Lewy's Visual Problems

When Annie went from the kitchen with a tile floor to living room’s carpeted floor, she’d step and stumble. To her, the change of texture looked like a change in height. Janice kept spilling her coffee. She’d reach for it and her hand would miss it by inches—or hit it and instead of clasping it. Charles blinked a lot. His daughter thought he might have sore eyes. Laura complained of often seeing two of everything, especially when she was tired. Worse, sometime her vision was cloudy and blurred. Her husband suspected cataracts. Harold saw a pillow on the sofa and thought it was the cat. Gary kept seeing a little black dog when he knew nothing was there. He and his wife thought maybe there was a blood clot in his eye. All of these people had LBD-related visual perception problems. In each case, they went to the optometrist and get a clean bill of health for their eyes. It wasn’t their eyes causing the problem. It was their brain’s perceptual abilities that were at fault.

The occipital lobe at the back of the brain is particularly important for processing visual information, that is, for making sense of what we see. Lewy bodies often migrate to that area of the brain and when they do, visual perceptions can be affected. The following problems can all occur long before any cognitive issues become serious:

• depth perception (Annie’s step up),
• hand-eye coordination (Janice’s spilled coffee),
• light sensitivity (Charles blinking) and
• double vision (Laura’s “cataracts”)
• blurred vision (also Laura’s cataracts")
• illusions (Harold’s pillow-cat)
• hallucinations (Gary’s little black dog)

When failing cognitive abilities become involved, the problems can become more difficult. Ray kept using other receptacles for the toilet—a flower pot, the laundry basket, even the corner of the closet and was confused when his wife got angry at him. Marge saw socks on the sofa, thought they were snakes and started screaming. Lenard also saw a little black dog, but he believed it was real and had to be fed and even walked.

In Ray’s case he was seeing these receptacles as toilets. This didn’t seem odd to him because his ability to make judgments had already been affected. He didn’t think, “What an odd place for a toilet.” He just used it. Marge’s problem was similar. She identified the socks as “snakes” and became hysterical. Her failing cognitive abilities did not allow her to stop and think, “Wait a minute. What else might they be?” Lenard’s cognitive abilities were also failing. Unlike Gary, he was unable to tell that the dog he saw wasn’t real.

If there is little cognitive involvement, the optometrist may be the first doctor to see a person with early LBD. However, few are trained to be alert for such problems or to connect them with LBD when they do recognize them. Do your part and share this blog along with a copy of the LBDA brochure with your optometrist. You can download the brochure for free from http://lbda.org/content/lbda-brochure but it does require legal size paper. You can also use the following link to order ten or more brochures by filling out a contact form. http://lbda.org/?q=contact

For more information about Lewy body dementia, read our book, A Caregiver’s Guide to Lewy Body Dementia, available in the LBD Book Corner on our website, LBDtools.com, along with many other LBD-related books.