Objective: To review the burden of eye pathologies in patients with Parkinson’s disease.

Background: Parkinson’s disease and eye problems are common in older patients. Alterations in contrast sensitivity, colour discrimination, blinking, eye movements, medications and Lewy bodies may all contribute towards poor visual acuity and perception1. Cataract, age related macular degeneration (ARMD) and glaucoma may also affect visual acuity. It is often difficult to differentiate between the different causes of visual impairment due to overlapping pathologies2.

Methods: Patients were identified from their clinic attendances on electronic patient record (EPR) and letters were accessed from Cubescribe between July and November 2017. Data was collected on an excel spreadsheet recording demographics, duration of PD, history of stroke, eye pathology (cataract, glaucoma, age-related macular degeneration (ARMD), visual hallucinations (VH)) and dementia.

Results: 61 patients with Parkinson’s disease (28 males and 33 females) average age of 82.2 years (range 69-91 years) were included. The average duration of PD was 6.42 years ranging from 0.08 to 30 years. 27 out of 61 patients (44.26%) had eye problems as listed in [table 1]. The major problem was visual hallucinations (51.85%) followed by a combination of eye diseases (29.62%). Cataract was present in 14.8% and ARMD in 3.7% patients. However, 34 patients (55.7%) had no recorded eye pathologies but may have retinal involvement due to Parkinson’s disease.

Conclusions: This study highlights that visual problems are quite common in older people with Parkinson’s with visual hallucinations being the most prominent because of cortical Lewy bodies. However, new evidence suggests retinal pathology should also be considered to look at early deterioration in visual acuity2. Enquiry regarding vision should be included in each consultation and referral to specialist centres for electroretinogram in patients with decreasing visual acuity should be considered.

References: 1R. A. Armstrong, “Visual symptoms in Parkinson’s disease,” Parkinson’s Disease, vol.2011, pp. 1-7, 2011. 2N. K. Archibald et al, “The retina in Parkinson’s disease,” Brain, vol.132, pp.1133-1139,2009.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/burden-of-eye-disease-in-parkinsons-disease-pd/