Dementia eye care pathway for residential aged care

Optometry Australia congratulates Dr Marianne Coleman, Research Fellow and Orthoptist at the National Centre for Healthy Ageing, on being awarded the prestigious $400,000 Dementia Australia Henry Brodaty Mid-Career Research Fellowship. Dr Coleman is working to co-design a dementia-friendly eye care pathway aimed at ensuring people with dementia in residential aged care can “see well, to live well.”

Dementia is the umbrella term for a group of progressive neurodegenerative conditions that impact cognition, behaviour and daily function. People living with dementia are particularly vulnerable to vision impairment, especially from conditions such as cataract, age-related macular degeneration, and glaucoma.^1,2

Among the ~242,000 Australians living permanently in residential aged care, more than half (54%) have been diagnosed with dementia.³  Vision impairment in older Australians has been associated with an increased risk of falls, depression, poor mobility and reduced quality of life.⁴ Consequently, optometrists play a vital role as 44% of vision impairment in patients with dementia is correctable with spectacles.¹

Despite this, individuals with dementia, particularly those in residential aged care, are less likely to access eye care services.^5,6 Optometrists often report reduced confidence in providing care to patients with dementia, citing a need for further training in dementia-friendly eye care.^1,5 At the same time, care staff in residential facilities may not be equipped to identify vision issues or initiate appropriate referrals.⁷ A key barrier is the absence of a structured dementia-friendly eye care pathway in aged care. Dr Coleman’s research seeks to address this gap.

This important initiative that has been welcomed across the optometric sector.

‘As a public eye health provider, we welcome research that enhances training and strengthens eye care pathways for individuals with dementia. Early detection and management of vision issues are vital in improving quality of life, and this work is essential in ensuring equitable eye care for all.’ – Dr Josephine Li, General Manager of Outreach Programs, Australian College of Optometry Eye Health.

Optometry Australia recognises that Australia’s ageing population is reshaping the environment in which our members are practicing. It’s more important than ever to advocate for the role of optometry in residential aged care. While some progress has been made in expanding access, there remains a significant gap in equitable and routine eye care for aged care residents.

Optometrists in Australia are highly trained primary eye care professionals, well positioned to provide comprehensive eye health service in these settings. We welcome continued investment from the Dementia Australia Research Foundation and other bodies to ensure aged care residents receive the high-quality vision care they deserve.

Read more about Dr Coleman’s project here: https://dementiaeyecare.org/

References

1. Bowen M, Edgar DF, Hancock B, Haque S, Shah R, Buchanan S, Iliffe S, Maskell S, Pickett J, Taylor JP, O’Leary N. (2016). The Prevalence of Visual Impairment in People with Dementia (the PrOVIDe study): a cross-sectional study of people aged 60–89 years with dementia and qualitative exploration of individual, carer and professional perspectives. Retrieved April 2025, from https://pubmed.ncbi.nlm.nih.gov/27489923/

2. Chriqui E, Law C, Kergoat MJ, et al. (2017). Visual impairment in older institutionalised Canadian seniors with dementia. Ophthalmic & Physiological Optics 37, 225–233. doi:10.1111/opo.12358. Retrieved April 2025, from https://onlinelibrary.wiley.com/doi/10.1111/opo.12358

3. Australian Institute of Health and Wellbeing (AIHW). (2024). Dementia in Australia – Residential Aged Care. Retrieved April 2025, from https://www.aihw.gov.au/reports/dementia/dementia-in-aus/contents/aged-care-and-support-services-used-by-people-with/residential-aged-care

4. Vision 2020. (2025). Clear vision: Key priorities for eye health & vision care. Retrieved April 2025, from https://www.vision2020australia.org.au/wp-content/uploads/2025/02/Vision-2020-Australia-2025-Clear-Vision-priorities.pdf

5. Piano M, Nguyen B, Hui F, Pond CD (2024). Access to primary eye care for people living with dementia: a call to action for primary care practitioners to ‘think vision’. Aust J Prim Health. Retrieved April 2025, from: https://pubmed.ncbi.nlm.nih.gov/38422501/

6. Jyoti Khadka, Julie Ratcliffe, Gillian E. Caughey, Steve L. Wesselingh, Maria C. Inacio. (2021). Prevalence of Eye Conditions, Utilization of Eye Health Care Services, and Ophthalmic Medications After Entering Residential Aged Care in Australia. Trans. Vis. Sci. Tech. 10(14):3. Retrieved April 2025, from https://doi.org/10.1167/tvst.10.14.3.

7. Dawes P, Leroi I, Chauhan N, et al. (2021). Hearing and vision health for people with dementia in residential long term care: knowledge, attitudes and practice in England, South Korea, India, Greece, Indonesia and Australia. International Journal of Geriatric Psychiatry 36, 1531–1540. Retrieved April 2025, from: doi:10.1002/gps.5563