Has anyone else had eye Dr. say that eyes are fine but vision issues are cognitive?

The most detailed information I have ever found is Oliver Sacks’ last book ‘The Minds Eye’. It may not answer your question, but it’s a great read and probably the clearest way to understand the neurology of eye-to-brain.

This is how our Mom started out. We had her tested with a psychiatrist for cognitive testing. It took a couple of years to get her diagnosed correctly with a compitant neurologist. Read up about Lewy Body Dementia, have the Dr prescribe Home Health and be prepared for hallucinations to come soon. All family members need to agree to a care plan. (My brother and Dad thought my Mom could still drive a car!) Be your Mom's advocate for her health care no one else will be there for her except her loved ones. Question every medication and side affects and don't let them over medicate her. Teepa Snow is an excellent teacher for caregiver, family or assisted living center. Google her and watch and learn!!! Prayers for you and your family!

EllenSW, I am a neuro-optometrist by profession. I specialize in vision rehabilitation for patients with neurological disorders. There are very few of us, but those of us in this field can restore vision loss to Alzheimers and other dementias, strokes, double vision from Parkinsons and other neurodegenerative disorders. For patients who are unable to participate in a full rehabilitation program, there are compensatory treatments as well to maintain visually guided functions.

I agree that you have to ask the doctors what caused the loss of sight. Saying it is cognitive is meaningless. If it is a medication side effect that must be addressed ASAP. The longer her vision degenerates the more difficult it can be to treat successfully. Where there is a problem there is a cause, and that leads to better diagnosis and more effective treatment.

Most optometrists and ophthalmologist don't know how to diagnose much less treat these types of disorders successfully. Go to noravisionrehab.org to find a specialist near you. Not everyone who is a member of NORA is trained or certified in this specialty, so call and ask the doctor about their training and level of certification. Feel free to pm me with questions.

I strongly urge you to get your mother off of the risperidone as quickly as possible. Your mother may not be able to adequately express herself, but I suspect that the side effects of the medication are much worse than the initial vision problem.  And FYI, the elderly should not be given haloperidol, as it is not well tolerated.  Studies have shown that anti-psychotic medications substantially increase early death in elderly patients.
For visual disturbances, have your mother look directly at the delusional image.  It will probably disappear. She should sleep with a low wattage light on.  This will help decrease visual disturbances.  Make sure she gets adequate sleep and is well hydrated at all times. Good luck to you both.  I'm so sorry you have to deal with this.

If you feel she needs to be seen by a specialist, an opthamologist or a retinologist may be the choice. But the doctor on this thread offers valid, expert advice - Dr. Benshir.

Ellen, I don't have first hand knowledge of Alz & vision change, but I can tell you that you might want to look into vision therapy. I've been doing it for several mos (not related to Alz or dementia). It has helped me tremendously. My vision therapist told me we really do "see" more w/ our brains than our eyes. I never knew how much of a correlation there was. The eyes are really just the lens but what we see is processed in the brain.

The majority of her patients are children or stroke patients.
I don't fit into those categories, though. Part of my situation was hereditary. It manifested differently in me (some tendencies to going cross eyed, eyes not moving together, esp when tired) than your mom.

So depending on what is up w/ your mom, it may be worth at least looking into.
Treatment in my case involved weekly visits and vision exercise homework 6 days a wk. I am "graduating" treatment and am seeing now how I do w/ 4 days a wk.

I live in So CA, and even here there are not a lot of qualified Vision Therapists. It's still considered kind of "new" for people like me and as such, insurance didn't cover my treatment, but maybe your mom would fare differently. The industry is trying to get it accepted by more by insurance.

Best of luck to you and your mom!

Dear EllenSW..
Yes w the cognitive diagnosis & eyesight..My father’s spatial awareness & depth perception were the first to be compromised..A bit later, he developed pinpoint-pupils, which narrowed sight even further..When the brain communication center changes, it affects many of the senses.😢

An unforgiving disease..Prayers to you & Mom..🙏🏻❤️

discontinue the med.

I am a seasoned therapist and I have NEVER made a diagnosis about a patient's eyes! How about taking your mother to her PC for a complete annual checkup. And then you can also schedule an appt with a psychologist who you have seen before OR one that your mom's Dr Suggests, God's love & my prayers for you! Dr Jack Grenan

The occupational therapist who treated my mom after a hospital stay said she had no depth perception, and said that this is something common in the very elderly that an ophthalmologist doesn't test for. They can see the edge of a step, but not how far down it is to the next step - the edge could just be a line on a flat surface for all they can tell.

There is a subset of Alzheimer’s Disease called Posterior Cortical Atrophy that significantly affects vision and the brain’s ability to interpret visual input. A good eye doctor, a OT or Neuropsychologist doing cognitive testing can often pick up on the visual field cuts and reading problems. It is hard because it doesn’t get better with therapy. The best thing is to put effort towards adaptations similar to what helps others with low vision.

I found this Teepa Snow helpful as I noticed my husband losing peripheral vision https://m.youtube.com/watch?v=iaUsRa5kNyw

If anyone told me that, I'd be seeing my retinologist STAT.