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PMR & GCA Summary

Eye problems associated with PMR are often not caused by the condition but rather the steroids used to control it. It is usually the long-term use of these steroids that can cause cataracts, Central Serous Retinopathy (CSR) and more seriously glaucoma. It is therefore strongly recommended to have regular eye tests whilst taking steroids.

Cataracts

Cataracts are a common eye condition and can affect anyone regardless of age and health conditions. 91% of the general population between 75-85 years old have been found to have developed cataracts to some degree. Prednisolone can encourage the formation of cataracts and long-term use of steroids may make PMR sufferers more prone to developing them.

Cataracts can cause a blurring to the vision. In mild cases the vision can be corrected by prescription spectacles. However, with advanced cases, glasses may not improve the vision. In such cases, if the patient desires, the Optician can refer you to an eye specialist, who can surgically remove the cataract. The operation is performed under local anaesthetic (you are awake when they perform the surgery) and often only takes around 20 minutes. The resulting change in vision is usually very remarkable.

CSR

This is usually a temporary visual impairment caused by leakage of fluid from the central part of the retina inside the eye. It affects men 3:1 more than women. It can cause distorted vision, for example straight lines can appear wavy. Prognosis of this condition is good with 90% of patients regaining a good standard of vision within 6 months. Treatment can include a review of steroids that stimulate corticosteroid hormones, laser treatment (rarely needed for single episodes) and relaxation techniques (the latter form of treatment is because increase in stress can cause CSR).

Glaucoma

The most common form of Glaucoma (primary open angle glaucoma) is known as ‘sneak thief of sight’ as the condition usually develops so slowly, by the time symptoms present themselves they become irreversible and blindness can result. The good news is that this condition can be detected early by an Optometrist and can be very treatable, often halting the disease progression. The best way to ensure the preservation of your sight is to take advantage of your FREE NHS EYE TESTS, so your eye health can be monitored on a regular basis and problems like glaucoma can be detected early. You can claim a free eye test every year if you are over 70 and every other year if you are aged 60-69.

If you are unable to make it to your high street Optician then call 0845 674 10 10 and we will send a fully qualified Optician to you and you will get a free NHS sight test in your own home. Do not wait until you think you need new glasses; our priority is looking after the health of your eyes. Your optician may advise an eye test at 6 month intervals if you are taking a certain dose of steroids.

GCA

PMR sufferers are probably all too aware of their 30% risk of developing GCA (giant cell arteritis). GCA is an inflammatory disease of the blood vessels, most commonly the arteries in the head are affected and this is why the disease is closely connected with eye problems. The onset of this condition can cause the blood supply to the eyes to decrease resulting in ‘starvation’ of the optic nerve leading to irreversible blindness. If any of the following symptoms occur you should consider it a medical emergency and get to the nearest hospital straight away. If you are unable to get yourself to a hospital immediately call 999. Because the eye is such a delicate organ there is always a consultant Ophthalmologist available at main A&E units, there is one at James Cook Hospital 24 hours a day, so use the facility if you feel you need it. Better a false alarm than irreversible damage.

Symptoms of GCA:

•PAIN ON CHEWING. Often people are able to chew for a while but eventually the pain becomes so bad they have to stop.

•SUDDEN HEADACHES. The headache is usually concentrated in the temple region of your head. Just above your eye and near to your hairline.

•TENDERNESS OF SCALP. Often the temples are tender to touch and things like combing your hair may be painful. You may be able to feel or see the temporal arteries bulging under the skin.

•VISUAL SYMPTOMS. You may experience a sudden loss of vision in one eye lasting only a few seconds or minutes. The vision may then return to normal, but this symptom should not be ignored.

Double vision is also sometimes reported. The worst case scenario would be permanent loss of vision in one eye, which if not treated straight away can result in both eyes losing sight (fortunately, this is rare).

•There are other symptoms such as fever, night sweats, loss of appetite, weight loss and generally feeling unwell.

If you have any questions about the eyes in general, or if you are in need of an eye test, please do not hesitate to call an Optician at Home Visit Eye Care.

Best Wishes,

John Prouse BSc (Hons) MCOptom

Principal OpticianCall: 0845 674 1010

Home Visit Eye Care