I'm hoping I can give you a description of what it is like to have severe photophobia and visual impairment as I have a condition that causes both. Hopefully, this will bring more of the world to your elderly loved ones and help you as a caregiver.
I have been caring for my parents as of of late, my dad is in late stage Alzheimer, is deaf, and has only vision in the right side of each eye due to multiple strokes.
To begin, have your loved one tested to see which fields of vision they still currently have. Most people have a "focal point". You may be able to figure it out just by watching them eating, walking, or gazing.
I have had severe photophobia, therefore, my eyes have acclimated to focus far down away from light, so I focus best far down. Now watch your loved one. Notice where they gravitate their head towards as they walk, which direct do they gravitate toward, left or right? I gravitate toward my left , so it is best to walk on my right side otherwise I will constantly walk into you. For, example, my dad has lost vision in both eyes, the left sides of each, has no point of reference for the left side of his body due to a stroke. Therefore, I if I stay to his right , he will gravitate naturally toward me and remain clear of a wall or other obstacle he does not notice on his left.

With photophobia, they may have focusing issues. So if they hesitate to step forward or put their foot on the floor, it could be a depth perception thing. Telling them the following may help " wood floor, it is safe... stepping onto carpet, it is safe".

Place a bright orange or contrasting solid colored towel down onto the spot where they are to sit. Pattern on furniture is confusing.

The movement of walking across in front of a window or door with the sun shining in is just enough to cause a flicker sensation and put the person off balance when they try to compensate.

I hope this also helps you with their tv viewing. My family had a huge screen tv in their tv room thinking it would be best large so he could see it. The large tv requires one to sit far from the tv to focus. Unfortunately, his focal point is down-and- right. He wasn't staying awake and would become agitated or depressed sitting with my mom "watching" tv. I showed them by putting my 36" samsung tv about 2' off the floor, about 4' from the seat , and to the right of a recliner he would be able to watch , and YAY! It worked. The recliner also helps because when he reclines back in the chair the focal point of the tv is automatically lower and he does not need to hold his head so high nor look up or straight to see the screen. For me, the muscles that have me looking up or even straight are not as strong so looking up at the center of a screen or straight forces me to hold my head higher causing neck pain or my eye muscles to fatigue and have tremors. Have them watch SLOW moving objects on tv with brilliant colors. Some that work well are Animal or Most Amazing Animals, Survivorman ( he is slow talking and methodical, a best friend kinda guy) , Our Planet, Planet Earth. Having to track fast moving object gets very confusing for the brain to process through the eyes. Have a small light on in the room out of their field of vision ( for my dad off to the left about 12 ' away)and minimal objects around the tv so they can stay focused.

Those of us with severe photophobia, we function better and relax wearing a baseball cap or sunglasses indoors. If they prefer sunglasses, the dark brown tint helps objects pop out vs the dark grey that feels more depressing. Putting on dark glasses indoors "slows movement in front of me down" and lets my eyes process better. Please consult with an eye specialist before trying this as a specialist will be able to tell you if it is safe for your loved one to be abulatory with dark lenses.
Use incadescent bulbs in open light fixtures. Glare is very disturbing to those with photophobia.
I am so grateful we have this group to share.

this article has been written for seniors just encountering these problems. Great ideas. But unfortunately not helpful for our situation.- which is much more advanced. Lights? NO NO NO. not for anyone who is light sensitive. Beyond Charles Bonnet syndrome and encountering 3 eye diseases
Hope it helps someone else

Terrific, informative article. Thank you!

This is so good, one of the best articles I have seen on AgingCare. I can verify that all of the above are definitely helpful, if not a must! I first noticed I was "losing things" too much, then, I noticed a pattern. The things that "disappeared" were dark objects, because I couldn't see them contrasted against a dark background. A "tip" for anyone might be to avoid dark colored stuff. Unfortunately, the tech industry makes everything black! A workaround would be using stickers, bright cases, labels, or even bright duct tape. If your floor is very dark, consider brightening the room (if you can) with lighter floor coloring, but not a bright red rug. Rugs also present problems if they buckle. Also, make a habit of carrying a reliable pocket flashlight. Have spares and hang these around the house in handy places.

