Fuzzy vision - is this PMR or Diabetes or Dry Eyes related???

[CJDLSR]

A bit of background:

I had been seeing a "retired GP with a special interest in Opthalmology" (a lovely man) at an NHS community clinic for a few years due to blurred vision which my optician insisted was dry eyes. The specialist GP told me I had cataracts developing and eventually, in April and May last year (2024) I had them removed.

When I had my new specs, I chose to have varifocals again, as I couldn't be bothered with reaching for reading glasses every time I wanted to see something close up.

I have never been 100% happy with the specs provided by my high st optician and the latest was no exception - in fact they are worse as I still need reading specs for some close work. I am now looking for a new optician - especially as my current one said (very dismissively) that PMR would have nothing to do with my ongoing blurred vision! Lost all confidence in her at that point!!

In July last year, I was diagnosed with PMR and in November with steroid induced diabetes. I have been following a low carb / low sugar diet since then. I have a home blood glucose monitor (finger prick test kit) and use it pretty randomly (as advised) but the reading has always been what I was told was in the acceptable levels (under 7 first thing in the morning, and under 11 at any other time). I'd be interested if others would agree with these readings being "acceptable".

The visual problems seem to be getting worse and I feel I'm back to constantly blinking or shaking my head to "clear" my vision, which is what is was like before I had the cataract surgeries.

From what I have read, diabetes can lead to visual problems if the blood glucose levels are consistently high, or uncontrolled (frequent spikes). I don't believe this is the case with me.

I use eye drops several times a day for the dry eyes, and have for years, with variable degrees of "success" in that sometimes the blurring is less troublesome - but is that due to the eye drops or something else??

I have no symptoms of GCA - ie no headaches, no stiff jaw, no trouble eating, no tenderness in the temples etc. I do get occasional shooting pains in my head but they are no more than that and don't continue. I try not to be paranoid about them!

I am unsure whether I should see my GP (very supportive about the PMR and my handling of it) - although it would probably take several weeks to get an apptm with her - or a new optician. Any suggestions or ideas would be gratefully received.

Thank you so much.

[PMRpro Ambassador]

First of all - has the cataract surgery been followed up? A very common post op effect is posterior capsular opacification which causes blurry vision and is very easily sorted. It can happen at any time.

my.clevelandclinic.org/heal...

ANd dry eyes - you have to be really consequent with using drops, at least 2x daily and the right ones for you. I tried one that actually made it worse!!