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The Visual Impact of Dementia

As most people age, it is common for vision needs to change. Dementia, including Alzheimer’s disease, is one of many conditions that may cause significant problems with vision in the senior patient.

Patients with dementia are less likely to articulate their vision problems, making these deficits more challenging to diagnose. Vision deficits include problems with colour vision, depth perception, visual field, and contrast sensitivity.   Also common are difficulties in maintaining steady fixation on an object and making accurate eye movements to follow moving objects.

Importantly, patients with dementia often have difficulties making sense of the information that the eye are receiving, resulting in problems with reading, recognizing familiar objects and people, locating and identifying objects by sight, distinguishing objects from the background, and moving confidently in one’s environment. Diminished quality of life and loss of independence can be a result of these vision deficits.

Sleep disturbances are common in patients with dementia. Light therapy has a positive impact in regulating sleep cycles and also in decreasing the risk of falls. A novel lighting system is currently being studied and could be used to improve postural control and stability in the patient with dementia.

Some vision tips for family members, caretakers, and health care providers to assist patients with dementia:

  • Arrange for regular eye checks with an optometrist to ensure that any eye health issues are addressed and that any necessary glasses are up-to-date.
  • Ensure that the patient’s environment has adequate, even lighting. Eliminate shadows as much as possible.
  • Minimize busy patterns, especially on walls and flooring, and use high contrast objects (such as white plates on a black table). Anticipate situations which could cause difficulties with visual perception.
  • Highlight important objects (such as handrails), making them as conspicuous as possible.
  • Slow down your movements around the patient.

The optometrist can play a significant role in optimizing visual function and improving the quality of life of the patient with dementia. The Ontario Association of Optometrists recommends annual comprehensive eye exams for all seniors age 65 and over because of the higher risk of eye conditions that may affect one’s sight. Yearly comprehensive eye exams and any required follow-ups are covered by Ontario Health Insurance Plan (OHIP).