Fibromyalgia
Issues for your eyes and vision
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Some of the information below, is shattered about on the site, but I felt it was time to put all the issues, that can effect our eyes with FM, all in one place, the whys, wherefore's and possible treatments and outcomes.

Ok, let's start off with, what tends to happen to our eyes in our condition, in general, they are:

  • Dry eyes
  • Tearing eyes
  • Blurred vision
  • Double vision
  • Light sensitivity
  • Touch sensitivity
  • Shift of focus issues
  • Eye pain
  • Eye pain on moving the eyes
  • Dizziness
  • Visual Distortion
  • Floaters
  • Flashing lights
  • Transition, near to far issues
  • Macular Degeneration
  • Frequent eye glass changes
  • Difficulty wearing contacts ( due to touch sensitivity )
  • Blindness ( in persons with rheumatoid arthritis,  a rare condition )
All of the above can occur with or without the most common medications given for FM, but ... they tend to become worse in many cases, due to the medications we are commonly given, see details below.

Now, let us look at some possible causes for all of the above, they tend to come down to just a few, starting with, one of the most common co-commitant disorders to tag along with FM, which is CMP. ( on site link )

"Our eyes each have postural muscles involved in moving the eyeball and allowing us to focus, if these muscles are not functioning correctly due to spasms or trigger points, then eyesight can be distorted."

"In order for vision to be clear, both eyes must take the same picture at the same time," explains Devin Starlanyl in her book The Fibromyalgia Advocate. "When this doesn't happen, double vision, blurry vision, and/or changing vision can result. Misalignment of the eyes can be caused by trigger points interfering with the muscles that hold the eyeballs in place. Trigger points can be responsible for contracting these muscles at different tensions. Muscle fatigue would make things worse." (Research ) " 

Other issues :

"Visual problems and visual symptoms are common with FM. The different FM "problems" can also explain specific visual problems:

FM myofascial pain ( Which is the CMP above ) = eye muscle pain. Eye pain is frequently the result of painful eye muscles. Yes those muscles get myofascial pain pain too and can cause headaches, pain when looking in different directions, pain when blinking hard or opening the eyes wide, "stiffness" with moving the eyes. This may also cause our eyelids to twitch, and contributes to blurred vision and problems focusing.

FM allergies/sensitivities = eye allergies/sensitivities. Our eyes water, itch, and burn more, are bothered more by smoke, strong odors, and sunlight. This contributes to blurred vision and eye pain.

FM autoimmune dysfunction = eye autoimmune dysfunction. Dry eyes are common and they contributes to eye pain and blurred vision.

FM dysautonomia = eye dysautonomia. This likely plays a role in sensitivities, poor night vision, difficulty focusing, blurred vision and other eye symptoms.

FM brain fog = eye "fog." This leads to the visual overload we often experience especially when shopping and scanning shelves and having problems visually deciphering exactly what we are seeing. This also explains when we read and re-read the same paragraph and still don't "understand" what we just read. This is our visual-brain disconnection that's part of the fibro-fog. ( Notations )

Dry eyes:

Is a very common issue in FM/CFS that is often mistakenly taken to be Sjögren's syndrome, a common overlapping disorder with FM, but it can be found for some, to be a root cause for dye eye as: " the body's immune system attacks the moisture producing glands, like the tear glands and salivary glands, leading to symptoms of dry eyes, that can feel itchy, gritty or burning, and a dry mouth, which can affect talking, chewing and swallowing." it is rather easy to see why the eyes would be effected in this case.

But this diagnosis however as I said, is often wrong, and it is rather easy to find it out, as there are specific blood tests for this disorder, More commonly seen however, is something called Sicca Syndrome ( which also has common blood work ), which is very common in CFS and FM. While the baseline effects with regard to the eyes are the same, the treatments, are rather different, as well as the range of effects.

A study ( while admittedly small ) found decreased tear production in 90% of those with Fibromyalgia. Experience has shown that dry mouth is also common, aggravating dental and digestive problems. In those who suddenly get a bunch of dental cavities along with their CFS/FMS, dry mouth is the usual cause. This occurs because saliva is critical for preventing dental infections.

