Application of a CCTV as a rehabilitation tool for saccadic dysfunction in Parkinson’s disease

Title Application of a CCTV as a rehabilitation tool for saccadic dysfunction in Parkinson’s disease
Author, Co-Author Kara Crumbliss
Topic Low Vision
Program Number
Ballroom A-B
The Chicago Lighthouse for People who are Blind or Visually

Introduction: Parkinson’s disease most commonly results in hypometric saccades, resulting in eye strain, fatigue and/or diplopia. Unfortunately medications used to treat the primary physical movement disorders in Parkinson’s can have an adverse impact on these ocular manifestations. It is common for individuals with Parkinson’s to have significant impairment in reading ability. While exercise has been shown to have beneficial effects on motor deficits in Parkinson’s, no studies to date have evaluated the effect of vision therapy for saccadic dysfunction in this population. One strategy used in saccadic vision therapy is to practice saccades with charts progressing from larger to smaller targets, as larger targets allow for greater saccadic inaccuracies. We discuss the application of a closed circuit television (CCTV), a traditionally recognized device for low vision, to provide reading material with enlarged font and word spacing in order to compensate for a patients’ saccadic dysfunction in Parkinson’s disease restoring their reading ability.

Case report: A 72 year old male with Parkinson's disease and 20/25 acuity presented for a vision rehabilitation examination with primary complaint of difficulty reading. Pertinent findings included preserved 20/25 acuity, saccadic undershoots and restriction of head down positioning due to neurologic impact of Parkinson's. A music stand to compensate for the restriction in head movement was evaluated but a CCTV which allowed for straight ahead viewing and enlarged font to compensate for inaccuracy of saccades was preferred and allowed for increased reading speed and enjoyment.

Conclusions: Further research should examine the most effective rehabilitation strategy for this symptom, optometrists should be aware that a traditional low vision device  CCTV, may be applied for individuals with normal visual acuity and saccadic dysfunction. This device may restore reading ability and enjoyment increasing quality of life.

Affiliation of Co-Authors