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Has anybody found a solution for eye exams? We struggle with my brother being able to answer the questions which one looks better and I don’t know if it’s the doctor I need to switch or if he’s going to need pictures instead of numbers. Day-to-day he has a hard time with decisions. For example, if we were to go to a restaurant he as expected struggles to pick out something on the menu so it’s best just to make the decisions for him. With eye exams obviously he has to provide input.

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RDuncantx, welcome to the forum. Is your brother going to an Ophthalmologist or an Optician/Optometrist?

If one is having difficult eye issues or is unable to understand the directions of the Doctor, an Ophthalmologist is the best choice. An Ophthalmologist would have Autorefractor which is a machine that automatically determine the correct lens prescription for your eyes.

An eye test on a Autorefractor consist of just looking into the machine, one eye at a time, and try to sit still for a minute while the machine does its job. The Ophthalmologist would normally also do the "which is better, A or B" and compare that with what the Autorefractor had shown.
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My husband’s prescription is hardly ever correct. He is an engineer and must see precisely in his profession.

He doesn’t hesitate to return to his eye doctor for them to check the correct diagnosis.

Another thing that he has discovered is that the people who make the glasses do measurements and if they are slightly off it makes a difference.

They make a mark to indicate how the progressive lenses are made. Occasionally this measurement is not where it should be for optimal viewing.

The optician told my husband that she only sees people who are engineers and airline pilots come back to have their glasses remade.

Most people will not feel like the slight difference is noticeable. Others like my husband will notice the difference.

My mom had Parkinson’s disease and it affected her eyesight. She couldn’t see well with her glasses.

I can see how it would be difficult to get a proper diagnosis for a patient with dementia. I’m sorry that you are going through this, it is a frustrating situation.
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NeedHelpWithMom Mar 2023
Adding to my posting. My right eye was almost blind due to a specific type of cataract. Once I had cataract surgery, my eyesight was greatly improved.

Cataract surgery is a snap! It’s so quick and virtually painless.
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You know when the doctor starts the "which one is better" thing when it gets to the last two, its not that much difference. I have been told, though, that I always pick the higher of the two. Butvsomeone with Dementia could probably not tell the difference or understand what is being asked of them.
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There are very few solutions to elders with dementia, in reality. You're expecting the impossible from your brother by thinking he has the ability to correctly answer eye exam questions. I stopped taking my mother to the eye doc when her dementia advanced and would buy her new frames and lenses when she ruined them, on my own. Never a new prescription was written, but the old one was better than nothing. It also took her 1 hr to decide from a menu, so I gave her 3 choices I knew she'd like and that ended that chaos.
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Your profile says your brother is 69 and has dementia/ALZ. If he cannot comprehend the doctor's questions and provide an accurate answer, I think the days of having eye exams are not over. My MIL, 88 and in LTC hasn't had an eye exam in years. She's worn glasses her whole life but seems to still be able to read and do everyday things in her facility even without an updated prescription.
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I can't imagine that anyone would have a better answer for this other than someone who does these exams. The sad truth may be that other than examining the eye itself for macular degenration and other thing, glaucoma for instance, I don't think it possible to get a good exam ever again for subjective responses. I mean your elder isn't going to be able to answer "this...............or THIS" questions as different numbers are flashed before their eyes. And I don't have a clue how to make it better. Hoping your eye doc can help. I wouldn't switch without first asking that honest question of this doc. There may BE no good answer. I sure do wish you the best.
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At an eye exam they do a check to see what your 'baseline' prescription is with your current glasses. Then a more involved exam to fine tune.

For many people, that first check is all they do. If the patient is unable to make the 'better/worse' choices, then an exam for glasses is kind of pointless. The eye exam is for both the health of the eyes, but also for changing prescriptions. You could get by with the first check and not even attempt to do a more involved vision check and just have the 'eye health' done. (looking for glaucoma, cataracts and Macular degeneration, among other things.

My BIL is my optometrist and he does fine tune things for me, but I am able to sit still and make decisions and give answers.

Talk to the dr and see if the first step exam would be sufficient. Then a quick check for the overall eye health and your LO would probably be fine.
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Funny, my eye doctor and I were just taking about this. My nephew wore glasses at 8 months. The doctor said for kids who cannot read yet, they shine a light off the back of the eye and can tell how it comes back what prescription the child needs. I would think that this could be done for an adult.

You may want to look into facility care for your brother. Dementia is 24/7 care. He could wake up one morning and be worse than the day before. The nurses I worked for called it an episode. I saw it happen with one of our clients.
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I have worn glasses since I was seven. My vision is correctable with glasses but when I first started wearing glasses they could not give me lenses that would correct my vision to 20/20. They raised it in levels. During any normal eye exam I struggle with the A versus B part of the test because my natural vision is so poor. Your brother may not be able to understand, or it may just be a case of his vision and his comprehension of his vision are having a struggle. Sometimes I can't make a decision between A and B because there is little to no difference and my brain/vision can not decide. I've had this discussion with every new person that checks my vision. My advice, ask the eye doctor to give your brother a better definition of what "which looks better" means. Sharper? clearer? more defined? better around the edges? The last eye doctor that I saw was very young and new and she told me "You are too young to have this kind of vision". My snappy comeback was " Well I was born this way, and I've worn glasses since I was seven, so you tell me. "
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JoAnn29 Mar 2023
I started wearing glasses at 6 when examined in school. My sister's GF had to wear contacts because he glasses got too thick. I have a lazy eye that never sees 20/20.
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Lea,

Your profile photo is so sweet!
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