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Eyes of M.E. By Gail Kansky It is not difficult to find information about eye abnormalities in ME/CFIDS but it is nearly impossible to find good information from medical journals about it. That is because the eyes are affected due to ME/CFIDS being a neurological disease and some patients have more problems than others with their eyesight. Over a decade ago, Byron Hyde, M.D. (along with Anil Jain, M.D. in The Clinical and Scientific Basis of Myalgic Encephalomyelitis Chronic Fatigue Syndrome) wrote about pain that is usually felt behind the eye but sometimes is felt above the eye. Photophobia is listed by many experts and patients often have to wear dark sunglasses even when inside brightly lit areas. If an opthamologist tests for pupillar contractions (a light source challenge test), he may observe dilation that is a contradictory cogwheel dilation instead of the normal contraction. Eyes are also slower to react when changing from near to far vision. Nystagmus is seen only at certain times of the day showing great inconsistencies. Blurred or double vision (diplopia) is not unusual along with an abnormal contraction and enlargement of the pupil that often is found on only one side. Tearing and dry eyes are another usual complaint (but can be eased with over-the-counter (OTC) medication) along with the loss of peripheral vision, night vision, and even color vision that has been noted to be one-sided or bilateral. Palpebral oedema is also one-sided. Patients fail to integrate visual information in a normal way which leads to problems with reading (reading comprehension is reduced or, sometimes, nonexistent) and writing difficulties (patients can find themselves making silly spelling mistakes and not even notice it). Spacial dysfunction is not unusual which causes problems crossing streets or judging the distance of automobiles. They find themselves stumbling on the last stair when the repetition of identical steps is not perceived correctly. Height perception is also altered which is why patients can turn their ankles while merely stepping off a curb. They may find themselves walking into walls or misjudging where a shelf when putting things away. Dr. Charles Shepherd, in his book Living with M.E., says the pain behind the eye (retro-orbital) does not respond to pain medications well and advises resting. Blepharospasm is the involuntary eyelid flickering which he finds is tied to light sensitivity. Many of these symptoms were noted in 1992 when Dr. Walter Potaznick and Dr. N. Kozol published "Ocular Manifestations of Chronic Fatigue and Immune Dysfunction Syndrome" in Optometry and Vision Science (Vol. 69). Dr. A. Macintyre followed with a study published in Optician in 1994 ("Post viral fatigue and the eye," 207/26). Vision is our most dominant sense of all our senses and it also affects our motor dysfunction making balance a problem as well. Vision is often affected with a neurological disease and ME/CFIDS is a neurological disease. While some patients find their vision affected mildly, others are very severely affected. The best explanation we've found is by the Neuro-Optometric Rehabilitation Association's piece written by Thomas Polizer, O.D. where he tells which cranial nerve has the damage according to the symptomatic damage being felt. Problems with vision can manifest itself in actually causing a patient to have vertigo. The "Rehabilitation" in their name, however, is something that is not possible in any neurological disease without first identifying and treating the actual cause of the problem. Like other symptoms, most of these visual problems are probably mostly reversible when the actual cause can be addressed. That's the direction we're going in! |
The National CFIDS Foundation
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