Double vision

l337-eye-chartI’m puzzled.

Over the last year or so I’ve experienced a noticeable change in my eyesight. At first, I chalked it up to the “normal” deterioration that most of us experience as we age—I am, after all, 56 years old, and I’ve needed prescription eyeglasses for the last 15 years or so. I have mild astigmatism and need some help reading close-up.

So, when I saw my rheumatologist a couple of months ago, I mentioned that I hadn’t received a notice for an eye appointment in more than a year. As I’m taking plaquenil, a rheumatoid arthritis drug that can cause, as a side effect, changes in the retina that can lead to blindness, he was surprised and concerned that I hadn’t been contacted. He put a flagged referral into the computer.

What are the changes? Vertical double vision is the one that has me worried. Less upsetting (and probably more normal) is that reading small VerticalDiplopiaprint is nearly impossible now. Heh. Hand me a microwave dinner, tell me to read the cooking directions on the back, and I’ll have to go looking for my drugstore reading glasses first. Now, really, this is no big deal—lots of  boomers have this problem these days. My prescription glasses used to correct for it. Now they don’t.

The double vision is the scarier of the two.

I finally saw the ophthalmologist about a week ago. He checked for plaquenil-caused changes in my retinas. Holes, for instance. There were none, thank goodness. He dilated my eyes and studied them through the slitlamp. Everything looked good, he said. He had me read the eye chart, adjusted my eyeglass prescription a little and told me all was well.

“But what about the double vision?” I asked, trying not to sound plaintive.

“That’s most likely because of changes in the shape of the lens. It’s caused by aging,” he said. “Nothing to worry about.”

Right. I’m trying not to worry as I wait for my new glasses to arrive in the mail. Perhaps they’ll fix the problem. But if they don’t, what then? Do I just accept that my world now includes a ghost image slightly above and to the right of all the text I read? That all objects I see that are more than a foot away also have doubles?

My eyes also frequently feel gritty and itchy. Now, I have a grass allergy that’s most active in spring and fall, so red, burny eyes and I are old acquaintances, and that’s very likely the reason.

But for good or bad, I always look things up on the Intertubes.  Sjogren’s Syndrome, a common co-morbidity of RA, also causes abnormal dryness in the eyes, mouth and other mucous membranes. It makes the eyes  red and feel gritty and itchy.  Can it also cause double and/or blurred vision? I don’t have a dry mouth or nasal passages.

Being practical, I bought some allergy eye drops along with some that simply lubricate the eyes. I’ve been using them both each day, the latter as needed. They make my eyes feel better, for sure, but the double vision remains the same. Nevertheless, if I have Sjogren’s—or even just dry eyes for whatever reason—shouldn’t the ophthalmologist have noticed that? Surely he’s familiar with it?

I’ll be visiting my rheumatologist again in about four weeks. By then I’ll have my new glasses. If I’m still experiencing double vision and irritated eyes, I’m going to be a lot more vocal about it than I was last time. It probably has nothing to do with the plaquenil—a good thing—but it’s definitely affecting my daily life. It’s hard to drive (at night, especially) when the yellow line in the middle of the road doubles and floats.

Anyway. I know that some of you have Sjogren’s along with RA. Was your experience before your diagnosis anything like mine?