PMR and vision

Posted by maryft @maryft, Aug 14, 2021

I was just diagnosed this past spring and started out on 20 mg of prednisone. I've been weaning the dosage and am down to 7 mg, but my pain has returned. I've been having problems with blurry vision and sore eyes and am wondering if any else has this issue. My GP told me to see an optometrist. I know I need to increase the prednisone again, but first want to be sure my vision will be alright.

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Hello @maryft, Welcome to Connect. You may want to ask your doctor if you may also have Giant Cell Arteritis (GCA). The reason I say that is because I was diagnosed my rheumatologist first diagnosed me with PMR and I was able to taper off of prednisone 3-1/2 years later. When my PMR was active, my primary care doctor would always ask me to let him know if I had any scalp tenderness, facial pain or blurry vision which can indicate Giant Cell Arteritis (GCA) which is sometimes present with PMR.

"Polymyalgia rheumatica sometimes occurs along with giant cell arteritis, a condition that causes swelling of the arteries in your head. Symptoms include headaches and blurred vision. Doctors often prescribe prednisone, a steroid medicine, for both conditions."
— Polymyalgia Rheumatica | PMR | MedlinePlus: Polymyalgia Rheumatica | PMR | MedlinePlus

Are you also having headaches or other symptoms along with the blurry vision and sore eyes?

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Hello John,
Thanks for your reply. I have read about both conditions, but didn't think I had GCA; however, I do have headaches, which is nothing out of the ordinary for me. In addition to PMR, I also have hypothyroidism, microscopic colitis, some arthritis, and restless leg syndrome, so I usually present as a difficult case. I was having shortness of breath on the higher prednisone doses (I was also under a ton of stress at that time) and was referred for pulmonary testing and a myriad of cardiac tests, resulting only in finding a premature heart beat. Propranolol was prescribed for that. I had vision problems shortly after starting the prednisone, which I told my GP, (and that is listed as a side affect) and she said it's probably the prednisone. If it was GCA, wouldn't the prednisone then help the blurry vision? It's frustrating because the PRM pain has returned, but I'm very concerned about my vision presently.

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@maryft

Hello John,
Thanks for your reply. I have read about both conditions, but didn't think I had GCA; however, I do have headaches, which is nothing out of the ordinary for me. In addition to PMR, I also have hypothyroidism, microscopic colitis, some arthritis, and restless leg syndrome, so I usually present as a difficult case. I was having shortness of breath on the higher prednisone doses (I was also under a ton of stress at that time) and was referred for pulmonary testing and a myriad of cardiac tests, resulting only in finding a premature heart beat. Propranolol was prescribed for that. I had vision problems shortly after starting the prednisone, which I told my GP, (and that is listed as a side affect) and she said it's probably the prednisone. If it was GCA, wouldn't the prednisone then help the blurry vision? It's frustrating because the PRM pain has returned, but I'm very concerned about my vision presently.

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Hi @maryft, Here's some information on how GCA is diagnosed. From what I remember my rheumatologist telling me is that you might have to be on a higher dose of prednisone if you have GCA.

"The best way to confirm a diagnosis of giant cell arteritis is by taking a small sample (biopsy) of the temporal artery. This artery is situated close to the skin just in front of your ears and continues up to your scalp. May 13, 2021" — Giant cell arteritis – Diagnosis and treatment – Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/giant-cell-arteritis/diagnosis-treatment/drc-20372764

"Temporal artery biopsy is still regarded as the diagnostic gold standard for GCA. It can be carried out as an outpatient procedure under local …" — The Diagnosis and Treatment of Giant Cell Arteritis – NCBI – NIH: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3679627/

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It might help you to know my experience. PMR diagnosed late January 2021. 40 mg.prednisone one week, then 20 one week, then 10. 5 mg March, 4 mg April, 3 mg May, 2 mg June and July, now 1 mg. I always worry way too much. Rheumatologist assured me blood tests were great. Sed rate only 3 recently. I'm 76 BTW. Tender forehead due to hot weather and Prednisone making scalp oily and pimples. Vision problems of more pronounced "floaters" due to age are normal. Mucous in eyes recently due to fall hay fever season beginning. I always worry too much, don't do that, but check with your doctor's when you have concerns.

