Parkinson’s disease is a slow progressive disorder of degeneration of the substantia nigra within the brain resulting in dysfunction of motor organization which affects posture, balance, and speech. In early stages, it often produces a tremor of the limbs and/or jaw that can increase over time. Vision can be affected, and visual complications will often reinforce characteristic difficulties with posture and balance.
While clarity of vision can be affected by degenerative states in the optic nerve, the primary visual dysfunction caused by Parkinson’s disease is the interference and compromise between the spatial visual process and the postural support producing an upright alignment against gravity. This dysfunction causes vision problems.
Parkinson’s Disease & Balance
The spatial visual process establishes support through peripheral vision with balance centers to organize postural alignment upright against gravity early in life. In early development, children begin to explore their environment in an upright position. Their spatial visual process (which provides information to the spatial process) matches visual information with balance centers in their bodies to establish a visual midline in relationship to their Center of Mass (COM) and the Center of Gravity (COG). As we develop, our spatial visual process continues to support postural alignment throughout life by maintaining organization of visual midline with the COM and the COG.
Parkinson’s disease disrupts this by compromising the neurological information received from the muscles and the joints about the body’s position upright against gravity. In turn, the brain does not receive nor respond to the postural cues to vertical alignment of the body. The characteristic common to those with Parkinson’s disease is a shuffling of their feet on the floor instead of lifting the foot for each step, often described as “the Parkinson’s Shuffle.” While there are neurogenic effects that cause this characteristic the shift in the visual midline is a primary reinforcer of this postural imbalance. This can result in Visual Midline Shift Syndrome (VMSS) which drives the COM and COG forward, exaggerating the characteristic of shuffling during walking in individuals with Parkinson’s Disease.
Neuro-Visual Processing Rehabilitation
At the Padula Institute of Vision Rehabilitation, individuals with Parkinson’s Disease are carefully evaluated for an imbalance in visual processing. This is done through a neuro-visual evaluation which is very different from a routine eye exam. Its purpose is to provide an in-depth analysis of the relationship between the spatial visual process and the neuro-motor system using a variety of tests. If you would like to learn more about what to expect during an exam, please click here.
Treatment of visual processing symptoms often comes in the form of yoked-prism glasses which are usually prescribed for therapeutic use and should only be used under the direction of the prescribing doctor. These prisms can help reduce the risk of fall and injury further impacting quality of life. We also provide Neuro-Visual Postural Therapy ™ (NVPT) when necessary and appropriate, providing an individualized approach.
For many, dysfunction of the visual process can be a primary cause of the symptoms many experience. Treatment through neuro-optometric rehabilitation becomes an interdisciplinary approach that can maximize potentials in other therapies such as physical, occupation, speech, and cognitive therapies. Collaboration is often the key to successful rehabilitation.
The Padula Institute of Vision Rehabilitation
provides a patient-centered approach to evaluate each person’s individual imbalance in visual processing and will provide an individual direction for rehabilitation based on each person’s needs and abilities.
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