PSP and Eyes

PSP and Eyes

A characteristic of PSP is vertical gaze palsy resulting in a difficulty looking up and down. This can lead to falls, difficulty placing things down without dropping, difficulty closing buttons and dressing. Not being able to see food drop when eating results in messy eating. Reading and writing becomes more difficult. Prism Glasses can help for awhile. Eventually the ability to look from side to side is lost so the head has to turn in order to see to left and right.

Other eye problems in PSP

  • Double or blurred vision is common making reading more difficult. Try a patch over one eye or if wearing glasses cover one lens to aid vision.
  • Tunnel vision reduces the peripheral vision causing difficulty driving, walking etc. This is especially hazardous at night and in low light conditions.
  • Light sensitivity requires the use of sunglasses at all times.
  • Small eye jerks are seen if  looking at distant objects and can effect reading
  • Eyelid apraxia – an inability to open the eye
  • Blepharospasm- squeezing blink of the eye

Eyelid Apraxia and Blepharospasm

 What is happening?

Generally the person will have a spasm which forces the eyelid to squeeze close, then the eye relaxes and because of the eyelid apraxia the lid does not open. The person will raise the eyebrows in an effort to open the eyes. After a few seconds it will open. As this condition progresses the lid will drop down again and will need manual assistance to open .e.g. use of a finger to lift eyelid.

 Options when lids will no longer open

  • Lundi loops can be fitted to glasses to hold lids open.
  • Botox injections work well but the effect is short term and will have to be repeated.
  • Surgery

It is important to discuss any eye problems with your doctor or consultant and get advice early.

Dry Eyes & Sore Eyes

Dry eyes are a common problem and can lead to irritation and infection. This occurs when the natural tears that lubricate the eye are not working properly. Too little fluid or too much fluid results.

  • Lubrication or artificial tears can help. Eyes are individual so test a few different products to find the one most suitable to your needs.
  • Introduce foods that support the eye. Turkey combined with flaxseed oil work together to help reduce toxin loading in the eye. If you are a vegetarian combine soya with flaxseed oil. For a snack try smooth peanut butter and flaxseed oil on bread. Blueberries and strawberries have been shown to support eye health. 

Eye Care

If eyes are sore or red, watch out for infection. See your doctor immediately.

Always wash the eyes with sterile lint free pads and cooled boiled water. Use one pad per eye and wash from the outside edge towards the nose. If the eyes are sticky or dry in the morning a pad with baby oil will help to remove tack and lubricate skin. 

I like reading what are my options? 

  • Prism classes are suitable only for people who do not need prescriptive lenses.
  • larger type books from your local library
  •  books on tape from your local library
  • change font and increase size of letters on your  computer
  • change the background colour to reduce glare
  • use computer software programmes that will read any script
  • voice recognition software will type what you say


 It is better to use single lens glasses. Bi-focals or vari-focals are not recommended as both can increase the risk of falls.

Consider choosing break resistant or plastic lenses. Polycarbonate frames are usually stronger than metal.

As we get older we need more light to enter the eye to see therefore choosing glasses that are too dark can increase the risk of trips and falls. The colour lenses you choose can make a difference. Yellow, orange, and brown colour lenses improve contrast and make it easier to see kerbs and steps. Avoid blue lenses.  

Eye sensitivity and Sunglasses 

Ultraviolet light and blue light can damage the eyes and as people with PSP and CBD are more sensitive to light it is important to protect the eyes. Apart from sunlight, glare from polished surfaces, pavements, shop windows, white paper and reflective surfaces, fluorescent light and water all add to the strain on sensitive eyes.

The best types of glasses will protect from UV-A, UB-B and harmful blue light.

Polarised lenses will filter out the glare from water and other surfaces to provide excellent comfort for sensitive eyes. Low vision filters will reduce the light getting to the eye causing irritation and damage.  Wrap around glasses prevent light from reflective surfaces and peripheral glare from entering the eye area. Larger glasses with broad frames will block more harmful light reaching the eye. Wearing a peaked hat or hat with wide brim is advisable for comfort and protection.

Other considerations:

  • transition lenses change with the degree of light when moving in and outdoors

It may to be necessary to have a number of sunglasses

  • clip-on’s can be useful if you are happy with the glasses you have but need extra protection in strong sunlight
  • Night driving glasses cut the glare of on-coming vehicles. are cheap and available over the counter
  • Sunglasses filter category 0-3 is best for day time driving. 4 is too dark
  • in general grey lenses are considered best for driving in daylight
  • anti-reflective coating can be added to glasses to eliminate glare
  • look for UV400 for the highest protection category
  • always check that the glasses have either of the following:
  • European Safety Standard Mark CE
  • British Standard BSN1836: 2005

Eyes are individual and what works for others may not necessarily work for you so look around, get advice and use what works for you.