Authors

Hutchinson CV, Maltby J, Badham SP, Jason LA

Institution

College of Medicine, Biological Sciences and Psychology, University of Leicester, Leicester, UK

Background

People diagnosed with CFS/ME consistently report that they experience vision-related symptoms associated with their illness and some of these reports are being verified experimentally. Although vision-related symptoms may represent a significant clinical feature of CFS/ME that could be useful in its diagnosis, they have yet to be included in clinical guidelines.

Methods

A recently developed, standardised measure designed to assess core CFS/ME symptoms, the DePaul Symptom Questionnaire (DSQ), includes four vision-related items: eye pain, sensitivity to bright lights, unable to focus vision and/or attention, loss of depth perception. For each item, respondents rate the symptom frequency along with the associated severity/bother on a 5-point scale. Here, we report DSQ vision-related item responses for 59 individuals (39 women, 20 men) who, after completing the DSQ, met its criteria for diagnosis of CFS/ME.

Main results

Responses on each item revealed that vision-related problems were frequently experienced, the most frequent being sensitivity to bright lights (92%) followed by being unable to focus vision and/or attention (88%) and eye pain (86%). Loss of depth perception (61%) was least frequent. The more frequent the symptom, the greater the apparent severity/bother.

Conclusions

Responses of individuals with CFS/ME to the visual items included in the DSQ indicated that they experienced frequent and often severe vision-related symptoms associated with their illness. These findings are in agreement with those of previous self-report studies and recent experimental evidence for problems related to visual attention in those with CFS/ME. They add to an emerging body of evidence that vision-related symptoms represent a significant clinical feature of CFS/ME that may provide insights into its aetiology and prove useful in its diagnosis.

Publication

Br J Ophthalmol 2014 Jan; 98(1): 144-5

Acknowledgements

This work was supported by ME Research UK and The Irish ME Trust

Comment by ME Research UK

In this interesting short report, researchers from the Vision and Language Research Group at the University of Leicester describe using the new DePaul Symptom Questionnaire to quantify the vision-related symptoms (eye pain, sensitivity to bright lights, unable to focus vision and/or attention, and loss of depth perception) in their ME/CFS patients. All 59 patients reported having no history of eye disease, yet 92% had some degree of sensitivity to bright lights; 88% were unable to focus vision and/or attention; and 86% experienced eye pain. Each of these symptoms was severe or very severe in more than 30% of the patients. Fewer people reported loss of depth perception, but this symptom was still present in around 60% of the group. The researchers’ aim is to increase awareness of the importance of vision-related symptoms in ME/CFS among professionals, including ophthalmologists. As they point out, their report “adds to an emerging body of evidence that vision-related symptoms represent a significant clinical feature”, that might be useful for diagnosis, yet these symptoms are not presently included in clinical guidelines.

This report is the third scientific study to emanate from a project funded by ME Research UK and the Irish ME Trust. In two robust scientific papers, the group at the University of Leicester has shown, first, that ME/CFS patients perform worse than matched controls across three specific aspects of vision; and, second, that eye movement dysfunction is a prominent feature. The next steps are for other researchers to confirm these findings in their own local populations, and for moves to begin to incorporate vision-related symptoms into clinical and diagnostic guidelines, such as the NICE Guideline in the UK.