According to the Parkinson’s Disease Foundation, Parkinson’s Disease (PD) difficulties related to the eyes and vision often progress alongside other PD symptoms. Some vision difficulties are related to changes in the movement of the eyeball. These are motor symptoms, similar to other motor symptoms that are caused by loss of dopamine neurons.
Someone with PD may experience changes in motor symptoms such as:
- Blurred, double vision, and eye strain because the eyes have trouble moving together to focus on things traveling toward or away from them.
- Trouble reading because the eye movements that are needed to follow the lines on a page are slowed down. Those people may also have trouble with scanning the paper to start reading at the appropriate spot on the page. This is a type of visual scanning problem.
- A need to blink, in order to change the position of the eyes.
- Trouble opening the eyes voluntarily. This is also known as apraxia.
- Eyelid spasms or dystonia. This can also categorize blepharospasms when it entails excessive blinking of the eyes.
Someone with PD may also experience changes in perception such as:
- Decreased sensitivity to contrast (color and brightness) making their vision less sharp. This is caused by the loss of dopamine neurons in the eye’s retina.
- Altered color vision. This is a sort of color blindness of the blue-yellow in the spectrum.
- Difficulty with judging distance as well as difficulty knowing the position of one’s body parts.
- An impaired ability to read other people’s facial expressions.
- Visual hallucinations
A Neuro or Low Vision specialist trained Occupational Therapist can help provide compensatory strategies for both the motor and perceptual deficits with PD. Some treatment examples for visual deficits are listed below.
- If there is trouble opening the eyes voluntarily, lid tape may be used to help hold the lids open for functional activities. This should be introduced ONLY by trained professionals.
- If one has blepharospasms, using a sensory trick (such as a quick wipe of the eyelid from inner to outer aspects of the lid) can calm the blinking.
- If one has visual scanning problems, using anchor strategies is important. Using an anchor, such as a colored piece of tape, in the direction of the limited visual field can be helpful to increase recognition. For instance, you can put it on the edges of steps or stairs, on the side of a doorway or on the page when reading.
- Utilizing increase in visual contrast throughout the day. For instance, use of bright colored placement underneath your plate or use of increased contrast accessibility option on computer/tablet.
- Avoid visual over-stimulation in the house. An increase in visual clutter can worsen perceptual difficulties.
- Give your eyes a break. When using your eyes for strenuous activities (such as spending time on the computer), make sure you allow appropriate rest periods for your eyes to avoid over-stimulation.
- Utilize a line tracker for reading if needed to increase the ease with tracking and decrease visual over-stimulation.
If you have PD, consider adding a Neuro-Ophthalmologist to your medical care team. This is a specialist, which has additional training in diagnosing and treating problems with the eyes and with vision changes that are associated with PD and other neurological diseases. Also, check with your Parkinson’s physician to discuss further as these vision changes could be related to PD medications the patient is on.
Written by: Kimberly Roach, OTS
Edited by: Heather Simpson, MOT, OTR/L
Goetz C, Koller W, Poewe W. Management of Parkinson’s disease: an evidence-based review. Mov Disord. 2002;17(Suppl 4):1–166.
Daniel Gold, D.O. (2015). More Than Meets the Eye: Vision Symptoms of PD. Retrieved from http://www.pdf.org/en/vision_parkinson