How often should the elderly get an eye test?

Vision issues and eye health are extremely important considerations for older adults, as this age group is more likely to suffer from problems that could impact their health and safety. Here, we are exploring the crucial role of regular eye tests in detecting vision problems and maintaining eye health in older adults, how often they should be tested, what to expect during an eye test, signs and symptoms of underlying problems, how to maintain eye health at home, the emotional support needed for those with vision problems, and how home caregivers can help. At Home Instead, our aim is to help people age positively and in place by bringing expert care to their home. For nearly 20 years, we have been providing the highest standard of care, and creating industry-leading training programmes for our Care Professionals that are accredited by nursing and medical professionals. Today, we are the world’s largest global domiciliary care network, supporting over 100,000 older adults with personalised, tailored care at home. So whatever questions you have about eye health and vision in older adults, we can help. 

What are the most common eye issues older people experience?

The most common eye conditions older people suffer from include:

• Age-related macular degeneration (AMD) – This eye condition can lead to a deterioration in the type of vision required to see objects clearly, so developing this can affect everyday activities like driving, watching TV or cooking. This condition accounts for around 23% of sight loss in the UK. 
• Cataracts – You have likely heard of cataracts before, as they are extremely common among older people. They cause a cloudy area in the lens of the eye which leads to blurry or hazy vision, and while they can be present for many years without causing much of an issue, sometimes they can develop to the point where they negatively impact vision. This accounts for around 19% of sight loss in the UK. 
• Diabetic retinopathy – Diabetes is a common condition in older adults, and those who have it could develop diabetic retinopathy which can affect vision. There are no warning signs for this, so prevention relies on effectively treating diabetes by managing blood sugar, blood pressure and cholesterol. This condition accounts for around 5% of sight loss in the UK. You can learn more in our article: Diabetes In Older Adults
• Glaucoma – This common condition causes excess fluid pressure inside the eye, which, if not addressed quickly, can lead to vision loss or even blindness in extreme cases. Glaucoma offers no early warning signs, so regular eye tests are crucial in order to catch this condition before it worsens. This accounts for around 7% of sight loss in the UK. 

It is extremely important for older adults to address the early signs of eye problems as soon as possible, as these could also indicate things like aneurysms, cancer, diabetes, heart disease, high blood pressure, multiple sclerosis (MS), stroke, shingles complications (if a shingles rash spreads to the eye), and more. Also, studies have found older adults have an increased risk of falling if they have reduced vision, so ensuring eyes remain as healthy as possible for as long as possible is incredibly important. In addition, one particular type of dementia, known as posterior cortical atrophy (PCA) dementia, can result in eye problems. Although it is thought to only affect less than 5% of people with Alzheimer’s disease, it is worth knowing about due to its primary symptoms that include issues with blurred vision or double vision, and difficulty judging distances or recognising depth perception. You can read more about this type of dementia in our guide to understanding PCA dementia.

What can older adults expect during eye tests? 

Eye tests for older people may be slightly more in-depth than the typical exams other people receive to check whether they need glasses or whether their prescription has changed. For anyone with a higher risk of specific eye health issues, such as older adults, they may receive more thorough testing. During eye tests, they can expect an optometrist to:

• Carry out a visual acuity test, which usually involves reading lines of letters on a chart to determine how well they can see at various distances
• Carry out a refraction test to determine what the correct prescription may be for glasses or contact lenses
• Examine the health of the eyes using a slit lamp to notice signs of cataracts, glaucoma, macular degeneration or any other age-related conditions
• Measure eye pressure to screen for glaucoma
• Examine the retina to check for signs of damage or disease
• Perform a dilated eye exam to check for any conditions, which involves putting drops in the eye to dilate the pupils – those aged 50+ could benefit from having a dilated eye exam each year, as well as those who have diabetes or high blood pressure
• Perform an optical coherence tomography (OCT) exam to get images of the back of the eye, known as the retina

You may be entitled to free eye tests through the NHS, which you can find out more about here.

What signs indicate the need for an immediate eye test? 

