Parkingson's Disease Guide

Eye Disorders & Vision Problems in Parkinson’s Disease

Although tremor and rigidity are the typical symptoms of a patient with Parkinson’s disease, eye problems are quite common too, and are important because they can interfere with the quality of life of a person. When faced with eye disorders or vision problems in patients with Parkinson’s disease, it is important to bear in mind that some of these conditions may not be related to Parkinson’s. Old age, poor eyesight, complication from other chronic conditions, like diabetes, may impact on the eyesight in any person, even when Parkinson’s disease is not present.

Types of Eye Problems in Parkinson’s Disease

  • Blurred vision or difficulty in focusing may be due to difficulty in moving the eyes or due to the side effects of Parkinson’s drug therapy, especially anticholinergics. This problem may occur on starting treatment with anticholinergics, but normally improves over time. It may also occur with long-term treatment with anticholinergics or after some dose adjustments.
  • Double vision usually occurs in Parkinson’s disease due to problems in moving the eyes in alignment from side to side, such as when reading. This occurs as a result of impaired coordination and fatigue of the muscles moving the eyeballs.
  • Excessive tearing (lachrymation) of the eyes.
  • Dry eyes is caused by reduced blinking of the eyes.
  • Difficulty in moving the eyes may be manifested in two ways : (i) difficulty in starting a movement of the eyes or (ii) problem with moving the eyes quickly when following a fast moving object. Instead of moving smoothly, the eyes move in a slow and jerky way. Driving a vehicle may pose difficulties.
  • Sensitivity to contrast – there may be difficulty in seeing in dim light, or making out light colored objects against a light background, or difficulty in reading fine print.
  • Color vision may be affected for differentiating between slight color differences, especially for shades of blue or blue-green.
  • Problem with visuo-spatial orientation or depth perception – the person may have difficulty in assessing the distance between objects and may need to reach out to touch the sides of the wall or objects while walking through a narrow place. This may create problems while walking or driving.
  • Glaucoma and anti-Parkinson’s medication – levodopa and anticholinergics should be used with caution in patients with glaucoma.
  • Some patients with Parkinson’s disease cannot judge the speed of moving objects, which may be dangerous if driving or trying to cross the street.
  • Hallucinations and illusions or visual misinterpretations are more likely to occur in those people who have had Parkinson’s disease for a long time. It may be due to the disease itself or due to anti-Parkinson drugs.
  • Blepharospasm or involuntary spasm of the eyelids.

Treatment of Eye Problems in Parkinson’s Disease

  • Blurred vision – modification of anticholinergic medicine dose and adjustments in power if wearing glasses.
  • Double vision – improves with anti-Parkinson medicines and by resting the eye.
  • Dry eyes – using artificial tear drops and avoiding dry, hot and smoky places.
  • Difficulty in moving the eyes – usually improves with anti-Parkinson drugs.
  • Sensitivity to contrast – improves with treatment by levodopa.
  • Color vision – problem may improve with anti-Parkinson medicines.
  • Hallucinations – reducing the dose of anti-Parkinson drugs and use of neuroleptics such as clozapine and quetapine.

12 Responses to “Eye Disorders & Vision Problems in Parkinson’s Disease”

  1. jane murray says:

    Is there an Ophthalmologist in Phoenix, Az that specializes in P.D eye problems?

    • Dr. Chris says:

      Hi Jane Murray

      Unfortunately we cannot provide you with the details of any such practitioner. Ask your general practitioner or specialist physician for a referral in your area.

  2. Diana Conrad says:

    Can Parkinson’s cause your vision to go really bright, like the light is way to bright?

    • Dr. Chris says:

      Hi Diana

      Light sensitivity is possible, however, it is important to verify if it is a side effect of any drug that you are using.

  3. Marianne says:

    I am the next of kin of my ex-husband who has schizophrenia, parkinsonism and perhaps now epilepsy because of numerous falls. He has been moved from a mental health residential care home to a nursing home, category dementia, much against my will.
    It is a big place and the corridor where his room is is usually unlit. He gets lost, finds the different colours difficult to negotiate. I am fighting the authorities to have him moved to a mental health nursing home.
    He is very confused at times and does hallucinate (differently from the hallucinations of schizophrenia, I think), but is orientated in time, place and people a lot of the time too. Is there any information that I could put forward to make some of the decision makers understand that some symptoms of confusion are not necessarily dementia?

  4. ann says:

    First let me say your ex husband is lucky to have you, and you sound like a wonderful person.

    The problem with having both PD and schizophrenia is one results from too little dopamine and the other from too much, and this is where his Parkinsonism is that it is so difficult to get the balance right. Presumably if his dopamine levels are low then he is more coherent and more with it, although not able to move as well as normal? Which do you think he would prefer, Parkinsonism and no schizoid behavior, or no P’sm and off the wall behavior or dementia? I have PD and know I would choose that rather than the symptoms of dementia.

    Marianne, you so badly need to talk to a sympathetic medic, and with one on your side go political, talk to your congressmen, your Mayor, whooever – it is your right and your ex husband will thank you, AND you will know you have done all you can, and maybe it would be enough to get him back out of the nursing home.

  5. Cindy says:

    My father has a problem with his eyes and I am wondering if it has something to do with him not blinking his eyes as often as he used to. He gets a thick white matter that “strings” across his eyeball and is extremely hard to remove. I have tried eye drops, which help a bit, but it is quite a process and in the morning, must be dealt with before he will get up for breakfast or to take his medication. Any suggestions as to what might be causing the problem and how we might prevent it or make it not so debilitating?

  6. Barry Apfelbaum says:

    Is it a symptom of the disease or a side effect of the medication to be constantly mistaking a tree trunk for a medieval knight? It seems funny but in fact it can be very disturbing. usually it comes into focus as a depth perception issue .

  7. Shery says:

    My 82 year-old mother has Parkinson’s disease. Over the past few years, and more often now, she closes her eyes extremely tightly and seems to be almost frozen in that position. The first time I saw her do this, I wondered if she was in pain. Sometimes I see her do this when there appears to be too many “distractions” around, i.e., more people than she’s used to. I have been researching to see if this is typical of people with Parkinson’s disease and have not had much luck. Has anyone else observed this in a Parkinson’s patient? Could this simply be that my mom is trying to cry or to shut out vision problems?

  8. Kay says:

    My 82-year-old mother was diagnosed with PD 12 years ago and is now in later stages. She recently bought new prescription eyeglasses with prisms. But she can only read for a short time before words get distorted. She’s trying drugstore reading glasses as her doctor suggestion. Any other suggestions for helping her vision to read?

  9. Laura says:

    My 79 year old father has PD he has been having a problem with his eyes. He has to pry his eyes open. He has gone to numerous eye doctors and specialists. When he first went to the first optic nuerologist. He mentioned botox he did it every 3 months for a year and a half sometimes it worked for a little while than others nothing. Than went to another optic nuero and he did it alittle different. Lets just hope this one works. He is total wheelchair bound and runs into walls someday he is going to hurt himself bad, He wants his independence. Which can blame him. Has anyone else tried botox.

  10. john says:

    while driving one day I started to have doublevision.I couldnt drive well so I called my doctor and went to a ER.They thought i was having a stroke and gave me the works.I told them I had PD and it might be a drug problem.I didnt know at the time how common DV is with PD.I also have some depth perception problems.
    I guess eye problems with PD are very average,I just wish doctors would read up on PD people and save us alot of uneeded anxiety.
    I also think this came about because I was having a off period when the drugs wernt working well.

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