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Vision Changes
Chammer
Posted: Sunday, April 5, 2020 1:18 PM
Joined: 7/31/2016
Posts: 20


My 57 yo DH isn't diagnosed with dementia, but has changes that suggest that he is having cognitive issues.  He has multiple health issues including Type II DM and alcoholism and has said that he just can't think and reason like he used to. He has eye injections every 6-8 weeks for "wrinkly retinas" and bleeding in the back of his eye.  He says he can no longer see well enough any more to read emails or documents even with a magnifying glass.  He says he can see distances and he tells me that his retinal specialist says he is seeing 20/20 in one eye and 20/25 in the other.  He has  prescription glasses that are less than a year old and uses "readers" that are +2.75.  He can read texts on his phone, but only when the text is maximized to about 2 words on the screen at a time.  Could these vision changes be related to dementia as well as his DM (he swears the retinal specialist says changes aren't related to DM)?  I know there are spatial changes in AD.  

DH saw a neurologist about 3 years ago for restless leg and thinks they are quacks now so it will be difficult to convince him to see a neurologist again anytime soon.  Would the retinal specialist be able to provide any insight?  I go w DH to most all of his Drs. appts but never go back at the eye appts so haven't actually spoken to that Dr. since the first appt a couple yrs ago.


SSHarkey
Posted: Sunday, April 5, 2020 2:09 PM
Joined: 3/15/2018
Posts: 489


Vision change is usually not one of the initial things to watch for. But with everything else going on I’m sure his cognitive skills are diminished. His comment about the neurologist may be any indication that he was told back then he had symptoms of loss. Consider going to your primary care doctor but before you go be sure to write down all of his behaviors and get it in the doctors hands before you have the appointment. Your husband will more than likely deny all changes that link him to anything neurological.
Army_Vet60
Posted: Sunday, April 5, 2020 2:13 PM
Joined: 6/21/2019
Posts: 682


Alcoholism, the longer it goes, does a lot of damage to the brain and can cause a type of Dementia.  My mother suffered from alcoholic dementia. It's a lot different from Alzheimer's,  and from I understand, it's reversible to a degree if the person stops drinking.

My mother's brother was also an alcoholic and it effected on his vision. eventually, he went temporarily blind. He quit drinking end his eyesight eventually returned. 

If your DH has never addressed his alcoholism, it sounds like he is getting a number of warnings from his brain and body that it's time.


harshedbuzz
Posted: Monday, April 6, 2020 9:28 AM
Joined: 3/6/2017
Posts: 2156


Chammer wrote:

My 57 yo DH isn't diagnosed with dementia, but has changes that suggest that he is having cognitive issues.  He has multiple health issues including Type II DM and alcoholism and has said that he just can't think and reason like he used to

This sounds very familiar. My late father had mixed dementia- Alzheimer's and Wernicke-Korsakoff's Syndrome. WKS is a specific kind of alcohol-related dementia that can include eye and vision issues. Dad also had T2D, he was blind in one eye as the result of an unrecognized detached retina and early stage AMD which made sorting out vision issues was tricky at best. 

Early on, before his Alzheimer's hit the moderate stage, he was cognizant that his brain wasn't working as it used to. Later, as the ALZ progressed, he developed anosogonosia and was unable to appreciate how cognitively impaired he'd become.


He has eye injections every 6-8 weeks for "wrinkly retinas" and bleeding in the back of his eye.  He says he can no longer see well enough any more to read emails or documents even with a magnifying glass.  He says he can see distances and he tells me that his retinal specialist says he is seeing 20/20 in one eye and 20/25 in the other.  He has  prescription glasses that are less than a year old and uses "readers" that are +2.75.  He can read texts on his phone, but only when the text is maximized to about 2 words on the screen at a time.  Could these vision changes be related to dementia as well as his DM (he swears the retinal specialist says changes aren't related to DM)?  I know there are spatial changes in AD.  

My dad had a lot of difficulty with spatial reasoning. When he was still driving, the cars and garage walls bore evidence of his inability to judge spaces. Later, he was constantly after me to park all 3 cars in a one car garage swearing he could make them fit or insisting I move large pieces of furniture into spaces where it wouldn't fit. 

One issue with WKS is that the eyes jump about and focusing is difficult. I would think if this was the case the retinal specialist would have noted it and likely not done the injections. Perhaps you need to go back with him next time. Perhaps you could reach out to him/her via a patient portal to share your concerns and what you are seeing. If you aren't on the HIPAA forms, the doc can't get back to you, but can take your concerns under advisement.

DH saw a neurologist about 3 years ago for restless leg and thinks they are quacks now so it will be difficult to convince him to see a neurologist again anytime soon.  Would the retinal specialist be able to provide any insight?  I go w DH to most all of his Drs. appts but never go back at the eye appts so haven't actually spoken to that Dr. since the first appt a couple yrs ago.

I would get him into a neurologist if at all possible, if not I'd speak with the PCP about his symptoms, lifestyle and ask for him/her to start the ball rolling on the blood work and a dementia screening. WKS is treatable to some degree if the patient is treated with IV Thiamine and remains abstinent. After dad's hospitalization, he did initially recover a significant amount of cognition temporarily until he started to drink again and the ALZ progressed into moderate and severe stages. The risk of WKS can run in families; dad had a nephew who was diagnosed in his early 50s and remained at a baseline where he could manage his ADLs but not his IADLs for almost a decade before he started drinking again after his wife died.

Good luck-
HB 



Iris L.
Posted: Monday, April 6, 2020 3:42 PM
Joined: 12/15/2011
Posts: 16411


Does he have macular degeneration?

Iris L.


Stuck in the middle
Posted: Monday, April 6, 2020 4:06 PM
Joined: 6/4/2017
Posts: 291


I am very sorry you are having this trouble.

If your husband's blood vessels are so compromised by DM that they are bleeding into his eyes, he has "advanced diabetic retinopathy."  DM is especially hard to control in patients who drink heavily, so if your husband is still drinking you need to plan for him to be blind before he is 60.  Of course, there are other complications of alcoholism and other complications of DM, and his health will likely be quite poor by then.  He is at high risk for peripheral neuropathy, kidney failure, cardiomyopathy, and many other things in addition to the brain damage and vision loss we have already discussed.

I wouldn't waste my money on a neurologist in this situation.  A neurologist can't help him if he won't stop drinking.


 
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