APDA American Parkinson Disease Association
Information & Referral Center

Vision in PD

Relevant Publications - Downloadable

“Eyes and Parkinson’s”
Published by Parkinson’s UK, July 2015
This 5-page information sheet looks at the difficulties some people with Parkinson’s can experience with their sight.  It looks at the range of symptoms that can affect eyesight, the causes of these problems, available treatment and advice on eye care.


“Neuro-opthalmology and Parkinson’s Disease,” by Andrew A. Berman, MD
Published by the American Parkinson Disease Association, 2011
This 4-page Educational Supplement (#17) confirms the frequency of oculomotor and opthalmic complaints in PD.  Referral to a neuro-opthalmologist, either a neurologist or ophthalmologist with additional training in problems of the eye and nervous system, is recommended.  There is an explanation of eye movements, external eye disease, and sensory deficits common in PD, as well as a discussion on management of these issues.


“Vision and Parkinson’s"
Published by Parkinson’s Australia, April 2014
This 2-page fact sheet explains that bradykinesia may result in several vision changes, as can impaired electrical signals and feedback in the brain.  It discusses each visual change and what can be done to help, as well as a brief discussion of glaucoma and PD. Changes to vision may impair mobility and increase risk of falls.  Not all vision problems are related to PD.


Relevant Online Information

“Ask the MD: Vision and Parkinson’s Disease,” by Rachel Dolhun, MD
Published by the Michael J. Fox Foundation, Foxfeed Blog, October 27, 2015
This webpage explains the visual problems that are due to Parkinson’s disease, the medications used to treat it, or to unrelated conditions of the eye or eyelid.  If you have visual problems, don’t assume it is due to either aging or Parkinson’s.  Address it with your doctor to maintain your ability to read, drive, and walk steadily to reduce your risk of falling.


“Eye & Vision Issues,” by Dr. Andrew Berman
Published by the American Parkinson Disease Association
This single page resource defines neuro-opthalmologist and common ophthalmic complaints in Parkinson’s disease.  It explains how Parkinson’s disease affects three fundamental types of eye movements, and contributes to external eye disease and sensory deficits.  Finally there is a brief discussion of managing these ophthalmic issues.


“Smell and Vision Difficulties”
Published by Parkinson’s Victoria
Only two paragraphs about the loss of smell in Parkinson’s precede nearly a dozen eye problems and vision difficulties for people with Parkinson’s and useful tips for coping with them.  Of note is a paragraph suggesting that those with glaucoma may have problems with anticholinergic medication and levodopa.


“Vision: More than Meets the EYE! Tricks to Aid PD Patients,” by Dr. Maria De Leon
Published by defeatparkinsons.com, August 9, 2015
This webpage, written by neurologist and Parkinson’s patient, Dr. maria De Leon, reminds us that vision is integral to our quality of life and safety, especially with respect to driving.  She lists 11 common eye problems with PD, and a few uncommon ones.  They may be helped by adjusting medications, with special lenses, or artificial tears.  See your doctor to find out.


“Vision Changes”
Published by the Parkinson's Foundation
This webpage identifies six common difficulties with the eyes associated with PD and aging, tips for managing them, as well as the uncommon condition, blepharospasm (involuntary closure of the eyes), several potential causes (not related to Parkinson's) anda bit about the botulinum toxin (Botox) injections that treat it.


Relevant Online Lectures and Webinars

“More Than Meets the Eye: Vision Symptoms of PD”
By the Parkinson’s Disease Foundation (Now the Parkinson's Foundation), 2015
In this 68-minute webinar neuro-opthalmologist Dan Gold discusses common eye movement disorders in Parkinson’s disease and provides practical advice for coping with vision issues at home and with your health care team.


"My Parkinson's Story: Visual Disturbances"
By the Veteran's Administration
This 6-minute video alternates between an interview with a man and and doctors. The man shares his vision changes due to Parkinson's disease. The doctors explain that the muscles of the eyes develop a tremor in those with Parkinson's disease, causing blurry vision. Parkinson's medication reduces eye tremors by 75-90%, but eye exercises and reading are also beneficial.


“Your Vision and PD - Patient Seminar”
By the Parkinson’s Institute, July 9, 2012  
This is a 4-part lecture by Stanford neuro-opthalmologist, Dr. Y. Joyce Liao.  Part one is 10-minutes to explain that reduced dopamine affects the eyes and can result in difficulty with vision.  Part two is 15-minutes explaining normal eye function and testing for eye health and visual acuity, ending with a chart of the areas of the brain involved in vision, overlapping with those parts of the brain affected in PD.  Part three is 12-minutes about normal eye movement, coordination between the eye and brain, and several audience questions.  Part four is 20-minutes explaining PD eye difficulties: convergence, double vision, and square wave jerks, as well as the problems these cause with driving.


Expert-Level Resources

“Ocular and Visual Disorders in Parkinson’s Disease: Common but Frequently Overlooked,” by Merel S. Ekker, et.al., Parkinsonism & Related Disorders, July 2017
This literature search covering 50 years reviews the range of ocular and visual disorders in patients with PD and classifies these according to anatomical structures of the visual pathway.  It discusses six common disorders in more detail, reviews the effects of PD-related pharmacological and surgical treatments on visual function, and offers practical recommendations for clinical management.


“Ocular Motor and Sensory Function in Parkinson Disease,” by Zina Almer, et. al.
Opthalmology, January 2012
The purpose of this paper is to evaluate the effect of dopaminergic medication and deep brain stimulation on ocular function in Parkinson Disease (PD) and to measure vision-elated quality of life in subjects with PD.  The conclusion is that convergence ability is significantly poorer in PD subjects in both “on” and “off” states compared with controls, but significantly improves with systemic dopaminergic treatment.  Ocular motor function in PD subjects fluctuates in response to treatment, which complicates ophthalmic management.  PD subjects have a significant reduction in vision-related quality of life, especially near activities, that it not associated with visual acuity.


“Ophthalmologic Features of Parkinson’s Disease,” by Dr. V. Biousse, et.al, Neurology, January 27, 2004
This paper is a systematic evaluation of the ocular complaints and ocular finding of 30 PD patients with early untreated PD, and 31 control subjects without neurologic or known ocular diseases.  The ocular abnormalities found more commonly encountered by PD patients frequently respond to treatment.  Abstract and access to the full article.


“Visual Disturbances in Parkinson’s Disease,” by Barack Samuel
Journal of Neurology, November 10, 2009
This article reviews several papers that have been published describing ophthalmological abnormalities, including problems with visual function, ocular movements, and visual hallucinations, as well as complications of drug therapy or neurosurgical interventions.


“Visual Symptoms in Parkinson’s Disease,” by R.A. Armstrong
Parkinson’s Disease, May 25, 2011
An overview of visual problems likely to be encountered in PD.  If visual problems are present, they can have an important effect on the quality of life of the patient, which can be improved by accurate diagnosis and where possible, correction of such defects.


This list of resources was updated in January 2018. It was first compiled by Denise Dagan for the Stanford's Parkinson's Community Outreach Program, February 2017.

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