Eye movements may be key to chronic fatigue syndrome diagnosis

[Hoopoe]

“What we’re trying to do is generate a unique ME/CFS signature based on characteristic changes to eye movements, a behaviourial signature that is specific to the disorder that can be used to help diagnose it and monitor the effects of any treatments.”

“Tentatively, what we’ve found already looks like a set of aberrant eye movements that suggest that something might be going on at the level of the brain stem – but it’s early days and that’s at best, speculative,” she said.

https://www.monash.edu/medicine/new...-be-key-to-chronic-fatigue-syndrome-diagnosis

 

[InitialConditions]

I would not be surprised by this. I have all sorts of issue with my vision, and particularly visual processing. There hasn't been much work on vision/eyes and M.E—except a few studies at the University of Leicester.

 

[Charles B.]

Visual dysfunction and refractory ocular pain constitute my most disabling symptoms. Even more so than the pervasive exhaustion, visual maladies render daily existence abysmal. I hope these efforts provide some insights into underlying pathology. As the eyes are the windows to the soul, perhaps they’ll also be the windows to ME (forgive the poetic musing).

 

[duncan]

I wonder how this test is different from vestibular occular tests like the VOR test - which theoretically also can be looking for brain stem issues that translate back to the eyes.

And what does she mean by "behavioral" signature? Isn't this more reflexive? It strikes me as an unfortunate choice of wording.

 

[Braganca]

Vision impairment for me is a hugely disabling feature of my Severe ME. In my first two years of illness it came and went, would be better and clearer for periods or come on with a crash. But for six years it has been permanent. I’ve had full battery of tests by neuro-opthamologist — all normal. Perfect vision technically. But cannot see straight, or focus on objects in distant. Movement in my field of vision. The world is both flattened, loss of depth of field, and too bright and overwhelming to look at. Would be delighted to see research into this.

 

[Jonathan Edwards]

And what does she mean by "behavioral" signature? Isn't this more reflexive? It strikes me as an unfortunate choice of wording.

Behaviour can be reflex.
I think this is the sort of talk that derives from the behaviourist approach - which basically denies the existence of the 'mental' other than in terms of input and output. Behaviour is any output you can measure.

 

[duncan]

Behaviour is anything you can measure

Well, or observe. It's a step removed from first person. For me it is a reminder of the psychs who co-opted the word from that "sickness behavior" veterinarian.

But fair enough.

 

[Amw66]

Bansal uses an eye reaction test I believe as part of his diagnosis process .




The discussion of the pupil reaction test has been moved to a separate thread:
Bansal (eye) pupil reaction test

 

[Creekside]

I think it's likely that they'll find that the aberrant eye movements will vary with the individual. One PWME will have trouble focusing, while another will have trouble tracking, and another will have convergence problems. I think ME varies in which parts of the brain it affects to which degree.

 

[Snow Leopard]

If this merely recognises fatigue, then it won't be specific to ME/CFS.

 

[Hoopoe]

(Responding to a post that has now been moved)

Pupillometry

I think this is not about pupil responses but movement of the eyes. Saccades are one type of movement of the eyes, where the movement occurs in rapid steps. I read that saccades are generated by the brainstem.

 

[rvallee]

I can confirm that it's common in LC. What's described is usually what I experience: blurry vision, difficulty focusing, light sensitivity, phosphenes, floaters, static, double vision (mostly with lights), unusually long afterglow. It usually gets worse with overall symptoms. Most of it is probably neurological and, well, given the sorry state neurology is in, I wouldn't expect anything useful here.

Odd but I think there's possibly something that could be gleaned from checking tears. Some of the blurry vision is a sort of film that sticks to the eyeball, as if the chemical composition of the tears has changed, like it has extra clumpy proteins or something like that. Then again maybe that's normal with heavy fatigue, it usually happens later at night when I'm normal tired, but I never experienced this before so who knows?

 

[Arnie Pye]

This reminds me of one of my mis-diagnoses which is still on my medical records...

I hate having people standing in my personal space. I get rather twitchy and nervous in case they do something unexpected. I had this doctor standing very, very close to me so that he could examine my eyes.

As he looked into my eyes with his little light I couldn't stop myself repeatedly looking at him because I felt so uncomfortable. I ended up being diagnosed with nystagmus. I don't have it at all - I just don't like strangers getting too close!

 

[Hutan]

If this merely recognises fatigue, then it won't be specific to ME/CFS.

If that's what it is, that alone may not be a bad thing - an objective and relatively easy measure of fatigue/fatiguability. From what I have briefly heard and if I have remembered right, dots appear in various places around the field of vision and the eyeball's response to the dot is tracked.

There seems to be some confidence that people with ME/CFS do show abnormal responses, and that the test is an objective one, with little scope for volitional responses. It will be interesting to see the paper when it comes out.

Edited a bit, and to add

“Tentatively, what we’ve found already looks like a set of aberrant eye movements that suggest that something might be going on at the level of the brain stem – but it’s early days and that’s at best, speculative,” she said.

Associate Professor Fielding's quote seems to hint at something beyond slower response times.

 

[adambeyoncelowe]

My eyes are always a mess these days, even as some other symptoms have got better. It'll be interesting to see what they come up with. It might just be a general marker for fatigue or maybe even brain changes, but even that would be useful.

 

[Mithriel]

I got PIP points for my vision so it must be bad

I developed a bad phobia about being in a car, especially busy roads with roundabouts. Not good when we had to travel though a city road with 17 roundabouts to go see my grandchildren. Then it dawned on me the problem was that I cannot see movement well.

Not a problem when I am sitting in my chair all day but vehicles just suddenly appear next to me when I am a passenger in a car. Anyone would get a scare, not a psychological problem at all.

 

[Wonko]

I can't help but wonder if this eye movement thing is the reason why I periodically have issues with my varifocals, which even at the best of times have a very narrow area/tunnel that is in focus, and require a fair amount of cognitive effort to see through. At times this is impossible for days/weeks at a time and I have to switch to a different pair, of 'super readers' that operate much more like single vision lenses (with the change in focus only operating vertically and not in a tunnel fashion).

Currently been unable to use my varifocals, for seeing with as opposed to using them as a paperweight, for around 3 weeks.

Then 'suddenly' the things I am currently using will become less effective (harder to focus clearly with/process the things I am looking at) and the varifocals will work again - until the next time.

 

[Tom Kindlon]

“What we’re trying to do is generate a unique ME/CFS signature based on characteristic changes to eye movements, a behaviourial signature that is specific to the disorder that can be used to help diagnose it and monitor the effects of any treatments.”

“Tentatively, what we’ve found already looks like a set of aberrant eye movements that suggest that something might be going on at the level of the brain stem – but it’s early days and that’s at best, speculative,” she said.

https://www.monash.edu/medicine/new...-be-key-to-chronic-fatigue-syndrome-diagnosis

Open Australia (Melbourne): Study looking to develop an ocular motor marker or signature of disease for ME/CFS
https://www.s4me.info/threads/austr...ker-or-signature-of-disease-for-me-cfs.28136/