title: Ocular and visual disorders in Parkinson's disease: Common but frequently overlooked.
abstract: Patients with Parkinson's disease (PD) often compensate for their motor deficits by guiding their movements visually. A wide range of ocular and visual disorders threatens the patients' ability to benefit optimally from visual feedback. These disorders are common in patients with PD, yet they have received little attention in both research and clinical practice, leading to unnecessary - but possibly treatable - disability. Based on a literature search covering 50 years, we review the range of ocular and visual disorders in patients with PD, and classify these according to anatomical structures of the visual pathway. We discuss six common disorders in more detail: dry eyes; diplopia; glaucoma and glaucoma-like visual problems; impaired contrast and colour vision; visuospatial and visuoperceptual impairments; and visual hallucinations. In addition, we review the effects of PD-related pharmacological and surgical treatments on visual function, and we offer practical recommendations for clinical management. Greater awareness and early recognition of ocular and visual problems in PD might enable timely instalment of tailored treatments, leading to improved patient safety, greater independence, and better quality of life.
authors.affiliation: Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, The Netherlands.
authors.forename: Merel S
authors.initials: MS
authors.lastname: Ekker
authors.affiliation: Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, The Netherlands; University of Twente, MIRA Institute for Biomedical Technology and Technical Medicine, Biomedical Signal and Systems Group, Enschede, The Netherlands. Electronic address: sabineneuro.janssen@radboudumc.nl.
authors.forename: Sabine
authors.initials: S
authors.lastname: Janssen
authors.affiliation: Medizinische Universität Innsbruck, Department of Neurology, Innsbruck, Austria.
authors.forename: Klaus
authors.initials: K
authors.lastname: Seppi
authors.affiliation: Medizinische Universität Innsbruck, Department of Neurology, Innsbruck, Austria.
authors.forename: Werner
authors.initials: W
authors.lastname: Poewe
authors.affiliation: Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, The Netherlands.
authors.forename: Nienke M
authors.initials: NM
authors.lastname: de Vries
authors.affiliation: Radboud University Medical Centre, Department of Ophthalmology, Nijmegen, The Netherlands.
authors.forename: Thomas
authors.initials: T
authors.lastname: Theelen
authors.affiliation: Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Rehabilitation, Nijmegen, The Netherlands.
authors.forename: Jorik
authors.initials: J
authors.lastname: Nonnekes
authors.affiliation: Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, The Netherlands.
authors.forename: Bastiaan R
authors.initials: BR
authors.lastname: Bloem
mesh_terms: D006801:Humans; D010300:Parkinson Disease / Q000503:physiopathology*; D011788:Quality of Life; D014786:Vision Disorders / Q000503:physiopathology*; D014785:Vision, Ocular / Q000502:physiology*; D014795:Visual Pathways / Q000503:physiopathology*; D014796:Visual Perception / Q000502:physiology*
keywords: Clinical management; Parkinson’s Disease; Visual disorders