PMR

[TMenz]

PMR can anyone tell me if this affects your eyesight or steroids does please? Maybe just a coincidence as turning 50 and I know your eye sight can alter x

[HeronNS]

As you probably know PMR and GCA (giant cell arteritis) are related diseases and if you experience any new visual problems you should report this to your doctor. If you have serious symptoms go to the emergency department of your hospital.

However pred can cause some less dire visual effects, such as blurry vision, especially when first starting taking the steroid. Pred is also implicated in increasing the chance of getting cataracts, or speeding up their formation if you were going to get them anyway. Anyone on pred should have their eye pressure monitored regularly as pred can increase ocular pressure and cause glaucoma. If monitored any increase in ocular pressure can be caught and treated if necessary (if it's high enough) to prevent permanent damage. The increase in ocular pressure will reduce back to normal as pred is tapered.

[TMenz in reply to HeronNS]

Oh wow okay thanks. Glad I booked opticians Saturday. I have read about GCA and have not had any headaches at all just feel like my eye prescription has changed over last few weeks. Will get them checked now thank you for info.

[HeronNS in reply to TMenz]

The possibility of ocular pressure increase is reason enough to have your eyes checked when you start pred even if you have no symptoms. I had mine checked when I'd been on pred for about six months and my dose was already half the starting (down to about 7 from 15) and my ocular pressure had increased enough that the doctor wanted to see me a few months later, and even today, five years later, and on a vanishingly small dose of pred, he wants me to go in annually rather than every two years which had been my habit for years. The eye pressure is normal now. But I wonder how high it had gone in the early days, given that it was high enough at 7 mg. that some doctors might have prescribed drops, mine didn't, and the pressure had trended down by the second visit. I also, as of recent visit, have been told I have the beginnings of cataracts, but so far not noticeable, and this could have been happening anyway as I'm in my 70s.

Make sure your eye doctor knows you are on pred.

[TMenz in reply to HeronNS]

Yes I will make sure to tell my optician and show this message. Thank you for your very helpful advice again. X

[jinasc in reply to TMenz]

As you have an opticians appt on Saturday, I assume you wear spectacles.

Therefore you need to change your lens to re-actolite rapide, as pred+sunshine =cataracts and they can grow quickly.

If your optician is a good one they should know all about it. If not advise them to make enquiries.

We found this out when an Optician who was a speaker at a support group meeting told us about it all. He did get a lot of new customers. His Mother had PMR and was a member of the group and she had re-actolite rapide since day one of being diagnosed.

My optician, when I was diagnosed with GCA, immediately changed my lens. I never asked why, just accepted it. She also gave me 'night driving glasses'

I had the start of cataracts and they have never grown, even though I was on pred for 5 years. The upside is they have still never grown so far and I am in my 9th year of remission.

[HeronNS in reply to jinasc]

Ever since they became available my everday glasses have had a UV-blocking coating on them, plus I wear sunglasses when needed. As I've been on pred for nearly five years, four of them at 3 mg or less I think I shall have to attribute my recently detected incipient cataracts to old age.

[PMRpro Ambassador in reply to HeronNS]

So I can still hope?????

[HeronNS in reply to PMRpro]

Just keep getting older, apparently. Of course I don't know how long this will take. Maybe it'll be years before I need treatment. Not really something I've ever looked forward to, but everyone I know who's got their new lenses have been happy enough.

[PMRpro Ambassador in reply to HeronNS]

I just want rid of specs!!!

[HeronNS in reply to PMRpro]

I've thought about that, but after wearing glasses for about 64 years I think I would have trouble getting used to it. I think my eyes would feel very vulnerable and exposed!

[PMRpro Ambassador in reply to HeronNS]

PMR stopped me using contacts - it would be a return to that

[HeronNS in reply to PMRpro]

Okay. I've never used contacts. It would be nice to see the world without a frame around it. However my recent and current glasses have been frameless and extremely light, so next best thing.

[PMRpro Ambassador in reply to HeronNS]

Have been very difficult to find here for the last few years - I had one wonderful pair years ago. They seem to be back though

[HeronNS in reply to PMRpro]

I've noticed young women wearing huge glasses with plastic frames. Shades of, was it the sixties? My "frames" (at least very close, they are an earlier model) :

silhouette.com/en/optical-e...

[Boss302Fan in reply to HeronNS]

I’m 65yo and can attest to this. After being on Pred since Jun ‘19 for PMR, my ocular pressure in my left eye 2 months ago was 31! After a month of using Rhopressa 1 drop per day, the follow-up now has it at 22 which the Optometrist is satisfied with. Fortunately, no damage to the internal anatomy of the eye, but if not reduced would have led to severe complications.

Another impact was to my average blood pressure, it had increased to 144/90. My GP put me on the lowest dose of Metoprolol Succinate extended release 25mg 1x/d and it now averages 130/80. However, this has led to dry eye syndrome so 4x/d adding a drop of Refresh Optive to both eyes. My Optometrist said this isn’t unusual with taking of blood pressure medicine.

It’s believed by my Optometrist and GP that these issues will dissipate once I’m off Prednisone or dose decreases. I’m now on week 3 of transition to 8mg/d using PL Simple Taper.

[SnazzyD]

It certainly can. I found my prescription of my glasses didn’t work any more and my eyes were unable to change focus from one depth of field to another quickly. I got the shock of my life in the early weeks when I looked up from a book and could not focus on the garden at all for a few minutes and I was long sighted. I thought my GCA was back. My eyes also got confused with close scenery moving as I walked so I often got dizzy so I had to stick to fields rather than woodland. optician said the muscles of the eye are affected and not to bother trying to change my specs until I was at much lower doses or it would get expensive. I also lost my tear film which made the usual minor haemorrhages more frequent so had to have eye drops, both thick and watery ones.

