Research by optometrists reveals undiagnosed eye conditions in people with dementia

Research by optometrists reveals undiagnosed eye conditions in people with dementia and paves the way for improvements to services.

When we think about dementia we rarely think about eye health, but its importance is clear. Good vision is essential for so many everyday tasks and arguably even more so for people with dementia, who may rely on vision if abilities such as memory and planning are affected.

The Prevalence of Visual Impairment in People with Dementia, or PrOVIDe, study was developed as a collaboration between the College of Optometrists, Alzheimer’s Society and Thomas Pocklington Trust. The results revealed how common visual problems are, paving the way for improvements in eye care for people with dementia.

In the study, over 700 people with dementia had standard sight tests carried out by optometrists visiting homes and care homes. Of most interest to the researchers was the number of people with impaired vision, defined by low visual acuity (poor clarity of vision). When wearing their spectacles, one third of people with dementia had poor acuity. 

The researchers found that much of this could be improved with the right treatment. Almost half (44 per cent) could be remedied with new glasses and almost a quarter (22 per cent) was due to cataracts, which can often be operated on. The next leading cause was macular degeneration, which can sometimes be treated but not cured. In the study, people in care homes were significantly more likely to have impaired vision than those living in their own home.

James Pickett, Head of Research at Alzheimer’s Society, offered guidance from the start of the project, and Sue Maskell, a Research Network volunteer, assisted in a successful application for funding from the National Institute for Health Research. 

The study was led by Michael Bowen, Director of Research at the College of Optometrists, who said, ‘The fact we had three charities as full co-applicants on the submission was a strength. Having Sue as a co-applicant from the outset was very helpful in avoiding problems with the design.’

The striking results from this study have spurred the College of Optometrists to take further action. The college has published proposals in its journal, Optometry in Practice, to address the need for more dementia-friendly optometry practices and the creation of a dementia eye care pathway. 

This care pathway could provide people with dementia and carers with better information about the services available to them. For example, it’s not well known that sight tests at home, known as domiciliary visits, should be available to people who are unable to attend a practice unaccompanied. It could also provide additional subsidies for spectacles and improved access to eye care services. 

With the problems clearly outlined and potential solutions in the pipeline, it’s hoped that these insights will translate into better eye health for people with dementia in future years.