OCULAR MOTILITY IN PARKINSONS-DISEASE

Introduction: Parkinson's disease is associated with multiple abnormal ities of both the afferent and efferent visual systems. Blepharospasm, paucity of blinking, apraxia of lid opening, visual neglect, reduced vergence, reduced upgaze, and blurred vision are reported findings in these patients. The association of these findings with the disease, an d their duration, severity, and treatment have not been systematically investigated. Patients and Methods: Patients with Parkinson's disease were prospectively examined. An age-matched control group was recruit ed from accompanying family members and volunteers. Data recorded incl uded presence of visual complaint, the severity of the Parkinson's dis ease by Hoehn and Yahr Stage (scale=1 to 5), duration of disease, phar macologic therapy, visual acuity, ocular motility, accommodation, conv ergence amplitudes, and the near point of convergence. Results: Thirty -nine patients were entered into each group, each with 21 men and 18 w omen. The average patient had had the disease for 8.9 years with a sev erity index of 2.6. Asthenopia, upgaze deficiency, and convergence ins ufficiency were significantly more common in the patients with Parkins on's disease than in the controls. Mean geometric visual acuity was po orer in the Parkinson's patients (20/39 compared with 20/28; P<.001). Discussion: Visual complaints were significantly more common in the Pa rkinson's patients than in the age-matched controls. The frequency of ocular abnormalities was not related to the duration of the disease. I ncreasing severity seemed to be correlated with the presence of conver gence insufficiency and a decline in acuity.