Sight problems in older people
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Low vision is common in older age
Sight loss is linked to age; the older you are the more likely you are to be living with sight loss and the more likely to experience sight loss in combination with other health problems such as hearing loss, diabetes, poor physical mobility or dementia.
The most common eye condition causing sight loss in older people in the UK is age- related macular degeneration (AMD) but almost one quarter of older people that are registered as blind or partially sighted experience two or more eye conditions. Other common causes include cataract, glaucoma, diabetic eye disease, stroke, and other vascular problems affecting the nerves and blood vessels to the eye or the area of the brain responsible for vision. In many adults, poor sight is due to uncorrected refractive errors.
Stroke and sight loss
Poor sight loss is common in those experiencing a stroke. About 60 per cent of all stroke survivors are left with visual problems however, professionals treating stroke survivors do not always refer these patients to an eye clinic or provide visual information leaflets.
Dementia and sight loss
About 2 per cent of people aged over 75 are known to have concurrent sight loss and dementia. In reality, there are probably many more because both dementia and sight loss remain under diagnosed. Sight loss can make the effect of dementia much more severe, and dementia can make the effect of sight loss much more severe.
Diabetes and sight loss
Diabetes – is associated with different types of sight loss including retinopathy, circulatory problems affecting the retina and optic nerve and cataract. Variations in levels of glucose in the blood team can also cause fluctuations in vision. Cataract is more common and can occur at an earlier age in people with diabetes than people without diabetes. In those affected, sight loss can complicate care for diabetes with difficulties seeing the results of blood glucose monitors or using insulin delivery devices. Increasingly, alternative devices such as “ easy to see” or “talking monitors” can be valuable.
Don’t let age be a barrier to getting help with sight loss
Despite the link with later life, older adults are less likely to seek or receive help for sight problems. This is either because they assume that it is a normal symptom of ageing or because it is overlooked due to other problems such as dementia.
This is unfortunate because prompt assessment can help to ensure that those affected can be treated appropriately. Treatment such as cataract surgery can reduce sight loss, and practical support to tackle day to day problems can dramatically improve quality of life.
Common early signs of sight loss include problems reading, driving, getting out and about, watching TV, taking medication, and recognising faces and expressions.
Low vision can progress and impact on every aspect of life
he widespread impact increases the risk of falls, loneliness, isolation, depression and other minor injuries like scalds and burns. It impacts on
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- Reading and hobbies – letters, TV listings, computer screens, phone displays, handicrafts, jigsaws
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- Cooking, buying and preparing food – pouring liquids, measuring ingredients, seeing dials on cooker/microwave, reading instructions/sell by dates.
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- Getting out and about – crossing roads, using public transport, visiting unfamilar places
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- Communication – telephone, writing, computer, recognising friends,
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- Medication – taking tablets, self-injecting, reading prescriptions, instilling eye drops
Much sight loss in older people occurs gradually over time. This means that many of those affected will have to learn and relearn how to adapt to sight loss as their sight deteriorates
Simple ideas to make life easier
Clever use of colour, contrast and texture (commonly bump sticker dots) can make life much easier as this video demonstrates:
Specialist services
Low vision and Sight Loss Services
There is considerable variation in the scope of service provision across the four countries in the UK but also between different areas in each country. This is due to the differences in the way services are funded, provided and commissioned.
Ideally, you should be able to access – either in the community or at the hospital eye department – practical and emotional support from a sight loss adviser, Eye Clinic/Care Liaison Officers (ECLOs) or a Vision Support Officers (VSOs).
This video shows how an ECLO can introduce you to helpful aids and equipment and top tips for daily living with a vision impairment:
Vision rehabilitation services
ouncils across the UK should offer vision rehabilitation support to blind and partially sighted people and you should also be able to access this support
Many people don’t know that these services are available and can be accessed at any point – whether your sight loss is recent or even if it happened many years ago. You can also be reassessed if your sight or circumstances change eg moving house, needing to learn new new skills, worsening sight.
The support can include funding for minor aids, equipment and home adaptations and other equipment might also be available via a loan scheme. Research indicates that Councils vary in their provision of these services and the relevant referral pathways. You can contact your Council adult social care department to find out about local provision.
This type of service gives practical and emotional advice and support to help people with sight loss tackle day to day problems such as:
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- Tips, advice and training on how to cook, clean and maintain your home safely.
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- Advice on lighting.
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- Support with communication needs such as reading post.
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- Mobility training; e.g. how to use a white cane, building confidence to get out and about and cross roads
This video introduces the role and responsibilities of a Rehabilitation Officer of Visually Impaired People (ROVI).
Certifying and registering your sight loss can open up more support
An eye surgeon can certify you as having low vision. Once this has happened, you can give permission for that information to be shared with your local authority and become registered on their sight loss register.
Councils are required to maintain a Sight Loss Register which will then prompt them to make contact with you to offer Vision Rehabilitation Support (see above) – even if you have not approached them. This support can lead to other help, such as financial benefits or access to equipment and home modifications.
Individuals who are certified as sight impaired or severely sight impaired must not drive.
You must tell the Driver and Vehicle Licensing Agency (DVLA) if you’ve got any problem with your eyesight that affects both of your eyes, or the remaining eye if you only have one eye. This doesn’t include being short or long sighted or colour blind. You also don’t need to say if you’ve had surgery to correct short sightedness and can meet the eyesight standards.
This video explains the certification process
Diabetic eye screening tests
Throughout the UK, adults with diabetes type 1 or type 2 are offered regular eye screening tests. Diabetic retinopathy is an eye condition caused when high blood sugar levels damage the cells in the retina. Left untreated, diabetic retinopathy can cause serious damage to eyesight, even causing blindness. Screening is important because, in the early stages of the disease, you may not realise that you have it.
How to guide someone with low vision
- Always ask the person if they want help.
- Stand side by side so that the person can locate your upper arm.
- Ask the person on which side they prefer you to walk.
- Start moving and walk one step ahead.
- Give commentary concerning hazards for example “we are approaching a flight of stairs going up”.
Getting help from expert groups
Many of these organisations provide befriending services, tailored support and specialist aids and equipment