I went to the optician to get my eye pressures check every 3 months until my pressures dropped at about 15mg. Latterly it was found I had the beginnings of Pred induced cataracts. That was all 3 years ago aged 54.

[TMenz in reply to SnazzyD]

Oh blimey wow again Haha I have so much to look forward to. I am 49 and I'm not too bad with my glasses but finding my contact lenses not so good sometimes I can't read small writing but then I can later on in the day and the same,e piece of writing. Thanks for advice I'm going opticians Saturday so I'll, mention getting tested every three months for the time being. How are your eyes now if you don't mind me asking ?

[SnazzyD in reply to TMenz]

Fine, apart from the early cataracts. Do ask about the contacts and whether your eyes are ok while on Pred. It is quite common to get sub conjunctival bleeds which are harmless, if disconcerting to look at, that might be made worse by contacts. My eyes did vary through the day by the way and I was on high doses for GCA.

[DorsetLady PMRGCAuk volunteer]

Bit late to the discussion, but personally think more likely to be a side effect of Pred. However, they do need to be checked with your optometrist and make him/her aware of all the facts others have advised.

As for contact lens, would be inclined to use sparingly, certainly until things have settled and you know what’s going on with eyes.

[Lovebikes]

If it is for reading it could just be your age. Pre PMR, Both my husband and I, having had perfect eye sight all our lives, found our ability to focus close up took a rapid deterioration around age 50. Nicely coincided with arrival of the pooh screening kit. The joys!

[markranson in reply to Lovebikes]

With me it was aged 40. Prior to that my eyesight was perfect and at 40 I suddenly thought my arms had got shorter as I couldn't read the newspaper at arms length. Turned out I needed glasses for reading. So far my long range vision is good.

[Thelmarina in reply to markranson]

I had no idea that my sight was so bad until I had glasses and realised that the blurry drops I saw in the pear tree were actually pears!

[PMRpro Ambassador]

I had PMR untreated for 5 years and during that time had various eye problems - dry, sore and inflamed from something my superb optician couldn't identify. I had to give up my contact lenses as I seemed to develop an allergy to the storgae fluid. Dailies improved things a bit but were too expensive and inconvenient in the long run - I needed glasses and swapping back and forth didn't work well.

I had/have several pairs of glasses, never throw them away - I read without as I am very shortsighted but have mid-distance for the computer and distance specs. The mid-distance ones were very useful as I just moved them up and down my nose during the day/week to get the best result! Don't rush to get a new prescription with expensive lenses or frames - it may have changed next month. I have been able to go back to old pairs at times and they were as good as having new ones that were out of date by the time they were made! That has happened.

I'm much older now but I do notice more difficulty adjusting from close work to looking at the mountains outside the window, especially in poor light - it is something we should do regularly, look up at the distance for several minutes every so often.

[nuigini]

Like PMRpro I suggest you don't rush to spend a lot of money on new lens too quickly. In the early stages of PMR and prednisone my eyes were checked every 6 months and every six months my prescription changed. It was by minor amounts, either up or down. I held back buying new lens for quite some time.

I also experienced blurry vision from time to time at the higher doses.

Cataracts are now beginning, but normal for someone at my age of 71. They are 'regular' cataracts and not of the type which can be caused by prednisone. I didn't know there was a difference until only recently.

[valrene]

I’m late to this discussion stopped taking pred 16 months ago after taking pred for 4 years, my father had glaucoma so since I was 40 have had free eye tests every year, October 2018 pressure in eyes about 19, October 2019 pressure in eyes has shot up to 29, with some slight damage to optic nerve, after putting glaucoma drops in for 3 months pressure down to 21, hopefully no more damage to optic nerve for now, optician said I have pred induced glaucoma also I have pred induced type 2 diabetes, so don’t delay getting your eyes checked before any damage to eyes.

[singingloud]

I’m on drops for the pressure in my eyes. Tomorrow I have my eye surgery for the cataract in my right eye. Two weeks ago I had my left eye done. But I have to continue the drops for the increased pressure for several more months.

I’m one of those who are sensitive to prednisone in every way.

Hopefully my vision will not be so blurry after recovery from the surgeries and that I’m down to 13.5 mg of prednisone now.

[PMRpro Ambassador in reply to singingloud]

Are they including the procedure to reduce eye pressures in your cataract surgery?

[singingloud in reply to PMRpro]

My eye surgeries include Toric lens which will allow me to go without glasses for long distances. I will need readers for up close reading so I picked up my first pair yesterday.

[Hidden]

I will just say get the cheapest good lenses in glasses or contacts.... My eyes were constantly changing for 2 years before I got to a low enough dose for them to stabilise and then I got proper varifocal. Lenses... Which I have had to use since my 30s.

[singingloud]

Back from surgery. The anesthesiologist was wonderful. He gave me my steroids by iv which helped with the breakout pain in my shoulders. He also gave me something to help with nausea this time.

He also mentioned the Paleo diet for PMR.

Any comments on Paleo?

[PMRpro Ambassador in reply to singingloud]

In that it is low carb - excellent. But I personally don't think you have to go that far. Or give it a name that is only there for added-value - for the people who sell books about it ...

[Whitner]

I found that one of my eyes had a significant change in vision. My eye doctor thought it was a result of a growing cataract but I’m not convinced.