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@cgent

It might help you to know my experience. PMR diagnosed late January 2021. 40 mg.prednisone one week, then 20 one week, then 10. 5 mg March, 4 mg April, 3 mg May, 2 mg June and July, now 1 mg. I always worry way too much. Rheumatologist assured me blood tests were great. Sed rate only 3 recently. I'm 76 BTW. Tender forehead due to hot weather and Prednisone making scalp oily and pimples. Vision problems of more pronounced "floaters" due to age are normal. Mucous in eyes recently due to fall hay fever season beginning. I always worry too much, don't do that, but check with your doctor's when you have concerns.

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BTW … I'm personally convinced that my PMR was caused by anxiety, tension, retirement, lack of exercise, too much following political news, and too much playing with this damn smart phone 🙂

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@cgent

BTW … I'm personally convinced that my PMR was caused by anxiety, tension, retirement, lack of exercise, too much following political news, and too much playing with this damn smart phone 🙂

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I believe my PMR resulted from same list of triggers!—I also had a stressful job & am a constant worrier!—trying to reform in all areas—along with adopting anti-inflammatory diet & walking & stretching for exercise. Just recently tested positive for type 2 diabetes (from pred which I’ve been on since 2019–am tapering down—now @ 7mg). Hoping if I also lose weight diabetes will go away.🤗

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Reply to mimik211 … Tom here 😄 … In a very short time we (wife, Dixie and I) made several major changes in our lives. We sold our business building on the town square … we closed our small menswear store after 37 years … we had a whole new heating/cooling system installed and therefore quit burning a wood stove … we quit eating out and going out because of COVID-19 … we spent lots of time on the couch (something we never did before) … we spent lots of time watching the news on TV and our cell phones … we obsessed over politics in Washington … we didn't exercise at all. Surprised I didn't get sicker.
Now all my blood tests are normal … sed rate is at THREE 😁 We walk a couple miles most every day. I either attend or teach a yoga class Monday, Wednesday, and twice on Friday. The wind destroyed our TV antenna so that's out. We do watch a couple episodes of "Big Bang Theory" on DVD. I'm 5'8" and weigh 165. Currently tapered down to the last 1 mg daily of Prednisone. YOU can do it too !!! 😁

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@cgent

It might help you to know my experience. PMR diagnosed late January 2021. 40 mg.prednisone one week, then 20 one week, then 10. 5 mg March, 4 mg April, 3 mg May, 2 mg June and July, now 1 mg. I always worry way too much. Rheumatologist assured me blood tests were great. Sed rate only 3 recently. I'm 76 BTW. Tender forehead due to hot weather and Prednisone making scalp oily and pimples. Vision problems of more pronounced "floaters" due to age are normal. Mucous in eyes recently due to fall hay fever season beginning. I always worry too much, don't do that, but check with your doctor's when you have concerns.

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prednisone makes me nuts…..can't take it.

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Have you discussed this with your rheumatologist? Are you aware of giant cell arteritis? Any headaches? Probably not a problem, but I would discuss it with my rheumatologist. Just a thought.

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As some one who has other immune disorders, I would say that autoimmune is something this fussy body does. I also have glaucoma and pred is bad for that. By all means have your pressure checked. And I have just have my second cancer discovery after a routine test. The first was after a year and half of pred for my first PMR 25 yrs ago. Once again a screening test. No cancer in my family so I say prednisone allowed my body to ignore the bad cells. No medical person I've talked to seems to think this is a crazy idea so I share it with the group. Get your screenings done and don't skip, regardless of age. Catch it early, it is treatable then.

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Just curious. Is it possible to have GCA without the headaches? I recently had my eyes tested (2 months ago) and got new glasses. I've had PMR for 3 years and am on 3 mgs. Prednisone. My vision in the past few weeks has become blurred when reading and my head always itches. No dry skin and I wash my short hair every other day. I have trouble balancing, especially when I stand and close my eyes. I guess I should ask my rheumatologist, but don't have an appointment for another few months, Just curious if anyone else has the head itch and dry itchy eyes.

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