Losing pills is a problem if pets are around. A person who has trouble seeing may hear a pill hit the floor, but will have a lot of trouble retrieving it. Locate the pill by first shining the flashlight onto the floor. If that fails, try the "broom method." The lost pill is bound to show up among the dust bunnies.

As far as using a computer, I'd suggest color reversal, which is available with most browsers as an extension. In Google Chrome, try one called Deluminate. There are others, too. Firefox has several. I find for font enlargement, Firefox tends to do a better job since Chrome is more likely to overlap the print. I'm not sure about other browsers. Adobe Reader will reverse colors as will most Word-type applications (even Scrivener).

I am pre-senior, but my vision has decreased so much that most would feel limited at this level. However, I am very lucky because I gave up driving decades ago. I am still able to do most of what I need to do, including reading and writing, which are such important skills to retain to connect to the world if one tends to be verbal. I also enjoy distance running, usually on a treadmill but I can still run outside if I want. Don't ask me to read street signs! And much of the time, I can't recognize people faces, either. (Don't worry, I still love you all, though....)

cwillie, good idea but if its plastic I doubt she'll use it. Thats another pet peeve. But I will look for them. Thanks!

Cwillie, good points but dealing with a 91 year old man who regularly misplaces things and forgets to turn the lights off on his lighted mirror and magnifying glasses and refuses to wear the most current prescription of his glasses. At this point, whatever way he chooses to address his problem is the way we usually go and flashlights are something he is familiar with. My job is to make sure they all work and are nearby when he needs them. And there are no rugs on the floor. :)

Suzyq, I wonder if she would be open to using the travel mugs people get for their coffee, they are not childish and you could use the fact they are insulated as a selling point, good for either hot or cold beverages!

I enjoyed the article and we have tried all the mentioned tips to help our mom's declining eyesight, which is now pretty much gone. She refuses to use a cane, will not agree to organizing anything, and her memory is spotty at best. So what can be done to help her cope with her blindness when she chooses not to cope? For instance we have purchased sippy cups with and without straws to help cut back on spills. Only for her to refuse to use them because they make her feel like a child. We have had OT's come out and work with her and the cane, but my mom says she doesn't need a cane because she's not lame.
How do you deal with someone that...stubborn, and ignorant for lack of a better word. The fact that she's unwilling to relearn and cope basically means we wait on her hand and foot with the exceptions of her fixing her own pepsi, getting a cookie out of pantry, unwrapping a stick of gum and feeling her way to the bathroom. And if she's capable of doing that why does she refuse to try and do more? She no longer washes up daily, brushes her teeth or changes her clothes. Showers and hair washings are a fight. All she talks about is going home and everyone but her realizes that that isn't a doable thing anymore for many reasons. Help! We are desperately trying to keep her out of a nursing home, but her behavior and lack of cooperation is making it very hard.

Invisible, there are many different shades of sunglasses designed to reduce glare, my mom chose a very light amber tint in a wrap around frame that she could wear over her prescription glasses. On very bright days or when going places with florescent light she wore them inside, she had a dark amber pair for outdoors in sunny weather.
There are also so many magnifiers available with built in lights, ranging from inexpensive drugstore varieties to high power 14X magnification (usually prescribed after a low vision assessment). It has been a few years since I've checked, but I imagine the tech side of low vision aids has improved exponentially in the last few years too.

I realize this is a 2-yr old article but it timely. Just yesterday my father asked me to find his flashlight. He usually keeps one near the thermostat so he can see and one by the bedside so he can see the light switch on the lamp! For some reason, he doesn't use the nightlight. So he has flashlights and magnifying glasses in different spots all over the house so he can easily see writing on things like the washing machine, thermostat, microwave, etc. Also, the outside glare will frequently bother people with cataracts and macular degeneration. My mother also kept the curtains shut for that reason and she had always been a lover of the outdoors. I wish they could get a handle on it.

