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My husband is 75 and was diagnosed 5 years ago. He is very social and jokes a lot but has limited short term memory and has difficulty reading. He can’t remember how to sign his name. I’m afraid he won’t be able to take a vision test. Also his cataracts may be ready to be removed. It’s been 2 years since his last test. How do I handle it if he had cataract surgery? I don’t think he will stop touching his eyes. As an example, he keeps removing his hearing aids and last week he put one down the garbage disposal and it got ground up. I think he had it on his plate and when he went to wash the dish he washed the hearing aid down the drain. He had no knowledge or memory that he did it. Thanks for any suggestions about vision.

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You let the examining doctor know your concerns. He will arrange to do the exam differently than he normally would. It is crucial now to be examined for the eyes in terms of any chronic problems that come for elderly (macular degeneration and cataract and glaucoma only a few of those). It is crucial with cataract surgery that you speak with the doctor about how to handle to post op problems as well. Wishing you good luck.
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Eloise46, since small children are able to get glasses without knowing all the letters, the same can be done for an adult who can't name the letters. The eye doctor will know how to handle this when you bring up the subject.
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My husband had a massive stroke at 48, which left him unable to speak well, or read, so when it came time for his eye exams, thankfully we had a kind and patient optometrist, who figured out what to do. He would only use the eye charts that had the E's on them. Some E's would be pointing down, some sideways, and some up. He would have my husband point with his one good hand, which way the E's were going. That worked very well for my husband, and we never had an issue with his glasses.

I cannot speak much to the cataract surgery, as I never had to deal with that, other than to say, that I would perhaps put that off as long as possible, and maybe just keep getting him stronger glasses, as his eyes get worse. I wish you the best.
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I think you need to think deeply about the immediate post-surgery regimen. You may be correct that he won't be able to NOT rub his eye (they do one eye at a time). There are multiple eye drops that need to be administered multiple times a day for up to 2 weeks (and it's so confusing they actually gave my mom a chart). Then you get to go through it all over again when they do the other eye.

My mom had a post-cataract surgery vision problem which was only corrected through much effort and a Lasik surgery and because she could accurately communicate what was going on. I think you need to get advice from someone who's actually gone through this surgery with an LO with ALZ, as well as the surgeon. I hope you get much helpful info on this topic.
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This is just my feeling.....I would be concerned about having a dementia person go under anesthetic, unless it is a vital operation. I do not think of cataract surgery as vital. Because of his present condition he might not be able to read even after the surgery. I have had cataract surgery and know there was a vision help but really not super major and yes keeping his hands away from touching etc after surgery is very important. But mainly I would be concerned about the anesthetic and brain in its condition.
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jacobsonbob Jan 2021
There are probably several options as to the anesthesia, including local options, such as drops in the eye. I had cataract surgery on one eye, and afterwards drove back to work.
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There are vision tests for young children who don't read yet which use icons like hearts and suns. If he can recognize shapes, that might work. I had cataract surgery, and I had trouble keeping still on the second surgery; they loaded me up with some tranquilizer. I don't remember a thing. I'm pretty sure the opthalmologist has dealt with difficult patients before. I'd be more worried about keeping the eye guard taped on. It might not be worth that struggle. Short of keeping someone unconscious for about 24 hours, there's really nothing you can do to ensure that the eye stays protected. And knocking people out is not a safe idea.
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Talk to his eye doctor. They can do tests for people with difficulty reading - kids have an eye test where they have to point in the direction the arrow or letter points.
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I know exactly what you are going through!My sister who has Alzheimer’s would not wear her hearing aids! She drowned one when she was in the shower - some times she would hide the one she was wearing!She then would leave her glasses down & forget where they were!She would take her teeth out & forget that they were not in her mouth!That was about seven years ago! Now fast forward to now
she does not wear her glasses , or her dentures, or her hearing aids!
She is in a nursing home ,content & happy see sees well without her
glasses,— she can hear if you talk loud & still does not wear her dentures
She does not know me anymore ,she is on puréed foods ,does not walk
& is in a wheelchair!My sister is 76 years old! Alzheimer’s robbed her of
her hearing ,eating & walking!It is a terrible disease to have!
The nursing home takes very good care of her—I could never be able to care for her!
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Suggestion for the hearing aides ( my 95 yr old Mom deep into her Alzheimer's journey, ate one of hers. The aide got it out if her mouth before she swallowed the battery) . Have the audiologist attach a tether to it. One end goes on a loop to the device, a 6 to 8 inch thin, clear plastic leash with an alligator clip attaches to the back of the shirt or collar. When they take it out if their ear it just hangs from the tether. Good luck. My Mom also stepped on and broke her glasses. I could not replace them because her prescription was too old. She is blind in one eye ( macular degeneration) but manages with no glasses now for 2 years. The brain at this point can not process what she sees. It is just a horrible disease all around.
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Definitely talk with the ophthalmologist about the concerns for the surgery AND post surgery care. If he can't sit still for the surgery, that would be bad. If he can't stop touching his eyes, that would also be bad. As long as possible, I would try to keep up with exams at the least, because there are other conditions to worry about.

Up until mom's stroke, I kept up her Mac Deg treatments, every 4 months (she'd been doing this for many years before dementia, so it wasn't totally foreign to her.) The only real vision exams were done as part of the "treatment" - it was hard getting through some of it, due to hearing issues and dementia, but not too bad.

At his stage and condition, it might not be worth doing the cataract surgery. I know that my ophthalmologist told me I would need it done in about 10 years (maybe 5 years ago?) So far it only impacts driving at night, esp in the rain on dark roads, worst with on-coming traffic! So now I try to avoid driving far at night. I didn't want to get it done in case my mother needed me for anything.

Since it's not likely he is driving and distance vision isn't as important, it may be best not to put him through that. He may not grasp what they're doing, get restless mid-surgery, and will definitely be a problem post surgery. DO get all the exams done and see what options there are for helping his vision for now.

I'm not looking forward to it myself... It will be nice if they can correct my close vision - I don't drive as much now, so only having to need distance glasses will be nice!
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