. Parkinsonism Relat Disord 2017;40:1–10.
