Welcome to question of the day #343

Eyetool question of the day # 343

I was having a discussion with another eye care specialist and she told me that there is a link between dementia and poor visual acuity. Is this correct?

Yes, it is.

It’s been known for a while that people with good visual acuity are less likely to develop dementia or if they do it is less marked than in similar people with poor visual acuity.

Providing older people with the best possible visual acuity is a very important part of dementia prevention.

Providing the best possible visual acuity could simply involve prescribing optimum spectacles with clear instructions on when they should be worn and for what type of task.

Removing a cataract improves also visual acuity so another way of helping is to refer to an ophthalmologist for cataract extraction with subsequent provision of optimum spectacles.

People with wet age-related macular degeneration should be referred quickly for possible treatment with anti-VEGFs and others with low vision referred for a low vision workup where visual acuity may be improved with magnifiers and/or telescopes.

The interesting question is why having good visual acuity prevents dementia in some people. There must be a link between a sharp image on the retina and a reduction in the brain plaques that characterise many forms of dementia. Or is it that seeing well means being able to read and do other activities of daily living and it is these activities that reduce or prevent plaque formation? Or is it that seeing well allows better interaction with other people?

Whatever the cause, as the group that has responsibility for providing people with the best visual acuity, we have an important role to play in dementia prevention.