Vision disorders affect a significant number of Australians and the likelihood of developing a sensory problem only increases with age.

In Australia, about 55% of the population and 93% of people over the age of 65 are affected by a long-term vision disorder (AIHW 2023). Approximately 50% of Australians use corrective lenses (glasses or contacts) (AIHW 2016).

Given these statistics, it is almost certain that you will encounter clients who use corrective lenses, especially when caring for older adults.

Being able to ensure corrective lenses are being used appropriately is essential in keeping clients safe and enabling them to function in their daily lives.

Understanding Vision Disorders

The majority of long-term vision disorders are refractive errors: hyperopia (long-sightedness), myopia (short-sightedness), astigmatism (blurred vision) and presbyopia (aged-related loss of focusing ability) (AIHW 2021).

Refractive errors occur when the shape of the eye is not able to bend light correctly, resulting in blurred vision. Corrective lenses such as glasses can be used to correct these errors. Generally, these conditions are hereditary or associated with ageing (Kellog Eye Center 2018).

The term vision impairment refers to vision loss caused by conditions, diseases or accidents. People with a vision impairment often have limited useful vision and may have difficulty performing day-to-day tasks. Unlike refractive errors, vision impairments are generally unable to be corrected by glasses (Visability 2023).

Refractive errors are generally considered disorders, but not disabilities. However, it is possible for them to lead to major vision loss or blindness (McManes 2023).

It’s important to ensure all clients are using their corrective lenses appropriately.

The Impacts of Poor Vision

Clients who have an uncorrected refractive error may experience a variety of unwanted issues including:

• Blurry or distorted vision
• Headaches and eye strain
• Reading difficulties
• Double vision
• ‘Halos’ when looking at bright lights
• Haziness.

(Fred Hollows Foundation 2020)

Those with very poor vision may experience more serious consequences, including:

• Increased risk of depression
• Increased falls risk
• Social isolation
• Loss of self-worth
• Increased dependency
• Loss of confidence to walk and engage in hobbies and activities
• An overall decrease in quality of life.

(MDFA 2018)

For these reasons, it’s important to ensure clients are prescribed corrective lenses if they need them, and that clients who already have corrective lenses are actively using them with the right prescription.

Issues Surrounding Corrective Lenses in Care Environments

Despite common vision disorders being easily correctable, there are several issues that can arise in care environments.

Clients in residential aged care often have poor awareness of their own vision and may not realise they are experiencing issues in the first place. As a result, they may not be prescribed the corrective lenses that they require (Cummins & Heraghty 2018).

Additionally, some clients with corrective lenses may have an outdated or incorrect prescription or stop wearing them altogether. Corrective lenses may be lost, broken, scratched or dirtied and clients will not necessarily speak up if this happens (Cummins & Heraghty 2018; Kell 2017).

The accidental switching of glasses between clients is also possible, especially in residential aged care settings where clients may mistakenly pick up and keep someone else’s glasses (Cummins & Heraghty 2018).

Checking Corrective Lenses

In some cases, a client may have an incorrect prescription due to changes in vision over time, human error or inaccurate readings during an eye examination. Someone who has an incorrect prescription may experience blurred vision, dizziness, headaches, eye strain or other symptoms similar to those experienced when not wearing corrective lenses (Win 2023).

Glasses should fit correctly. When checking a client’s glasses, ensure that:

• The centre of each of the client’s pupils is aligned with the optical centre of the lens
• The distance between the corners of the client’s eyes and the edges of the lens are equal on both sides
• The frames sit no higher than the client’s eyebrows
• The frames are evenly balanced across the bridge of the client’s nose or equally distributed on the nose pads
• The glasses are not leaving marks or digging into the client’s nose
• The glasses do not rest on the client’s cheeks when they smile
• The arms of the frames fit securely and comfortably around the client’s ears
• The glasses stay securely in place when the client moves, bends or shakes their head
• The glasses fit slightly against the client’s temples.

(Belden 2019)

Communicating and Caring for Clients With Impaired Vision

Read: Sensory Loss in Older Adults

Practical Tips for Corrective Lens Usage

The following tips will help ensure your clients are using corrective lenses properly and are referred to an optometrist if required.

• All clients should undergo a comprehensive eye exam from a specialist every 12 months to ensure prescriptions are accurate and that eye problems such as glaucoma, cataracts and macular degeneration can be identified early
• Any sudden vision changes should be addressed immediately
• Look out for signs that indicate a client is experiencing vision issues, such as falls or reduced socialisation
• Ensure adequate lighting
• Declutter client rooms, spaces and walkways
• Ensure clients’ glasses are kept in a familiar and easily accessible place
• Ensure glasses are cleaned regularly
• Ensure your facility has a procedure in place for identifying the correct owners of glasses to prevent clients from losing their glasses or picking up someone else’s glasses
• Check periodically to ensure clients are not mistakenly wearing someone else’s glasses
• Consider keeping a photographic record of clients wearing their glasses
• Consider having clients’ glasses engraved with their names
• Encourage healthy eating, exercise and adequate sleep for overall eye health
• Encourage clients to wear sunglasses or contact lenses with a built-in UV filter when outside.

(MDFA 2018; Healthdirect 2021)

Conclusion

Corrective lenses are an easy way to treat common vision disorders. However, it is important to check that clients’ glasses and contact lenses fit appropriately, are the correct prescription and are being used by the right person. If there are any concerns or sudden changes in vision, the client should be referred to an eye specialist.

This will ensure clients are able to go about their daily activities comfortably and safely.