docet

Key Points

• Alzheimer’s disease (AD) has a strong association with a wide range of eye and visual abnormalities including sight loss.
  
• Patients with early stage cognitive loss show no significant differences in routine eye tests from those of similar age with normal cognitive function.
  
• Exaggerated mydriatic response has poor sensitivity as a diagnostic test.
  
• Increased amyloid protein in the aqueous with AD leads to supranuclear cataract.
  
• AD increases the risk of developing glaucoma.
  
• Detectable retinal changes in AD include optic nerve degeneration, retinal ganglion cell loss, reduced retinal nerve fibre layer thickness and macular cell loss.
  
• Advanced AD is associated with decreases in facial recognition, contrast sensitivity, colour vision and depth perception.
  
• Full correction of refractive error should always be considered for AD patients.
  
• Labelling of different use spectacles is helpful e.g. distance and reading.
  
• Yellow filters may improve contrast and reading speed in AD.
  
• Cataract removal is usually encouraged and referral should be considered early before informed consent is no longer possible.
  
• Increasing colour contrast in the home is helpful and has been shown to reduce the risk of malnutrition if applied to plates and drinking vessels.
  
• A study has suggested that only 9% of the public are aware of the link between AD and visual impairment and eye disease.