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-   -   Anyone taking Nuplazid? (PD Visual Hallucinations) (https://www.neurotalk.org/parkinson-s-disease/246454-taking-nuplazid-pd-visual-hallucinations.html)

jeffreyn 04-16-2017 10:03 PM

Thanks for the extra information, and the link.

Here is a similar link, which has a bit more information about visual hallucinations. After you have clicked on this link, click on the link which says "EYE PROBLEMS YOU MAY EXPERIENCE".

Parkinson's UK - Eye problems

The clear message seems to be that the vision problem(s) you are having could well be caused by PD, and that PD professionals should be well aware of this. I really don't understand why you are having so much trouble getting appropriate responses from the PD professionals you have consulted.

Jomar 04-16-2017 11:17 PM

[Treatment of Convergence Insufficiency
Treatments for CI can be categorized as active or passive:

Active treatment: A multi-site randomized clinical trial funded by the National Eye Insitute has proven that the best treatment for convergence insufficiency is supervised vision therapy in a clinical office with home reinforcement (15 minutes of prescribed vision exercises done in the home five days per week). The scientific study showed that children responded quickly to this treatment protocol...75% achieved either full correction of their vision or saw marked improvements within 12 weeks.8

Passive treatment: Prismatic (prism) eyeglasses can be prescribed to decrease some of the symptoms. Although prism eyeglasses can relieve symptoms, they are not a "cure" and the patient typically remains dependent on the prism lenses. In addition, adaptation problems can lead to the need for stronger prescriptions in the future. Scientific research as well as optometric and ophthalmological textbooks agree that the primary treatment of convergence insufficiency should be vision therapy.1]
PARENTS, TEACHERS, STUDENTS, CHILDREN: What is Convergence Insufficiency Disorder? Eyestrain with reading or close work, blurred vision, blurry eyesight, exophoria, double vision, problems with near vision or seeing up close, headaches, exophoric.

jeffreyn 04-17-2017 12:20 AM

Jazziecat,

Looking at your information again, I noticed that in your post of 09-09-2013, your list of vision problems does not include visual/optical hallucinations. This is first mentioned as a problem in your post of 11-11-2015.

I'm wondering whether you may have increased your levodopa dosage between these two dates? You are only on a relatively small dosage now (one 25/125 tablet 4 times per day), but I think there is still a small chance that this might be the cause. Can you provide more information on what dosage you started on (and when), and then how (and when) you increased the dosage to reach the level you are currently on?

Jeff

johnt 04-17-2017 12:28 AM

Jazziecat,

To get a rough idea of whether your visual problems are possibly caused by too much or too little levodopa, or are not connected in any way with PD, ask yourself the following question:

Are your visual problems linked to your place in the drug cycle?

You start with low dopamine levels. You take a pill and levodopa levels rise, reaching a maximum after about a hour and then halve about every 90 minutes, until eventually you are back to your original levels. In that time you go from "off" to "on" and back to "off" again. So, if there's no difference over the cycle, it suggests the vision problems are unrelated to PD. If they are worse when you are "off", it suggests that a higher dose may help. Finally, if they are worse when you are "on", it suggests that it is a side effect of the levodopa.

John

Jazziecat 04-17-2017 02:05 AM

Once again, thank all of you for trying to help.

Jo*mar. I know of an optometrist who works with children and their visual problems. It is very costly and not covered by my insurance. Plus I don't drive any more and transport each time would be $40.00. I am retired living on SS. Several years ago I got binocular glasses with prisms. It did correct the double vision but because of the eye movement difficulties, the glasses were of limited value. I put a link to a photo taken of me with the glasses. (oh gosh but I have aged a lot since then). (Just as a side note, the photo is posted on a website that I started back in 2002 so it's a safe site.)

Telescopic Eyeglasses for Macular Degeneration in Off Topic Forum

The glasses I now have do have prisms for the distance part only which is why I still wear them occasionaly. Doesn't help for close up.

Jeff, my levadopa was increased from 3x to 4x a few years ago. I don't have any records of when that happened. The neurologist has since fled and gone, as has my next neuro, so records are somewhere hidden. (seems doctors leave this town all the time)

John, I have to do some thinking about your post. I've never paid attention to off or on periods. I'm going to try and see if I can keep track for a few days. You have given me something new to look into.

Carole

jeffreyn 04-17-2017 02:58 AM

Carole,

I think those records are no longer needed. Just carry out your plan over the next couple of days to observe how your vision problems vary (or not) over the course of the drug cycle.

Jeff

jeffreyn 05-01-2017 08:22 AM

I've just been alerted to another good webpage dealing with hallucinations. It describes a fairly comprehensive three-step process.

What Are the Treatment Options for Hallucinations and Delusions? | National Parkinson Foundation

(hat tip to park_bear at HU for the link)

Jazziecat 05-01-2017 05:20 PM

Thank you so much Jeff for that excellent link. I have it printed out and will be taking it with me when I (finally) get to see new neurologist in two weeks.

Carole

Tupelo3 05-01-2017 07:16 PM

8 Things You Should Know About Parkinson's Disease and Psychosis
 
Some additional information about PD psychosis

Facts About Parkinson’s Disease and Psychosis | Everyday Health

Jazziecat 05-02-2017 03:59 PM

Thank you tupelo3. Another very helpful article for me to use.


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