Dementia and sight loss

“I call it brainblindness - I can’t see. There is nothingobvious wrong with my eyes, but I have Posterior CorticalAtrophy.That is a dementiawhich particularlyaffects my vision”.

How common is Dementia and Sight Loss?

Sight loss will affect 123,000 people with dementia and may be caused by:

• an eye condition, such as cataract

• another health condition, such as stroke

• normal ageing of the eye

• the dementia itself

People with dementia can have visual difficulties caused by the brain but still have healthy eyes. That is problems perceiving what they see rather than how sharply they see it.

Dementias that may have a direct impact on vision are:Lewy Body, Posterior Cortical Atrophy, Alzheimersand Vascular Dementia.

“With advice and support about my mum’s sight loss we were able to keep her safe and in her own home for a lot longer than we normally could have”.

What are the signs?

Sight loss is typically under diagnosed in people with dementia because the signs can be difficult to separate. One condition may mask or be mistaken for the effects of the other and lead to inaction.

When caring for someone with dementia you might want to consider whether the person is having difficulty with:

• reading

• recognising people

• coping with bright light, low light or both

• finding things

• avoiding obstacles

• locating food on their plate

• seeing well with their existing glasses

Sight Loss or Dementia?

Some unusual behaviour may simply be a reaction to sight lossor attempts to make the most of useful vision. You may noticethe person you care for:

• becoming withdrawn or uncommunicative

• being clumsy or falling more

• reporting visual hallucinations

• holding things up close

• confused and disorientated

• startled by noises or people approaching

Some of these things may be due to a person’s dementia, butit is important to have their sight tested as sight loss could be contributing to increased confusion.

“Sometimes its difficult to know which glasses are for what. The optician was great, she engraved Margaret’swith her initials and whether they were for TVor reading”.

What should I do?

Many people think the person they care for can see perfectly well. This is often not the case, and can simply be that theycannot tell you about changes to their sight.

It is important that someone with dementia has their sightexamined regularly. In Scotland the sight test is free and the overs 60’s are seen annually. *

The optician can give advice about eye health, how to support the person with dementia and sight loss, and ensure that thecorrect glasses are worn at the right time.

* In the rest of the UK the eye examination is free to over 60’s and you should be seen annually when you are 70 or over.

Will the sight test be too difficult?

Carers or relatives often feel that the optician may not be able to carry out the sight test due to the person’s dementia.

With some reasonable adjustments everyone can, and should,access eye care. Alternative tests and approaches are available to help everyone participate.

Many opticians will even come to your home or makearrangements to see you at a time most suited to you.

Speak to your local optician to see what support they can offer or contact RNIB for further advice.

What could help?

• make sure glasses are clean and well fitting

• make sure the right glasses are being worn

• ensure good even lighting to help reduce shadows

• reduce the risk of trips and falls

• use good colour contrast, especially for everyday activities

• plain backgrounds can be more helpful than patterned

• let the person know where they are, who they are with and what is going on

• ensure any medication, especially eye drops, are taken

Get advice or more information from RNIB Scotland or Alzheimer Scotland or complete the checklist overleaf and take this to the optician.

Identifying Sight Loss Checklist

Date of last sight test appointment:

If over 60 do you attend annually?

If under 60 do you attend every 2 years?

Is there a family history of eye problems?

Everyday Vision

Has the person stopped reading?

Are they struggling to see the television?

Are they finding it difficult to recognise people?

YES NO

YES NO

YES NO

YES NO

YES NO

YES NO

Please give details

Mobility

Is there an increase in trips/falls?

Does the person bump into furniture?

Does the person overstep/are they hesitantat kerbs or stairs?

Mealtimes

Does the person knock items over at the table?

Does the person consistently leave food ontheir plate?

Does the person search for objects with hands?

YES NO

YES NO

YES NO

YES NO

YES NO

YES NO

Interactions

Does the person repeatedly clean their glassesor ask them to be cleaned?

Does the person move objects close to theirface or move their face close to objects?

Does the person get startled when approachedunexpectedly?

Does the person dislike or avoid going out ona sunny day?

If you, or the person you are caring for, are havingdifficulty in any of these areas you should get youreye sight checked by an optician.

YES NO

YES NO

YES NO

YES NO

Identifying Sight Loss ChecklistIdentifying Sight Loss Checklist

• Let the optician know that you have dementia

• Take a list of your medication

• Take your glasses with you

• If there is a family history of eye problems let the optician know

• Take this leaflet and checklist with you

Handy hints for visiting the optician.

For more information contact:

RNIB ScotlandTelephone: 0141 772 5588Visit: www.rnib.org.uk

For support and information contactthe RNIB Helpline on 0303 123 9999orthe Dementia Helpline on 0808 808 3000

© RNIB October 2012 Reg charity no. 226227 and SCO39316Alzheimer Scotland 2012 Reg charity no. 149069 and SCO22315

Alzheimer ScotlandTelephone: 0141 418 3930Visit: www.alzscot.org

RNIB Scotland and Alzheimer Scotland provide:

• training for the public and professionals (including optometrists)• information services• vision and environmental assessment• a broad range of direct support and care services for people with dementia and confirmed or suspected sight loss• assessment linked to personalised budgets (SDS)