The National Institute for Health and Care Excellence (NICE) has updated its national dementia guidance to recommend that all patients newly diagnosed with dementia are offered an eye health assessment with an optometrist.
Previously, patients diagnosed with dementia were not routinely referred for ophthalmic review. As many of them might not notice a decline in their eyesight, people could experience significant, avoidable and sometimes irreversible deterioration in their eye health before being prompted to take a test.
Worsening vision can affect confidence; the ability to read and write; the frequency of leaving the home (meaning fewer interactions with other people including family and friends and less exercise); and falls and injuries. All of these can also accelerate the progression of their dementia. The updated guidance has taken over a year of research and advocacy.
Professional advice to clinicians is now that patients with dementia should be seen by an eye care specialist soon after diagnosis.
This change could have a profound impact on the safety, independence and quality of life of many thousands of patients each year. It could also delay institutional care and ease the burden on families and carers. This national recommendation represents a significant step forward in ensuring that eye health is better integrated into dementia care, reshaping policy and improving standards of care across the UK.
“This is a clear example of how clinical evidence continues to help advance clinical care with national impact,” said Kamran Saha, consultant ophthalmologist. “We look forward to seeing this work make a tangible difference to the quality of life of some of the most vulnerable people in society.”
Dr Simon Wheeler, senior knowledge officer at Alzheimer’s Society, also welcomed the change to NICE guidance. “Getting an eye test is one of the first things we advise people to do after a diagnosis of dementia. Poor eyesight adds to the confusion caused by dementia and makes it much harder to stay active and engaged. Yet in most cases it can be improved with a new glasses prescription or treatment. Eye tests can also catch cataracts early and get them fixed with a quick and simple operation before a person’s dementia becomes more advanced. It’s great to see NICE recognising this in their new guideline.”
The updated guidance will now form part of the dementia care pathway used by NHS trusts and primary care providers across the country.
