Vision is a complex sense that begins with your eyes. However, the vision processing centers of the brain are responsible for interpreting visual input so you can recognize and act upon what you see. When Lewy bodies impact the areas of the brain dedicated to vision, they can interfere with the ability to correctly process and respond to visual information.

Standard eye exams cannot readily detect visual dysfunction related to Lewy body dementia (LBD) because the problem exists in the brain, not the eyes. Measuring visual brain dysfunction requires specialized tests administered by a neurologist or neuropsychologist during a cognitive assessment. Still, the first step to support proper visual function—whether you have dementia or not—is to make sure your eyes are healthy, and your vision prescriptions are up to date.

Ensure general eye health

Not all eye doctors understand how LBD affects vision, but they can still provide important eye care services. Therefore, you should schedule an annual eye exam even if you are not experiencing problems with your eyesight. Changes can occur inside the eye before you notice anything wrong. Your vision is especially at risk if you have diabetes, which can cause blindness without proper care. In addition, early treatment of age-related eye disorders—such as cataracts, macular degeneration, and glaucoma—can prevent vision loss.

Care for dry eye

Parkinsonian motor symptoms, which are often present in people with Lewy body dementia, can cause infrequent and/or incomplete blinking. This simple change can dry out the cornea and lead to blurry or double vision.

Tips to care for LBD-related dry eye:

• Run a humidifier at home.
• Drink plenty of water.
• Apply artificial tears.
• Perform a lid scrub daily to remove debris from your eyelids. Simply wash your eyelids with a soft washcloth dipped in one cup of water with a drop of baby shampoo. You can also purchase a lid scrub kit at a grocery store or pharmacy.
• Ask your eye doctor if any of your medications could increase eye dryness.

Use the correct eyewear prescription

Eyeglasses with multiple prescriptions for different distances require small eye movements and neck adjustments to see things in focus. Slowing of eye movements, inaccurate eye focusing, and poor coordination of the eyes (convergence insufficiency) are characteristic of Lewy body dementia and can make multifocal point lenses (progressive lenses) difficult to use.

Tell your eye doctor if you have LBD because it might affect your ability to use prescription eyeglasses effectively. Instead of having a single pair of multifocal point glasses, you may find it worthwhile to have two or three pairs of glasses for different applications. In the case of convergence insufficiency, your eye care provider may add prisms to your reading glasses to help improve near vision. Discuss your vision issues with your medical team and inquire if a visit to a neuro-ophthalmologist would be helpful.

Seeking proper eye care is only one small component of managing Lewy body dementia. For more useful information, please explore the Lewy Body Dementia Association website. You can also sign up for our email newsletter, connect with us on Facebook and Twitter, or contact us directly with any questions you have.