Eye problems

If you're experiencing problems with your eyes, you should speak to your GP, Parkinson's nurse or specialist. They can make a referral to an eye specialist if needed.

If you need tests or treatment for your eyes, it's a good idea to tell the eye specialist that you have Parkinson’s. This is so they can look out for Parkinson's-related eye problems and make sure you receive the right care and support.

Who treats eye problems?

• Optometrists examine eyes and give advice on visual problems. They also prescribe and fit glasses or contact lenses. Some provide ongoing care for people with long-term eye conditions.
• Ophthalmologists are medically trained doctors. They examine, diagnose and treat diseases and injuries in and around the eye.
• Orthoptists diagnose and treat vision problems and abnormal eye movement. They usually work as part of a hospital care team.

Occupational therapists can also help people with eye problems manage at home and at work, by advising on strategies and recommending adaptations and equipment. Find out more about occupational therapy.

How often should I get an eye test?

If you have Parkinson’s, it’s recommended that you have an eye test with an optometrist at least once a year. You should try to do this even if you aren’t experiencing any problems with your eyes. 

You must tell the DVLA (or the DVA if you live in Northern Ireland) if you have any problem with your eyesight that affects both your eyes, or the remaining eye if you only have one eye. 

For more information visit www.gov.uk/driving-eyesight-rules or call 0300 790 6806. 

For Northern Ireland visit www.nidirect.gov.uk/articles/driving-eyesight-requirements or call 0300 200 7861. 

You can also speak to your GP, specialist or Parkinson's nurse for advice.

Difficulty moving the eyes

You may have difficulties when starting to move your eyes or when trying to move them quickly. This might be more noticeable when looking at fast-moving objects, such as cars. Sometimes, instead of a smooth movement, your eyes move in a slow and jerky way. Difficulties in moving the eyes up or down are more common in progressive supranuclear palsy (PSP) than Parkinson's.

Blurred vision

Blurred vision can be caused by difficulty moving the eyes. It can also be a side effect of Parkinson’s drugs, particularly anticholinergics (such as procyclidine), but may improve with time as your body gets used to the medication. Blurred vision can also happen after you’ve been taking anticholinergics for a long time, or when the dosage is changed. If you wear reading glasses, a slight change to your prescription might improve blurred vision. 

Double vision

Double vision is when you see two images of a single object at once. This can happen for varying amounts of time. The two images you see may be on top of each other, side by side, or a mix of both. Some people with Parkinson’s experience ‘tracking’. This is when the eyes have problems moving smoothly across a line or from one object to another. 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 might also help with double vision.

Dry eyes

People with Parkinson’s may blink less often than other people. Blinking helps to remove dust and dirt, so if you blink less often these can build up, making your eyes dry or sore. But dry eyes can have other causes, so see your optometrist for advice. They might suggest you try artificial tears, which are available over-the-counter.

Involuntary closure of the eyelids (eyelid apraxia)

Eyelid apraxia occurs when the muscles that open the eyelids have trouble opening. This often happens during speech. Sometimes the eyelids might close completely and stop you being able to see properly. In mild cases of eyelid apraxia, simply rubbing the eyelids might help. Sometimes, injections of botulinum toxin (Botox) are used to treat eyelid apraxia. Speak to your specialist for advice.

Problems with low light levels

You might find that it’s difficult to see in low light levels. You may also be unable to make out the shape of things clearly, such as a light-coloured object on a light background. This can also affect your ability to read small print.

Colour vision

Some people with Parkinson’s have difficulty telling the difference between certain colours. This problem may be worse for shades of blue or blue/green. You might find that your colour vision improves with Parkinson’s medication.

Spatial awareness

You might have difficulty judging the space around you. You may find it difficult to judge the distance between objects, which can make it harder to move between pieces of furniture or through narrow doorways. An occupational therapist can advise you on managing this problem.

Difficulty seeing movement

You might not see movement accurately, and seem unable to judge the speed of moving objects such as cars. If you experience this problem, try to take extra care when crossing roads or when driving, and speak to your health professional for advice.

Problems with glasses

Some people with Parkinson’s find that their posture becomes stooped, which causes problems if they wear glasses. If you often lean forward, then you might find that you end up looking over your frames instead, or your glasses slip down. Your optician should be able to help you adjust your frames and lenses to suit your posture.

Glaucoma is a type of eye disease that damages the optic nerve. If left untreated it can lead to loss of sight. 

If you have glaucoma, you might have problems with some Parkinson’s medications, such as anticholinergic drugs and levodopa. So you must tell your specialist or Parkinson’s nurse if you have this condition.

‘Open-angle’ glaucoma is the most common type. If you this condition, there may be risks when using anticholinergic drugs. Where there is no other option but to take anticholinergic drugs, your ophthalmologist or Parkinson's specialist can discuss the advantages and disadvantages of taking them with you.

For people with the less common 'closed-angle' glaucoma, anticholinergic drugs are not recommended and levodopa (co-beneldopa and co-careldopa) should be used with caution. 

Some dopamine agonists can have side effects that affect the eyes. The dopamine agonist rotigotine is not recommended for people who have closed-angle glaucoma.

It’s helpful if your Parkinson’s specialist and ophthalmologist can work together when prescribing your medication if you have glaucoma.
 

Look After Your Eyes

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.

Royal College of Ophthalmologists

An independent professional body that sets the standards and examinations for medical doctors aiming to become ophthalmologists, and provides surgical skills training.

College of Optometrists

The professional, scientific and examining body for optometry in the United Kingdom.