In the issue of Optician for 11.02.22, there were two CPD articles published concerning Alzheimer’s disease, the first (page 19) focusing on visual impact and the second (page 24) on communication. Some of the key points are repeated here, but to complete the interactive exercise it is essential that you read both of the features, which are the source material for your discussion.

Memory loss is the symptom most commonly associated with dementia. However, it is not always the first or more prominent symptom. Other symptoms include:

  • Communication difficulties
  • Disorientation of time
  • Place and person
  • Mood swings
  • Apathy and depression
  • Lack of coordination or balance
  • Visual perceptual difficulties and hallucinations

Alzheimer’s disease usually starts with memory loss, impaired reasoning skills and problems with word finding. As the disease progresses, the visual areas of the brain can be affected leading to less well-known visual processing disorders. Alzheimer’s disease can affect basic functions such as visual acuity, contrast sensitivity, visual fields and colour vision. When the occipital and parietal lobe are affected, this can lead to visual agnosias and disorientation as well as visual hallucinations.

The PrOVIDe study showed that, not only is sight loss found in a significant number of people with dementia, but many carers and family were unsure that people with dementia could have a full eye examination if they had difficulty answering questions.

Case Scenario for Discussion

A 76-year-old man attends his annual eye examination. His previous notes showed nothing remarkable other than ocular changes expected for age (low grade nucleosclerotic lens changes, minor arteriosclerotic retinal vascular changes), but his acuities were good (6/5 right and left) and maculae seemed normal. It had been recorded last year that he had a hearing impairment.

For your discussion, consider the following:

  • What patient behaviours might suggest that he was developing a cognitive impairment and how might these differ from those expected with hearing loss?
  • How might you best adapt your communication strategy accordingly?
  • If you have good reason to suspect a cognitive impairment at this stage, should you do anything and, if so, what?


Interactive CPD Instructions

In order to be able to log one provider-led interactive CPD point to your MyCPD account, this is what you need to do:

  • Make sure you have read the source material articles to be found with this exercise in the CPD area of opticianonline.net.  
  • Arrange a time to undertake a discussion on the subject with a similarly qualified registrant; another optometrist or dispensing optician.
  • Read the case scenario and questions (above) and use them as the basis for the discussion with your colleague. Note: the discussion needs to address each of the questions outlined above and must be for longer than 10 minutes.
  • When finished, you then need to send an email to ‘opticiancpd@markallengroup.com’ as follows;
  • Subject box should state ‘Alzheimer’s Interactive’ 
  • Please state your name and GOC number 
  • Please state the name and GOC number of the person you discussed the matter with
  • Please confirm you had read the source material
  • Please include a summary of your discussion, explaining your views and thoughts on each of the three discussion questions
  • Each submission will be read individually and, where needed, feedback will be given directly. Where the submission meets a required standard, you will receive an email confirming this, which you can then use as evidence of completion allowing you to log one distance learning interactive CPD point. 
  • A summary of the responses and discussions will appear in a future issue of Optician with comments from the authors.