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Association among visual hallucinations, visual acuity, and specific eye pathologies in Alzheimer's disease: Treatment implications

Lookup NU author(s): Professor Ian McKeith, Dr Clive Ballard


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Objective: Studies suggest a link between visual acuity and visual hallucinations in dementia, but links with specific eye pathologies have not been evaluated. Method: Fifty patients (20 with visual hallucinations, 30 without) with probable Alzheimer's disease had an evaluation of psychotic symptoms. Visual acuity was measured before and after refractions, and ophthalmological examinations included standardized assessments for cataracts and macular degeneration. Results: Impaired visual acuity and the severity of cognitive impairments were significantly associated with visual hallucinations. No patients with normal acuity (6/5 or 6/6 on the Snellen chart) experienced these symptoms. Impaired acuity improved with refraction in 60% (N=12) of the patients with visual hallucinations. Of specific eye pathologies, only cataracts were significantly associated with visual hallucinations. Descriptive follow-up information suggests that an optician's assessment for glasses improves outcome. Conclusions: Glasses and cataract surgery need evaluation as prophylactic or adjunctive treatments for visual hallucinations in patients with probable Alzheimer's disease.

Publication metadata

Author(s): McKeith I; Ballard C; Chapman FM; Dickinson J

Publication type: Article

Publication status: Published

Journal: American Journal of Psychiatry

Year: 1999

Volume: 156

Issue: 12

Pages: 1983-1985

Print publication date: 01/12/1999

ISSN (print): 0002-953X

ISSN (electronic): 1535-7228

Publisher: American Psychiatric Publishing, Inc.