1 April 2019

College research raises awareness of dementia that has early visual symptoms

The College of Optometrists has completed research on the experiences of vision assessment for people living with a form of dementia that impacts vision.

The research, published in the BMJ Open on 21 March, focused on posterior cortical atrophy (PCA) which can result in unusual visual phenomena, such as finding it easier to read smaller fonts than larger ones, as well as visuospatial and perception problems. These can result in misdiagnosis unless health professionals know about, and test for, the condition specifically.

The project, undertaken with researchers at the Dementia Research Centre at University College, London, guided three patients living with PCA through tests administered by three different health professionals; an optometrist; an ophthalmologist; and a neurologist. The key finding was a quick and simple visual recognition test that showed some promise in helping clinicians to differentiate between vision problems with neurological origins, from those with optical/ocular causes. 

The researchers also spoke to the patients, their carers and the health professionals about their experiences of vision assessment, and found that patients’ priority was early diagnosis, while the health professionals valued further research and learning materials to raise awareness of the condition.

Michael Bowen, Director of Research at the College, said: “Although this project was limited in scope, it builds on the evidence from the College’s NIHR-funded PrOVIDe project that there are vision assessments that people with dementia can complete, and that short and simple tests are preferable for this group of patients. It is important that optometrists, as the first port of call for those with vision problems, are aware of PCA, to ensure that patients are diagnosed as quickly as possible and can come to terms with the condition, which is why we have produced an online course for our members based on this project.”

Professor Sebastian Crutch, Professor of Neuropsychology at University College London, said: “The experiences of people living with this condition can be truly mind-bending at first. Their eye care needs are the clearest example of how the visual system is as much to do with the brain as the eye, and their stoicism in the face of misdiagnosis is humbling. Hopefully this research will lead to further work that could verify the effectiveness of tests that can quickly identify PCA, and so help all health professionals in their practice.”

Members of the College can complete the course “Which test is best? Managing patients with Posterior Cortical Atrophy” on the College website. 


Notes to Editors

  1. The College is the professional body for optometry. It qualifies the profession and delivers the guidance and training to ensure optometrists provide the best possible care. We promote excellence through the College’s affixes, by building the evidence base for optometry, and raising awareness of the profession with the public, commissioners, and health care professionals.
  2. The College of Optometrists has introduced an opportunity for members, organisations and the public to support the College’s research work. The College is inviting donations to allow individuals and organisations to play a part in its work to develop evidence that is capable of advancing the profession, reduce preventable vision loss and providing accessible, high quality, eye care for all. To contribute to the Research Fund, visit the College’s donation page. The College of Optometrists is a registered Charity no 1060431. 
  3. The PrOVIDe research was led by the College of Optometrists in collaboration with City, University of London, University of Birmingham, Thomas Pocklington Trust, University of Newcastle, Trinity College Dublin, University College London and Alzheimer’s Society. It was funded by the National Institute for Health Research Health Services and Delivery Research programme.

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