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 Is it worth seeing a neuro-opthalmologist? 
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Joined: Fri May 28, 2010 4:46 pm
Posts: 119
Location: Salem, Oregon
Post Is it worth seeing a neuro-opthalmologist?
My mom has LBD with Parkinson's, and although she has both motor and cognitive difficulties, her primary complaint is blurry vision. My dad has taken her to an opthalmologist at least 3 times in the past few months (2 or even 3 different ones), but they keep saying that her eyes are fine and her prescription hasn't changed. The last time she saw an opthalmologist, he told my dad that there were 2 tests that could determine what is causing her vision issues but that nothing could be done to fix the problem. Now my dad wants to pursue this with a neuro-opthalmologist. I think this is pointless, but I hope I'm wrong. Should I encourage my dad to go ahead and try to get a referral to one, or is there no hope for fixing this?


Wed Jul 14, 2010 10:30 pm
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Joined: Fri Jan 15, 2010 9:33 pm
Posts: 3395
Location: Vermont
Post Re: Is it worth seeing a neuro-opthalmologist?
Hi - this has been discussed somewhere on the forum recently - I know because I made some of the postings about my dad. His vision comes and goes because of his neurological disorders. I don't remember anyone saying that there was a fix for the symptoms but I could be wrong. We also talked about our LOs' hearing doing the same thing - sometimes it's very acute, sometimes he is almost stone deaf, as are several others' LOs.
I'd do some research before I took my LO to yet another dr. If there is a chance that something could help the symptom, then it sure would be worth it, but if it's just another "this is happening because he has PD or LBD, but we can't make it better" I probably wouldn't go. It gets pretty depressing when you hear that from several different drs. Sorry I don't know if there are meds for this or not, I just know that this seems pretty common from the reading I've done and I don't remember there being a "fix" for it. Sometimes my dad thinks he's watching a sports game and one of his CG has turned on a soap opera! LOL Lynn

_________________
Lynn, daughter of 89 year old dad dx with possiblity of LBD, CBD, PSP, FTD, ALS, Vascular Dementia, AD, etc., died Nov. 30, 2010 after living in ALF for 18 months.


Wed Jul 14, 2010 10:54 pm
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Joined: Fri Aug 11, 2006 1:46 pm
Posts: 4811
Location: SF Bay Area (Northern CA)
Post Re: Is it worth seeing a neuro-opthalmologist?
Sometimes having an appt with a specialist can give the patient and/or caregiver peace of mind that an MD has seen this problem before, it's related to a neurological condition, and there are a few ways to somewhat address the problem. You can find a neuro-ophthalmologist on nanosweb.org.

Have you tried eye drops for the blurry vision?


Thu Jul 15, 2010 2:30 am
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Joined: Fri May 28, 2010 4:46 pm
Posts: 119
Location: Salem, Oregon
Post Re: Is it worth seeing a neuro-opthalmologist?
Before posting I'd done an extensive search and found the discussion about vision and hearing, but I didn't see anything about treatment so wanted to ask specifically if anyone knows of anything that can be done to help. It doesn't sound promising. I'll ask my dad if my mom has tried eyedrops. Yesterday I was able to get her November appointment with her neurologist at OHSU moved up to August 10, so I'll encourage my dad just to wait and talk with that doctor about it.


Fri Jul 16, 2010 12:01 pm
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Joined: Fri Aug 11, 2006 1:46 pm
Posts: 4811
Location: SF Bay Area (Northern CA)
Post Re: Is it worth seeing a neuro-opthalmologist?
The only discussion I'm aware of on the Forum as to the treatment of blurred vision is an eye doctor (not a neuro-ophthalmologist) from Michigan State who presented on the topic of visual impairments in PD during a webinar a year or more ago. I'm sure eye drops were mentioned as a common treatment for blurred vision but there may be other things also. Did your Forum search bring up the notes from that webinar?

I don't know if any of the medical journal articles we've posted about on here on the topic of visual impairments has any info on treatment, but that would be another place to look.


Fri Jul 16, 2010 2:20 pm
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Joined: Fri Aug 11, 2006 1:46 pm
Posts: 4811
Location: SF Bay Area (Northern CA)
Post Re: Is it worth seeing a neuro-opthalmologist?
There's a researcher in the UK named Richard Armstrong who publishes extensively on visual symptoms in Parkinson's Disease and some of the other parkinsonism syndromes. I can across a reference to a 2008 article he wrote on visual signs in PD. I assume it addresses blurred vision. Perhaps you can find it (or purchase it online). The citation is:

Armstrong RA. Visual signs and symptoms of Parkinson's disease. Clin Exp Optom 2008; 91: 129–138

You can read the abstract for free at PubMed (pubmed.gov).


Sun Jul 18, 2010 1:22 am
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Joined: Fri Aug 11, 2006 1:46 pm
Posts: 4811
Location: SF Bay Area (Northern CA)
Post Re: Is it worth seeing a neuro-opthalmologist?
And here's another reference that discusses defects in visual acuity in DLB:

Bashir K, Elbe RJ, Ghabrial M, Struble RG. Hemianopsia in dementia with Lewy bodies. Arch Neurol 1998; 55: 1132–1135.

Because it's an older article, it may be available for free. Start with PubMed.


Sun Jul 18, 2010 1:37 am
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Joined: Fri Aug 11, 2006 1:46 pm
Posts: 4811
Location: SF Bay Area (Northern CA)
Post Re: Is it worth seeing a neuro-opthalmologist?
And another one:

Brett FM, Henson C, Staunton H. Familial diffuse Lewy body disease, eye movement abnormalities and distribution of the pathology. Arch Neurol 2002; 59: 464–467


Sun Jul 18, 2010 12:10 pm
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