Providing a State-wide Support Service for People with ME/CFS, their Families, Friends & Carers!

Assessment of Visual Function in ME/CFS

ME Research UK listed in a recent Breakthrough magazine (Spring 2010, p. 14

http://www.meresearch.org.uk/information/breakthrough/Breakthrough_Spring201
0.pdf) two reports in the scientific literature in the 1990s of ocular
symptoms in people with ME. In one, a Boston research group (Optometry &
Vision Science 1992) found 24.7% of patients had reduced or stopped driving
because of new eye problems compared with 3% of controls.

In the other (Journal American Optometry Association 1994) all of 25
consecutive CFS patients reported eye symptoms; commonest findings were
abnormalities of the pre-ocular tear film and ocular surface, reduced
accommodation for age and dry eyes. Then in 2000-2010, two more reports
appeared, first a case- control study (Annals Ophthalmology 2000) in which
the 37 patients had significant eye impairment compared with controls; 
impairments included foggy/shadowed vision and light sensitivity plus
problems of eyeball movement (oculomotor impairments) or tear deficiency.
The second, from Russia (Vestnik Oftalmologii 2003) reported vascular
pathology of the eye in 70.2% of patients.
The astounding thing is that these smallish observational studies represent
almost the sum total of research into eye problems in ME/CFS in the past 30
years. And because no attempts have yet been made to objectively quantify
the nature or extent of the visual symptoms in the illness, there remains no
solid empirical evidence-base to back up the patients' individual reports of
disabling visual disturbances.
So the aim of this one-year pilot investigation is to quantitatively and
objectively determine the nature and extent of the visual symptoms
experienced by people with ME/CFS, determine their rate of occurrence and
establish whether the types and extent of visual symptoms experienced can be
correlated with the severity of the condition and the specificity of other
(non-visual) symptoms.
Based on the commonest visual and vision-related symptoms reported by
people with ME/CFS, Dr Hutchinson's investigations will be primarily
concerned with 2 main categories of visual impairment: (1) heightened visual
awareness, of which hypersensitivity to light and difficulty suppressing
irrelevant background visual information are the main subjective visual
symptoms; (2) eye-movement problems, of which difficulty focusing on images
or tracking objects are the main subjective symptoms. Each aspect will be
investigated in specialist ophthalmic examinations used in the Vision and
Language Research Laboratory.
For this initial study about 100 ME/CFS patients will be recruited in the
Leicester area, and each patient will be assessed on their fulfilment of
both the Fukuda 1994 and Canadian 2003 criteria. To prevent sampling bias,
recruitment will be drawn equally from local ME support groups and via
clinics in the Leicestershire NHS Partnership Trust which take referrals
from GPs in the area.
For all experiments, participants with ME/CFS will be compared to a group of
control subjects matched for age, education-level, sex, etc. As well as
ophthalmic examinations, patients will complete a variety of outcome
measures, including symptom severity and quality-of-life measurements,
allowing associations to be examined between clinical status and any
objectively identified visual deficits that are uncovered. The results might
surprise us all, and might help delineate ME/CFS from other chronic
illnesses and aid diagnosis.