People with Parkinson’s often experience problems with their eyes and eyesight as a result. But eye problems may also be unrelated to your Parkinson's.
Professionals who can help with eye problems
If you do experience eye problems there is a range of specialists who can help.
- Ophthalmologists – are medically trained doctors. They examine, diagnose and treat diseases and injuries in and around the eye. They also perform operations on the eye.
- Optometrists – examine eyes and give advice on visual problems. They also prescribe and fit glasses or contact lenses. They usually work in the high street, but may also work in a hospital eye service. Some have a role in caring for patients with stable, long-term (chronic) eye conditions.
- Orthoptists – diagnose and treat vision problems and abnormal eye movement. They are usually part of a hospital care team looking after people with eye problems.
Eye problems you may experience
Difficulty moving the eyes
Parkinson’s can affect your ability to move parts of the body, including your eyes. So you may have difficulties when starting to move your eyes or when trying to move them quickly.
It may be more noticeable when looking at a fast-moving object, such as when watching moving cars or a tennis match. Sometimes, instead of a smooth movement, your eyes may move in a slow and jerky way.
This can make certain activities, such as driving, more difficult. If this happens talk to your GP, specialist or Parkinson’s nurse because Parkinson’s medication may help.
Difficulties in moving the eyes up or down are more common in a condition called progressive supranuclear palsy (PSP), which is a form of parkinsonism (an umbrella term that describes many conditions that share some of the symptoms of Parkinson’s).
If you are experiencing this problem, your specialist or Parkinson’s nurse will be able to give you advice.
Blurred vision may happen when you start taking anticholinergic drugs and may improve with time as your body gets used to the medication. But it can also happen after you’ve been taking the drugs for a long time or when an adjustment has been made to the dosage.
If blurred vision continues or gets worse, consult your GP, specialist or Parkinson’s nurse. Don’t stop taking your medication before seeking advice.
If you wear reading glasses you may find it helpful to visit your optometrist. A slight change to your prescription might improve blurred vision.
Double vision is seeing 2 images of a single object some or all of the time. The 2 images may be on top of one another, side by side, or a mix of both. This is also often caused by problems moving the eyes.
Some people with Parkinson’s experience ‘tracking’.
This is when the eyes do not move smoothly across a line or from one object to another, for example moving across a page when reading, or up and down. Poor co-ordination and fatigue of the muscles that move the eyeballs can also mean that the eyes do not quite move together. This can cause double vision.
There are also causes of double vision (a common and usually minor eye condition) that are nothing to do with having Parkinson’s, such as thyroid problems, diabetes, or an astigmatism in one eye.
If the problem continues, see your optometrist for advice. or ask your GP or specialist if you can be referred to an ophthalmologist for further tests.
Slight changes in your glasses prescription may also help with this.
People with Parkinson’s may blink less often than other people. Blinking helps to clean the eyes by removing dust and dirt. If you blink less often these can build up, making the eyes dry or sore.
Dry eyes can have other causes, so see your optometrist for advice. They may suggest you try artificial tears. These are available from pharmacies and may help reduce discomfort and dryness.
Involuntary closure of the eyelids
This is also known as blepharospasm. It occurs when the muscle that closes the eyelid contracts or goes into spasm. This can cause repeated twitching of the eyelid or difficulty in keeping the eyelid open. Sometimes the eyelid may close completely.
In mild cases, simply rubbing the eyelids may help. Sometimes, injections of botulinum toxin (botox) are used to treat blepharospasm.
Blepharospasm is more common in parkinsonism than Parkinson’s. Your GP, specialist, or Parkinson’s nurse can offer you more advice.
Some people with Parkinson’s may have visual hallucinations. This is where they see things that aren’t there, such as flickering lights, objects, people or animals.
It is more common in those who have had Parkinson’s for a long time. It may be partly due to Parkinson’s itself and partly to the medication that is used to treat it. Older people and those with memory (cognitive) problems are more likely to have hallucinations.
If you are experiencing visual disturbances, your specialist may suggest reducing or changing your Parkinson’s medication. If the hallucinations keep happening there are other treatments that can help.
If you’re experiencing hallucinations, it is important to rule out causes other than Parkinson’s, such as poor eyesight or bad lighting. The sudden onset of hallucinations may also be due to an infection or other illness. Speak to your healthcare professional if you are having hallucinations.
Problems with low light levels
You may find that it difficult to see in low light levels (contrast sensitivity). You may also be unable to make out the shape of things clearly, such as a light-coloured object on a light background. This may also affect your ability to read fine print.
Some people with Parkinson’s may have difficulty telling the difference between some colours. This problem may be worse for shades of blue or blue/green. Your colour vision may improve with Parkinson’s medication.
Some people with Parkinson’s may have difficulty judging the space around them. They may not be able to judge the distance between objects, and may have problems when walking past objects or getting through a narrow space. Sometimes reaching out to touch the sides of doorways or other objects may help.
An occupational therapist may be able to help with advice about organising your home or work space to help you manage this problem. Speak to your GP, specialist and Parkinson’s nurse about a referral.
Problems with spatial awareness can affect driving as well as walking so you may have to give it up. You must tell DVLA if you’ve got any problem with your eyesight that affects both of your eyes, or the remaining eye if you only have 1 eye.
Find out more on the gov.uk webpage on driving eyesight rules.
Some people with Parkinson’s don’t see movement accurately, and seem unable to judge the speed of moving objects such as traffic. If you experience this problem, try to take extra care when crossing roads or when driving. Speak to your health professional for advice.
Problems with glasses
If you have Parkinson’s, your posture may become stooped. This can cause problems if you wear glasses. If you often lean forward, then you might find that you end up looking over your frames instead, or your glasses may slip down.
Your optician should be able to help you adjust your frames and lenses to suit your posture.
Glaucoma and Parkinson’s medication
Glaucoma is a type of eye disease that damages the optic nerve, which, if untreated, can lead to loss of sight.
‘Open-angle’ glaucoma is the most common type of glaucoma. It is called ‘open-angle’ because the angle between the iris and the cornea is open. If you have open-angle glaucoma there may be risks when using anticholinergic drugs.
Where there is no other option you should discuss the advantages and disadvantages of using them with an ophthalmologist or a Parkinson’s specialist, so that you can make a decision together about whether they’re the right treatment for you.
Anticholinergic drugs are not recommended for people who have the less common, closed-angle glaucoma, and levodopa (Sinemet and Madopar) should only be used with caution.
Some dopamine agonists can have side effects that affect the eyes. For instance, rotigotine is not recommended for people who have closed-angle glaucoma.
Yearly eye check-ups are recommended if you are using these drugs.
It is helpful if your Parkinson’s specialist and the ophthalmologist can work together when prescribing medication for you if you have glaucoma.
How often should I get an eye test?
If you have Parkinson’s, it is recommended that you attend regular eye exams with an optometrist, at least once a year, even if you aren’t experiencing any specific problems with your eyes.
You may find it helpful to tell them you have the condition, so they can look out for any related eye problems and make sure you’re comfortable during your appointment.
More information and support about eye problems
This website has been set up for the general public by the College of Optometrists. They have developed a set of patient information leaflets to give straightforward advice about some common eye problems. You can also search for optometrists in your local area.
An independent professional body that sets the standards and examinations for medical doctors aiming to become ophthalmologists, and provides surgical skills training.
The professional, scientific and examining body for optometry in the United Kingdom.