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Mom has lost most of her vision in one eye due to Corneal tear about a year ago. Since than she has not been happy with her new glasses, but has trouble explaining what it is, just they are not working. She also can no longer read well and it is not enjoyable, too much work. She can read words just fine as well as signs.


We are using Large Print books, large print on Kindle, bright lighting, all to no avail.


Wondering if this could be something in the brain instead of the vision? At a loss as to how to help her. She shows signs of early dementia (several years now and progressing) but refuses to go for tests.


Any ideas or similar stories?

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Perhaps it is a comprehension problem, not a vision problem?

Can she follow the plot of a TV show? Does she listen to audiobooks and enjoy those?
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Weeroo Mar 2020
Thanks Barb, I hadn't put the reading together with not being able to follow the TV plots! That may be a lot of it.
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Its probably the Dementia. My Mom could do the same thing, read signs, but could not read a book. The brain no longer works well.
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Peekachu Mar 2020
Yeah, when the vision is poor, a sharp mind is needed to interpret the limited vision. Frustration stops the mind from participating. If there was dementia developing already, it can be exacerbated.
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What does her optometrist or ophthalmologist say about her vision?   Or is she refusing any tests, dementia or otherwise?

The best way to determine whether or not there's a vision blockage is through eye exams.    And if the glasses aren't working, take them to her optometrist or ophthalmologist and have them checked for prescription accuracy.   Perhaps they weren't filled property by whoever filled the script.
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Weeroo Mar 2020
I should have mentioned, we have a great eye clinic here and they are doing all they can, she sees 3 eye doctors, for glaucoma, macular, dry eye and a corneal tear. She has lost most of her vision in the right eye, 20/200, but with last prescription has overall 20/30 vision with glasses.
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While it could be cognitive decline it could also at least partially be that learning to function with monocular vision makes things difficult and sucks the joy out of attempting to read. My mom had vision loss due to macular degeneration with one eye having only 10% of her visual field remaining. Although she was prescribed magnifiers that allowed her to read in the optometrist's that never translated into being of any real use at home, it was just too much effort to make it worthwhile for anything but the most basic needs.
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Peekachu Mar 2020
Sorry to hear that. Living with mac D. is very difficult.
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My Mom had Macular Degeneration in both eyes and she had similar complaints: "New glasses didn't help her see better." "Can only read one or two words at a time even with 3X or 4X or 5X magifying glasses and large print magazines or books"...and so forth.

I agree with cwillie--My Mom found that learning to function with limited vision was difficult and time-consuming and that it sucked all of the joy out of attempting to read. 

The main reason that I lived with Mom was to assist her with reading bills, writing checks, and managing the farmland AND taking Mom to doctor appointments, church and visiting friends. Mom had to sit at an angle and use her peripheral vision to watch TV. Basically I became Mom's eyes and ears (and secretary) so that she could live in her own home for 9+ years until she got so depressed that she refused to perform any ADLs and needed more assistance than what I could provide at home.

Unfortunately Mom's vision was not ever going to get better--and she knew that--but it did not stop her from complaining about not being able to read or watch TV. I provided emotional support and just kept trying different magifying glasses just to show Mom that I cared and that I was willing to "try anything" to help her see better.
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This struck a chord with me.
I had a Macular Hole about 18 months ago. I should say I was diagnosed with it. I had not noticed a problem with my vision until one day the Guide on the TV looked odd. Anyway long story short the Macular Hole was repaired and that particular surgery causes a cataract so that was corrected about 6 months after the initial surgery. I have had my eyes examined, I have new glasses but they just do not seem "right" and I can not explain it. I used to enjoy reading no longer....
Have you considered Audio Books? Would she enjoy those?
So in your moms case it could be vision. It could be that she is having difficulty processing the words. When she does read does she comprehend the words. Being able to read and say a word does not necessarily mean she can comprehend it.
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Weeroo Mar 2020
She comprehends, but says it is just so much work to read it is no fun.
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Weeroo I know just what she means that it is no fun to read.
For me I almost do not know how to describe it. Exhausting might be a word but it is not just that, it is not knowing why the glasses are not "right" I fool with them I move them up my nose, down, a bit in a bit out I have trifocals and I try to look through each to see if it is any better and it just isn't.
And I was never a fan of audio books because the person that reads the book never seems to be the voice that I would hear in my head as I was reading if that makes any sense. But Audio books is better than nothing.
Please tell your mom at least 1 person understands what she is talking about!
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My mother, who was a avid reader, gradually lost her ability to read as her dementia progressed. At first, she was saying that her eyes got tired, but I felt that it was more a cognitive issue. We have stopped going for eye checkups because she wasn't understanding what she should do with the eye charts and exams. Eventually she stopped wearing her glasses. She seems to be OK without them, as she is accompanied everywhere.
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Go to noravisionrehab.org and find an expert near you. If you take her to a Fellow in this specialty they will be able to tell you how much is cognitive versus visual processing or vision loss, and develop a program to optimize her visually guided functions.

