Tulip Times, No 144, January – March 2013
Parkinson’s and Eyes
People with Parkinson’s may experience a range of problems with their eyes and eyesight. Some problems are related to the Parkinson’s or the drugs used to treat it. It is important to remember that difficulties with eyesight may be due to other factors.
Double vision in Parkinson’s may be caused by problems of tracking (eyes moving in alignment from side to side). Impaired co-ordination and fatigue of the muscles that move the eyeballs can mean that the eyeballs do not move together in alignment. The problem of double vision may be improved by medication to treat Parkinson’s. Resting the eyes for a while may help.
People with Parkinson’s often blink less frequently. Artificial tears (available from a pharmacist) can help reduce discomfort and dryness.
People with Parkinson’s may find that they have an inability to move the eyes quickly with the eyes moving in a slow, jerky way. These difficulties often improve with Parkinson’s medication. The inability to move the eyes quickly can have implication for activities such as driving.
Visual misinterpretations and visual hallucinations can be associated with Parkinson’s. They can be related partly to Parkinson’s itself and partly to the medication that is used to treat it. A reduction of the medication is usually the first line of treatment. It is important to remember that visual misinterpretations or illusions may not be linked to Parkinson’s. The sudden onset of hallucinations or illusions may be due to infection.
Some people with Parkinson’s may have difficulty judging the space around them. They may not be able to correctly assess the distance between objects. An occupational therapist may be useful with advice about organising space and carrying out everyday activities.
Physiotherapists look at a wide range of Parkinson’s movement concerns. There are many cues and movement strategies that can be practised and used to make every day movement easier – but not all at once!
Medication is only one part of managing Parkinson’s disease.
Getting out of a chair and a car properly (one of the main reasons for loss of independence) is often challenging. People with Parkinson’s tend to sit with the pelvis tilted backwards, so that getting out of a chair is difficult, tending to cause more stiffness and balance problems on standing.
Complied by Stevie Ferguson
In stages – sitting upright, placing hands carefully and not moving right to the edge as that increases knee flexion too far. Leading with the chin as far forward as possible, before pushing up can be successful.
To help someone out of a chair, stand at the weaker side, with your closer leg next to theirs, then gently push the trunk forward – do not pull up – just push forwards, holding one hand as the person rises.
If you are driving, which hand do you pull the seat belt down with? If you pull with the left hand, you have a longer and more efficient movement available) and less repetition strain in the right shoulder).
Another car safety issue – don’t reach into the back seat to lift something forwards.
Complied by Ann Buchan – Neurophysiotherapist at Unley Physiotherapy