The recently published report of the Lancet Commission on dementia (Livingston et al, 2024 ) has expanded its list of modifiable risk factors to include untreated vision impairment. You may be thinking that confirms our long-standing suspicion. But have no doubt, this significant addition warrants close attention from optometrists and greater emphasis on the public health importance of regular sight tests and ensuring our ageing population has access to visual correction. The report is a vital new piece of evidence. Notably, this is not about expensive drugs or costly, time-consuming diagnostics. It’s about keeping people seeing well, the bread and butter of optometry and dispensing, refraction and visual correction. 

The inclusion of vision impairment as a modifiable risk factor underscores the critical role of sensory health in cognitive function. It reflects growing evidence that untreated eye conditions such as cataract, glaucoma and age-related macular degeneration can significantly contribute to cognitive decline, and addressing vision problems could help prevent or delay the onset of dementia in a substantial portion of the ageing population.