With all of Mom's problems the traditional way of prescribing glasses won't work. She will need separate reading glasses, and the prescription can't be generated by an autorefractor. If there is no one close enough try covd.org or oepf.org. These sites all have "find a doctor" links. They won't have the same level of expertise but they will understand how to use optics for most benefit and how visual processing plays a part.
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Weeroo Mar 2020
thanks, had never heard of these!
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I would make an appointment with your Optition for your Mom and they will detect the problem very quickly.
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Rabanette Mar 2020
Optician?
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When a person has dementia, they gradually have difficulty with cognitive processing - which includes reading.

So, to answer your question - yes, it could be her "brain" rather than her eyes.

As an example, my father had a stroke which resulted in the loss of vision in one eye. The "eye" was working fine, but the "brain" was not receiving the information from the eye because the stroke had damaged the optic nerve - so he was permanently blind in that eye.
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There are many audio books you can borrow from the library, or download online from Amazon. They will keep her company for many hours!
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I agree with those who say it is likely a cognition problem. My mother in law was an avid reader. When she got macular degeneration, we tried audiobooks for her. They were given as gifts and she did not seem to ever listen to them although she thanks us graciously. But then we realized that she could no longer go to movies because she could not follow the story. She said she could not hear and she did have hearing problems but when she said she could not hear, it seemed to be more than that; we realized she could not really comprehend what she was hearing. She had trouble with seeing/reading and gradually just stopped reading all together. She would still watch Jeopardy but could not follow other TV shows. So if your mother is only complaining about reading, and she can watch TV/movies and follow the story, then it might truly be just her eyes. But if you are seeing other issues with comprehension of other types of input, it might be more than that. Perhaps you can get her to go for testing with the explanation that the testing might help correct her reading difficult by having a greater understand of her condition? If it is dementia, then new glasses won't help but at least you won't go crazy trying to fix her eyes when it is another problem.
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Get a good evaluation from an opthamologist. If there are eye illnesses, a low vision specialist could prescribe devices that may do more to help your mom use the vision she has. If the issue is dementia, then it may be a cognitive issue. Vision processing in the brain involves almost the whole brain. Dementia always involves two or more parts of the brain. Our field of vision is actually two parts. The central part is where we process vision and color and details. The peripheral vision is what we see to the sides of that. It is mostly held in memory! About 15 seconds of memory is needed for the brain to keep an ongoing image of the periphery intact. That's a lot of memory for an aging brain and even more so if dementia is present. Central vision is very small. Hold a nickel at arms' length and that is about the amount that the brain is processing at one time. The rest is held in memory. As dementia progresses, as long as there is not some illness in the eye, the brain holds less and less peripheral memory and only what is being processed at the moment is what is perceived. Teepa Snow has good videos about this (teepasnow.com). She says that what starts out like a swim mask, goes to binocular to monocular vision at the end. Reading becomes impossible. Objects and faces should be placed directly in that persons line of sight to be seen. Double check with the person to make sure they have seen what you want them to see. This is tough. An Occupational Therapist may be able to help you and your mom adapt so that it is not so frustrating.
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Have her evaluated by an eye doctor to make sure she has the correct lens. If she can read words and symbols, she may just need a time to adjust to her new "vision".

If she still has problems, ask her usual medical doctor for a neurologist consult. She may have a problem area in her brain dealing with reading: difficulty recognizing symbols, difficulty verbalizing what symbols stand for, or difficulty understanding context when you string symbols together.
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My 90-yr-old Mom who has dementia can not keep up with a plot on TV so we just watch Gunsmoke....over and over and over. She also used to read the newspaper from cover to cover. I now see that changing. She still subscribes to the daily paper, but I see her struggling to read it. I think her readers are too strong (4.5) but she says they are not strong enough. Plus, she does not understand what she is reading. Sometimes, she will try to read an article aloud to me and the words are just a jumble. She also has aphasia and it is becoming very difficult for her to make a sentence. So sad. I truly believe there is a disconnect in how her brain processes what she is seeing.
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My husband is still functioning quite well despite mild cognitive impairment diagnosed seven years ago. (He’s taking every drug they make to try to slow the decline but there’s no real way to tell if they’re working.) But reading books was one of the first noticeable changes - he used to have two or three books at a time going on his nightstand and now has none. He’s beginning to have trouble following movie plots, and although he watches and reads news all day, if I ask him a question about what he’s currently watching, he’ll say he wasn’t really paying attention.
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Take her to a retinologist and also a neurologist.
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Have you thought about contacting your local ass9ciation for the blind and visually impaired? They have a variety of assistive devices which may be useful such as books on tape as well as opportunities for socialization. A reevaluation by an opthamologist may be in order. A consult with a neuropsychologist,geriatric ps6chiatrist, or neurologist may be appropriate as well(If she will agree.)
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We discovered they were slightly off on the bifocal of my father's new glasses, but he couldn't explain that to me.
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Weeroo Mar 2020
How was this discovered? The opthamologists and opticians are stumped.
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Thanks to everyone, I could not figure if this problem even existed. So relieved to have some options to look into!

I am going alone to talk to the ophthalmologists Mom sees, to see if they have recommendations. I am with her at appointments but have not 'gone behind her back' so far. I bet they do not say anything because of the stigma and reactions they get "interfering" if they suggest neurological.

Time to go outside the box!
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