As well as vision, eye tests determine whether or not there are any eye health conditions, so it is important to seek an eye test immediately if you notice any signs or symptoms of an underlying condition. For example, you should get animmediate eye testif you experience: 

• Sudden vision loss 
• Sudden blurred vision
• Sudden double vision 
• Frequent light flashes in the eyes 
• Frequent floating spots in your vision 
• Persistent or significant pain in the eyes
• An eye injury 
• A red or swollen eyelid 

Other symptoms that may indicate the need for an eye test or doctor’s visit in the near future include things like:

• Burning or stinging in the eyes
• General discomfort in the eyes
• Not producing tears or producing too many tears
• Sensitivity to light 
• Difficulty telling colours apart
• Difficulty reading small print 
• Difficulty judging distances 
• Difficulty switching focus between objects in the distance or up close 
• Difficulty seeing clearly at night
• Tunnel vision, or loss of peripheral vision
• Headaches
• Tired eyes

It is vital not to put eye tests off for a long period of time if you experience any of these symptoms, as they could indicate the beginnings of a medical condition. Also, if you experience any of the more urgent symptoms mentioned above, attend a hospital or get an emergency doctor’s appointment as soon as possible to rule out any serious or life-threatening conditions. 

How can caregivers monitor eye health at home?  

Caregivers looking after an older adult should carefully monitor their eye health, particularly if they have additional health issues that could contribute to vision problems, such as diabetes. As a caregiver, it is important to be attentive to any changes in the vision or eye comfort of an older loved one, and ask regular questions about possible symptoms such as blurred vision, difficulty reading, or their ability to see in low light. It is also helpful to do visual checks for signs of eye discomfort, such as redness, or excessive watering from the tear ducts. There may be behavioural signs on display too, for example, if an older person has trouble recognising family members standing at a distance, becomes unable to recognise objects in their peripheral vision, needs to squint to see things close up, or frequently asks for brighter lights. As well as checking for any issues, caregivers can encourage older adults to wear their prescribed glasses when needed, keep track of any medication that might affect their eye health, and help them to schedule regular eye check-ups to detect any early warning signs for future issues.

How else can caregivers help older adults with vision problems?  

There are a number of ways home caregivers can help loved ones with vision or eye health issues. For example:

• Improving lighting in frequently used areas
• Making home adaptations and removing trip hazards like loose rugs or clutter
• Labelling items with large print or tactile markers so they are easier to identify 
• Providing magnifying glasses or devices to help with reading
• Guiding them through daily activities that require assistance, such as cooking or getting dressed in the morning 
• Assisting with managing medications for safety
• Encouraging the use of visual aids, such as glasses
• Providing transportation to regular eye appointments 
• Providing vital emotional support when they feel vulnerable, scared or confused due to vision loss  
• Monitoring for symptoms of anxiety and depression in response to vision loss 
• Encouraging them to join support groups or seek counselling to talk about how they feel
• Being available at night if a loved one is scared to be alone due to vision loss 
• Encouraging them to make healthy lifestyle choices (such as eating a well-balanced diet, safely exercising and quitting smoking) in order to maintain their overall health, which can have a positive impact on their eye health 

How can professional home care support older adults with vision problems? 

Professional home care can provide vital support for older adults with reduced vision by offering tailored assistance depending on what the person’s exact needs are. Trained caregivers can help with all of the aforementioned activities, but for those with severe vision loss, they can also help with tasks such as meal preparation, personal care, medication management and more. In addition, they can:

• Ensure safety and reduce the risk of accidents in the home through professional mobility support, and helping with the use of assistive devices and adaptive technologies to compensate for visual impairments
• Provide necessary diabetes monitoring for those with the condition, in order to intervene early on any possible complications that could lead to vision problems
• Be available for sitting services or overnight care for older adults who may feel scared to be alone at night when they cannot see well
• Offer companionship in order to reduce social isolation that may be compounded by depression – this is common in those with vision loss, with studies suggesting rates of depression and anxiety are higher in those with visual impairments. You can read more about mental health symptoms in older adults in our guide to supporting mental health in older adults

If you or a loved one are experiencing vision loss and would like additional support from a professional home carer, you can reach out to your local Home Instead office to learn more. Our Care Professionals are the best of the best, and highly trained to deliver the services you need. No matter what type of home care you are looking for, we can provide a tailored service that suits you or your loved one.We’re an award-winning home care provider and part of a worldwide organisation devoted to providing the highest-quality relationship-led care for older people in their own homes. Arranging care for yourself or your loved one shouldn’t be stressful, so whatever questions you would like answered, feel free to reach out to the Home Instead team to discuss your needs.