How Comprehensive Eye Exams Can Prevent the Leading Cause of Blindness

by | Jun 7, 2021

As we age, we become more susceptible to illnesses, medical conditions, and injuries that can be detrimental to our quality of life. Sometimes that means serious, chronic health concerns like cancer, diabetes, or dementia. But there are also less critical issues that may develop slowly over time, perhaps so slowly we don’t even recognize the adverse effects they’re having on our lifestyle. While these issues may not require immediate intervention and often do not pose a direct threat to our health and safety, they can still have serious consequences.

Cataracts are a good example. They are incredibly common – more than half of all Americans will have cataracts by the age of 75, [1] and they are the leading cause of blindness among older adults. [2] They are also generally painless and easy to treat. But your residents may not be aware they are developing cataracts until they experience symptoms that make it difficult for them to perform everyday tasks, threatening their sense of independence. More importantly, vision impairments caused by conditions like cataracts have been associated with increased fall risk among older adults. [3]

June is recognized as Cataract Awareness Month by Prevent Blindness America, a non-profit organization devoted to raising awareness about the importance of good eye health. Let’s take an in-depth look at how you can help your residents identify this common condition that may be impacting their ability to live independently in your community.

What Are Cataracts?

Put simply, a cataract is a clouding of the lens of the eye. [4]

There are several potential reasons why this clouding may occur – it can be brought on by long-term use of certain medications like steroids, prolonged exposure to UV rays, chronic medical conditions, or an eye injury.[5] However, in the vast majority of cases, cataracts are caused by aging. [6]

Our bodies are constantly replacing older cells with new ones. Over time, the cells in our eyes can begin to build upon the lens,[7] which affects the passage of light to the retina. [8] The retina is charged with transmitting the images we see to the brain, so when the light entering the eye is diminished by the existence of a cataract, vision impairments may result, such as:

  • Blurry vision
  • Double vision
  • Difficulty seeing at night
  • Increased sensitivity to bright lights or glare
  • Seeing colors as being muted or faded
  • No improvement in impaired vision, even with repeated changes to eyeglass prescription[9]

Unfortunately, it may be tricky for your residents to identify whether they have cataracts, which can be very slow to develop and may occur in only one eye at a time. They also generally do not present with outward symptoms like pain, redness, or swelling.[10]

If your residents do begin to notice changes in their vision, they may associate them with the common challenges of growing older. But that’s a dangerous assumption to make – studies have shown that impairments affecting older adults’ visual acuity – like cataracts – can be associated with multiple falls.[11] And in adults over the age of 65, falls are the leading cause of both fatal and nonfatal injuries.[12] That’s why it’s important for skilled nursing facility staff to remain vigilant for any vision changes reported by their residents and to ensure that residents receive regular comprehensive eye exams.

Diagnosing Cataracts

The best way to determine whether a resident is developing cataracts in one or both eyes is through a comprehensive eye exam.

The Centers for Disease Control (CDC) recommends that patients age 65 and older receive a comprehensive eye exam from a trained optometrist or ophthalmologist every one to two years.[13] These exams typically include a review of:

  • The patient’s general medical history
  • The patient’s eye health history, including any current problems or symptoms they may be experiencing
  • A test of the patient’s visual acuity and peripheral vision
  • A test of the patient’s eye movement
  • A glaucoma test
  • The patient’s retina, optic nerve, and macula made visible by dilating the patient’s pupils
  • A test of how the patient responds to glare.[14]

By providing regular eye exams for your residents, you can help protect their sight and safety for so long as they are under your care. And by encouraging ongoing relationships between your patients and trained eye health professionals, you can ensure that potentially dangerous issues are identified as quickly as possible so your residents receive the care they need in a timely manner.


[1] https://health.usnews.com/best-nursing-homes/articles/eye-exams-in-nursing-homes

[2] https://preventblindness.org/cataract/

[3] https://yoursightmatters.com/eye-exams-essential-caregiving-elderly/

[4] https://www.merckmanuals.com/home/eye-disorders/cataract/cataract

[5] https://www.merckmanuals.com/home/eye-disorders/cataract/cataract

[6] https://preventblindness.org/cataract/

[7] https://preventblindness.org/cataract/

[8] https://www.merckmanuals.com/home/eye-disorders/cataract/cataract

[9] https://www.healthline.com/health/cataract#symptoms

[10] https://preventblindness.org/cataract/

[11] https://pubmed.ncbi.nlm.nih.gov/9434666/

[12] https://pubmed.ncbi.nlm.nih.gov/27656914/

[13] https://www.cdc.gov/homeandrecreationalsafety/falls/adultfalls.html

[14] https://preventblindness.org/cataract/

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