Parkinson’s disease (PD) is a progressive neurological disorder that affects the nervous system and other parts of the body. Different parts of the body are controlled by nerves and portions of the brain that are impacted by the disease. Motor and non-motor symptoms can develop depending on which region of the brain and/or body is affected. Some symptoms can also develop as side effects to medications taken to help improve dopamine levels for individuals with Parkinson’s, as well as reduce other symptoms associated with the disease.
A 2016 study by Weil et al. found that close to 80% of individuals diagnosed with Parkinson’s will develop at least one vision symptom. If these symptoms develop, they can impact one’s ability to perform daily activities and navigate around their environment. This can negatively impact one’s life. Examples of vision changes can be:
Double vision
Dry eyes
Blurred vision
Eye movement problems
Trouble reading
Difficulty voluntarily opening eyes and blinking difficulties
Spatial awareness issues
Hallucinations
Color contrast issues
Our vision is one of our three main balance systems. When vision is impaired, our balance can be affected. We can use depth perception as an example. If an individual’s depth perception is impacted due to vision changes from Parkinson’s, this can impact their spatial awareness and ability to safely navigate their environment. This can lead to increased episodes of freezing, increased risk for falls, and an increased risk of falling, which can impact one’s ability to drive and operate machinery if their job entails it. Depth perception changes can also impact coordination and contribute to delayed reaction times.
Now, these symptoms may seem overwhelming or scary to think about. Fortunately, there are methods to address each of these symptoms. Medications can help address some symptoms such as dry eye, color and contrast changes, hallucinations, difficulty voluntarily opening eyes, and blurry vision. If an individual with PD is noticing vision changes, they should contact their doctor. They may refer the individual to an Optometrist, Ophthalmologist, Orthoptist, or Neuro-ophthalmologist. Neuroophthalmologists specialize in treating vision changes caused by neurological diseases. These specialists are medical professionals trained in working with vision impairments and can help find solutions to your specific symptoms.
According to multiple sources, including Fox Rehab, there are several tips for individuals with Parkinson’s and visual impairments in the home setting.
Increasing light is an excellent way to improve quality of life by allowing people to see flooring transitions between rooms and shadows, improving their navigation around their environment.
Magnification can be used, such as larger prints for books, on the phone, etc.
Using auditory cues to turn on lights around the homes versus having to find the light switches (ex., Asking “Alexa” or “Siri” to turn on the lights for you). Auditory cues, in general, can also help reduce freezing and improve ambulation in individuals with PD.
Reduce glare and improve contrast by using lampshades, blinds, or sheer curtains to reduce glare on floors. Increasing contrast between surfaces can also be beneficial to see the change and reduce the likelihood of catching feet/tripping. This can be done with brightly colored tape to floors or stairs where the colors all blend together and are difficult to see the change in surfaces.
These tips are great for creating a safer home environment for someone with visual impairments!
Physical therapy can also help! Since vision is a main part of the balance system, physical therapy (PT) can help improve your other balance systems to help compensate for vision impairment, improve stability, and reduce one’s fall risk. PT can also help people with Parkinson’s and visual impairments by providing ways to reduce freezing if it occurs, improving one’s ability to react appropriately. PT can also help improve coordination and reaction times to improve balance reactions and room navigation, which may be impacted if depth perception changes occur. Good lighting can help to bring awareness to obstacles in a room and improve one’s ability to see them.
The vestibular system may also cause eye impairments—another main balance system! The vestibular system helps control eye movement by working with our visual system to keep us balanced. Vestibular physical therapy is a specialty that focuses on improving eye control to reduce symptoms such as dizziness or imbalance caused by changes in eye and head positioning. Improving this balance system can help reduce one’s reliance on the visual system, which may be impacted.
If you have any questions about whether physical therapy may be beneficial to you, feel free to reach out! Wellness 360 Physical Therapy and Massage specializes in neuro-rehabilitation, focusing specifically on Parkinson’s disease, multiple sclerosis, ataxia, and post-stroke diagnoses. Check us out at www.wellness360fitness.com.
References:
2016 study Weil et al. - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5091042/