Sicca Syndrome is treatable, but not curable. It is caused by autoimmune disorders that injure the glands that make tears and saliva, but also is aggravated by nutritional deficiencies and many medications that are commonly given for FM and others in general, such as :

Antihistamines — Including Benadryl, Zyrtec and Claritin.... antihistamines are often found in over the counter sleep aids.
Antidepressants — Elavil is a major trigger of dry eyes and mouth, but most antidepressants cause this problem. Cymbalta and Savella and others
Birth Control Pills — May cause dry eyes as a side effect. 
Diuretics — These drugs are mostly used to treat high blood pressure.
ACE Inhibitors — Angiotensin-converting enzyme inhibitors are mostly used to treat high blood pressure.
Acne Drugs — Including Accutane and high dose vitamin A.
All Opiates ( Research )
and the most common Pain relievers, such as ibuprofen (Advil, Motrin, others) and naproxen (Aleve)

"The underlying cause of Sicca syndrome is the improper function of the immune system. With this disorder, immune cells attack the cells of the exocrine glands. Slowly, the glands begin to fail in their function of providing proper levels of hydration throughout the body."

"There is no cure for Sicca syndrome. For this reason, treatment focuses on making up for the failure of the exocrine glands and keeping the organs of the body properly hydrated. Artificial tears are administered daily in order to help with dry eyes, while prescription medications like pilocarpine or cevimeline are administered to help increase the flow of saliva to a normal range. Various other medications can help protect internal organs from complications arising from the syndrome" See Link for more on this disorder, which has some very broad and far reaching effects.

You are at higher risk for dry eye if you are:

Are older than 50. 
Are a post menopausal woman. 
Have a medical condition that reduces tear production.

Dry eyes are associated with some medical conditions such as:

Diabetes,
Rheumatoid arthritis
Lupus,
Scleroderma,
Sjogren's syndrome
Thyroid disorders
Vitamin A deficiencies
and of course FM/CFS

Other deficiencies that cause dry eye also include:

Vitamin D
Zinc 
Vitamin E 
All B complex Vitamins
( List of all Vitamins and their related issues when they are lacking)

Treatment of Eye Symptoms

"There are various steps you can take to help reduce the pain and discomfort of the eye symptoms you may be experiencing: Some basics, thanks to Kathy Longly, with additions by me.

Sensitivity to the environment

  • Avoid fluorescent lights when indoors ( meaning those new  low energy use florescent lights, lose em )
  • Wear sunglasses or tinted lenses when outdoors ( adding a hat also helps )
  • Avoid contact lenses if you work in a dry environment ( and for most of us, contacts are out of the question )
  • ( The above also applies if you live in a dry part of the county, which does not mean just where it is hot, as cold can make the air just as dry as too much heat )

Dry eyes

  • Use artificial tears to keep the eyes moist ( this is a must have )
  • The tear ducts can be plugged (called punctal plugs) by an eye specialist to keep natural tears around longer
  • Review your medications and change those that cause mucus drying effects ( if you can find an alternate that works as well, switch )
  • Use a humidifier during the winter and in dry areas
  • Before an eye test ensure that your eyes are well moisturized as fluctuating moisture can cause fluctuating visual perception due to the amount of moisture over the tear film and lens affecting light refraction. ( Now this one I would have never thought of, but it makes perfect sense, if you think about it )

Eye pain/strain

  • Gentle eye exercises can help to stretch out eye muscle trigger points: look up, down, right, left; close your eyes tight, hold them wide open; gently massage the eyeball ( this one can be very hard with MPS, as doing them can be very painful, but like any muscle, they need to move )
  • Anticipate eye fog and stay focused on one thing at a time to avoid getting overwhelmed ( eye fog = too much information to process )
  • Wear the correct glasses to avoid eye strain, especially when reading ( Another no brainier but recall, our script will change a lot more rapidly than healthy people )
  • Ensure adequate lighting when reading and watch out for eye fatigue ( Which does not mean ..  too bright, as too much light, is worse in many ways that too little, as what you are dealing with now, is glare off the page. Light the page, not the room and no more than you need to see it without stain. White page and black print, is not always the best choice either. Having issues ? Try lightly tinted lens, in a varity of colors, and you may find things are sharper to read. I did not make my background pink, just to be cute : )

Supplements that may help

  • Broad spectrum plant enzymes (biocare polyzyme forte)  Which is a brand name for a drink that is a mixture of digestive enzymes, which is enhanced with Lactobacillus acidophilus.
  • Anthocydins (procydin) an antioxidant containing grape-seed extract
  • Visionace ... Another brand name that has antioxidant vitamins, bilberry extract, natural carotenoids, and minerals such as selenium and zinc.
  • Flax seed oil
  • Omega 3 fatty acids (for dry eyes)
  • Beta-carotene ( good old Vit A of course )
  • Magnesium & malic acid ( Which along with Zinc,  the Vit A needs to have around, to really work )
  • Kathy Longly