Many years ago I lived in an apartment owned by a couple elderly (88 and 92) sisters. The older woman had limited vision, and she mentioned that she had a tendency to knock over her drinking glass. I suggested using one other than a transparent colorless one so she could see it better. I thought this was a rather obvious solution, but she and her sister thanked me rather effusively for suggesting it.

This is so tough, Osmiii. Dental exams are often a challenge of the same magnitude. I don't know what you can do, short of medicating her. You may be able to find a pediatric optometrist of ophthalmologist who would have some ideas. Has anyone on this community forum found an answer?
Thanks for any input,
Carol

My wife has worsening dementia and won't let the optometrist touch her. Any thoughts as to how to deal with this situation?

Terrific points, Creativedanger. The part about talking to the individual so that he or she is able to know that you're around is important. Also, you don't want to startle someone with low vision by just appearing at their side - talking as you move toward them can help. Caregivers are, indeed, some of the most creative people around.
Carol

Good stuff here. I might add keeping things in the same place all the time. If his breakfast cereal isn't in the same place as always it'll mess him up. I have to remember to put the computer mouse in the same spot and place his magnifying glasses where he can find him. When I'm in the house I talk when I move around so he can tell I'm there. Outside, I'll show him where the curbs are and use fighter-pilot directions (one o'clock level) with him.

JNelson, you've come up with excellent ideas of your own. We appreciate your sharing them. Most states do have books on tape (CD now) through their state libraries, but you're right in the people with dementia can't retain the story line. Therefore, music or familiar children's stories are better than the deep novel he or she may have once enjoyed. Make good use of music - it's not just about nostalgia, it physically changes the brain.

Thanks again for your wonderful suggestions.
Carol

My mother has advanced macular degeneration a, and dementia and is incontinent, a challenging trio. However, we are blessed in that her personality has not changed; she remains very pleasant. In North Carolina there is a free service for the blind that provides a CD player and tapes, free of charge. We now find that she can't follow anything with length, so I have begun to buy CDs with familiar fairy tales and children's stories. Music tapes are good, too. She can semi-follow her favorite basketball team, doesn't matter when the game was actually played! A reader (looks like a computer but just magnifies whatever is placed under its lens) was helpful in earlier days. It could be adjusted for magnification and could be changed to black background and white print. A good gift is a digital picture frame (large). All the tips provided by Carol REALLY work, believe me! Wish we had had the list, but figured most of them out ourselves. One of the best devices is a huge digital clock that gives date and time. Do an Amazon search.

I'm glad the article helped, freqflyer. One of my beloved elders had been deaf from middle age (Menere's disease) and then developed macular degeneration. The idea of being both deaf and blind is more than most people can take. His mental health started to deteriorate with is physical health. I felt that these resources were helpful. We can hope that there will be more solutions to come.
Carol

Carol, thank you for all the great ideas. Both my parents have macular degeneration and how I wish they would turn some lights on in their home... it's like walking into a cave. Plus several years ago my Dad went and changed all the old fashioned light bulbs to the new twisty florescent which I feel doesn't give the correct amount of lighting for them to see. And the shades are always drawn so very little outside light coming in.... Mom doesn't want to fade the rug or furniture :P

Mary, many elderly have some type of macular degeneration to which there is very little that any Ophthalmologist or Retina specialist can do to correct that, at this point in time.... there is research going on for stem cell to help reverse the degeneration but that is years away. Hopefully the next generation can be helped.

A wide range of services are available that can enable adults who are blind or have low vision to continue living independently. A fear of loss of vision can awake fear in many, which in turn leads to worse consequences. I am a caretaker and I strongly feel being at service can only be complete if solutions come handy like the one in Evergreen Eye Center at Washington . Solutions like implantable lens, lasik surgery, cataract surgery and many more are now available. These are opening up a new world for those suffering from vision loss.