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Vision problems
lovedogs1955 posted:
I have been noticing lately that after I do close-up activities, such as reading or similar things, that I have blurry vision in my right eye. Interestingly, my PD tremor started on my right side several years agol Any advice on coping? I saw my Opthalmologist a few months ago and got my new Rx eyeglasses.
Mark A Stacy, MD responded:
Hi, lovedogs1955,
I do not think that your vision change represents a PD symptom. Most visual symptoms from PD are associated with changes in eye muscles, not the eye itself. Some people may notice involuntary eye closing or some double vision, particularly when changing eye movements from near to far.
lovedogs1955 replied to Mark A Stacy, MD's response:
Thanks! It's nice to get more concrete information about the eye and PD.
njladyluck responded:
Dr. Stacy,

I also have problems with my eyes. I have blurred vision and sometimes double vision. Also my right eye turns to the right and I cannot focus it. My first Rx. was Azilect and my eyesight was the first symptom that got better. Azilect worked for about 6 months and then I started getting depressed, rigid, slow and my blurred vision, loss of control of the muscle in my right eye came back and then I started taking Sinemet and my blurred vision and focusing improved. I know that others on the PD support website I frequent complain of blurred and double vision as well.

I looked it up and the substantia nigra where Parkinson's happens is located in the mesencephalon or midbrain that is responsible for response to sight, eye movement and pupil dilation. Why wouldn't then one have to do with the other?

I am grateful the meds work to relieve me of my eyesight symptoms but it is very troublesome considering that I need to be able to continue working and have a job that requires my constant reading.
Mark A Stacy, MD replied to njladyluck's response:
Hi, njladyluck
You are correct that there is some influence on vision from structures in the mesencephalon. This part of the brain controls eye movement, and treatment can sometimes restore double vision.

The retina, or the area of the eye responsible for site is composed of 5 different cell types. One of them, the ganglion cell, works through the neurotransmitter --- DOPAMINE, same as in PD. The vision problems low dopamine produces is difficulty with focus or detection of a sharp line - kind of like a pixillated computer screen.

Another way vision can be blurred is from dry eyes as a result of decreased blinking. Eye drops are important for this reason.
njladyluck replied to Mark A Stacy, MD's response:
Thank you Dr. Stacy!!! This definitely helps me understand what is going on. The meds help with the focusing but after long bouts on the computer the blurred vision bothers me. Now I can explain to my boss what is happening when I complain of blurred vision and problems with focusing. My boss just didn't understand and I am sure he will understand your explanation.

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