2 April 2019
Source: College of Optometrists
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.