People with Alzheimer's disease or dementia typically have a normal visual acuity, unless there are problems such as cataract or macular degeneration.

However, because the affected person can have difficulty identifying numbers and letters, measuring his or her visual acuity can be a challenge for the optometrist.

Look for a doctor with patience and experience with elders, perhaps one that uses a "Tumbling E Eye Chart," features only one optotype — E — and the affected person only has to gesture the directions they see the E facing.

Prior to the symptoms of Alzheimer's disease or dementia being clear, the person may experience a Balint-like syndrome, which is a triad of severe neuropsychological impairments, such as: the inability to perceive the visual field as a whole; a difficulty in fixating the eyes and/or impaired reading capacity; and the inability to move the hand to a specific object by using vision. The optometrist or a neuro-ophthalmologist should be consulted if these symptoms or conditions are occurring.

The person with Alzheimer's or dementia can benefit from regular eye exams and particularly getting separate glasses for distance and reading. It is difficult for an optometrist to ascertain what an affected person is really seeing if the person makes only occasional visits with the doctor.

Additionally, the affected person can usually get accustomed to wearing progressive lenses, and having this good, intermediate vision also can assist in fall prevention. It is helpful to get polycarbonate lenses, and safe and sturdy frames, perhaps colored, so they won't be easily lost.

Some things to remember about eye exams for people with Alzheimer's or dementia:

  • Inform the optometrist/ophthalmologist/neuro-ophthalmologist of your loved one's condition, particularly how well your loved one can answer questions or follow instructions.
  • Schedule eye exams at a time when the affected person is at his or her best and remember that your loved one may not be able to complete the exam in one appointment.
  • It is possible to test the health of the affected person's eyes, and check his/her glasses, even if the affected person is noncommunicative.

All in all, it is helpful to find an optometrist with experience in providing eye exams for people with Alzheimer's or dementia. The optometrist can form a relationship and build trust with the affected person, which can lead to a less-challenging overall "eye exam" experience.

Questions about Alzheimer's disease or a related disorder can be sent to Dana Territo, the Memory Whisperer, director of services at Alzheimer's Services of the Capital Area at advice@alzbr.org or visit the organization at 3772 North Blvd., Baton Rouge.