Sensory Loss

Learn how to

  • Know signs and symptoms suggesting vision loss and identify assistive devices to assist someone with visual impairment.
  • Identify signs and symptoms suggesting hearing loss and find assistive devices to compensate for hearing loss.
  • Examine signs, symptoms and accommodations for loss of touch, taste and smell.

More than 4.2 million Americans aged 40 years and older are either legally blind (having best-corrected visual acuity of 6/60 or worse (=20/200) in the better-seeing eye) or are with low vision (having best-corrected visual acuity less than 6/12 (<20/40) in the better-seeing eye, excluding those who were categorized as being blind).

The leading causes of blindness and low vision in the United States are primarily age-related eye diseases such as age-related macular degeneration, cataract, diabetic retinopathy, and glaucoma. Other common eye disorders include amblyopia and strabismus.

Signs and symptoms suggesting lision loss  Prevent Blindness.org    

Abnormal, Non-Emergency

Any changes in the appearance of your eyes or vision should be investigated further. Some examples include:

  • Unusual trouble adjusting to dark rooms
  • Difficulty focusing on near or distant objects
  • Squinting or blinking due to unusual sensitivity to light or glare
  • Change in color of iris
  • Red-rimmed, encrusted or swollen lids
  • Recurrent pain in or around eyes
  • Double vision
  • Dark spot at the center of viewing
  • Lines and edges appear distorted or wavy
  • Excess tearing or “watery eyes”
  • Dry eyes with itching or burning
  • Seeing spots, ghost-like images

Emergency

Indications of potentially serious problems that might require emergency medical attention

  • Sudden loss of vision in one eye
  • Sudden hazy or blurred vision
  • Flashes of light or black spots
  • Halos or rainbows around light
  • Curtain-like blotting out of vision
  • Loss of peripheral (side) vision

Risk of Vision Problems  Adult Vision Risk Assessment 

 


Common eye disorders     CDC Vision Health  American Optometric Society

The most common age-related eye disorders are 

Glaucoma

Visual field loss, blurred vision (late)

Age-related macular degeneration

Blurred vision, image distortion, central scotoma, difficulty reading

Cataract

Blurred vision, glare, monocular diplopia

Diabetic retinopathy

Blurred vision, floaters, visual field loss, poor night vision

Other common eye problems include

  • “Refractive” errors – the most frequent eye problems in the United States. Refractive errors include myopia (near-sightedness), hyperopia (farsightedness), astigmatism (distorted vision at all distances).
  • Floaters are tiny spots or specks that float across the field of vision. Floaters often are normal, but can sometimes indicate eye problems such as retinal detachment, especially if they are accompanied by light flashes.
  • Dry eyes happen when tear glands can’t make enough tears or produce poor quality tears. Dry eyes can be uncomfortable, causing itching, burning or even some loss of vision. A health care provider may suggest using a humidifier or special eye drops that simulate real tears. Surgery may be needed in more serious cases of dry eyes.
  • Tearing, or having too many tears, can come from being sensitive to light, wind, or temperature changes. Protecting eyes by shielding them or wearing sunglasses can sometimes solve the problem. Tearing may also mean a more serious problem, such as an eye infection or a blocked tear duct. People with dry eyes may tear excessively because dry eyes are easily irritated. An eye doctor can treat or correct both of these conditions.
  • Eyelid problems can happen with many different diseases or conditions. Pain, itching, tearing and sensitivity to light are common symptoms of eyelid problems. Other problems may include drooping eyelids (ptosis), blinking spasms (blepharospasm) or inflamed eyelids near the eyelashes (blepharitis – See below after Diabetic Retinopathy). Eyelid problems often can be treated with medication or surgery.

                         
List of eye disorders National Eye Institute

Glaucoma                        National Eye Institute – Glaucoma    Mayo Clinic

Symptoms

  • Intense pain, which may result in nausea and vomiting
  • Red eye(s)
  • Swollen or cloudy cornea(s)
  • Halos around lights (rainbow-colored rings around lights)
  • Recurrent blurry vision
  • Morning headaches
  • Pain around eyes after watching TV or leaving a dark theater

Risk FactorsBecause chronic forms of glaucoma can destroy vision before any signs or symptoms are apparent, be aware of these risk factors:

  • Having high internal eye pressure (intraocular pressure) how diagnosed; not the disease itself
  • Being over age 60
  • Being black, Asian or Hispanic
  • Having a family history of glaucoma
  • Having certain medical conditions, such as diabetes, heart disease, high blood pressure and sickle cell anemia
  • Having corneas that are thin in the center
  • Being extremely nearsighted or farsighted
  • Having had an eye injury or certain types of eye surgery
  • Taking corticosteroid medications, especially eyedrops, for a long time

Prevention and management – Self-care steps can help you detect glaucoma in its early stages, which is important in preventing vision loss or slowing its progress.

  • Regular dilated eye examinations. Regular comprehensive eye exams can help detect glaucoma in its early stages, before significant damage occurs. As a general rule, the American Academy of Ophthalmology recommends having a comprehensive eye exam every one to three years if you’re 55 to 64 years old; and every one to two years if you’re older than 65. 
  • Be aware of family’s eye health history. Glaucoma tends to run in families. Those people at risk of glaucoma may need more frequent screening.  Ask the primary care physician or ophthamologist.
  • Exercise safely. Regular, moderate exercise may help prevent glaucoma by reducing eye pressure. Talk with a doctor about an appropriate exercise program.
  • Take prescribed eyedrops regularly. Glaucoma eyedrops can significantly reduce the risk that high eye pressure will progress to glaucoma. To be effective, eyedrops prescribed by the doctor need to be used regularly even without symptoms.
  • Wear eye protection. Eye protection can reduce serious eye injuries which can lead to glaucoma.  

 

Macular Degeneration        eyesight.org         American Macular Degeneration Foundation 

Symptoms

  • Worse or less clear vision. Vision might be blurry, and it may be hard to read fine print or drive.
  • Dark, blurry areas in the center of vision.
  • Rarely, worse or different color perception.

Results in debilitating loss of central or detail vision.  Sometimes only one eye loses vision while the other eye continues to see well for many years.  Condition may be hardly noticeable in its early stage.  When both eyes are affected, reading and close up work can become difficult 

Risk Factors – The biggest risk factor for Macular Degeneration is age. Risk increases with age.  The disease is most likely to occur in those 55 and older.

Other risk factors include:

  • Genetics – People with a family history of AMD are at a higher risk.
  • Race – Caucasians are more likely to develop the disease than African-Americans or Hispanics/Latinos.
  • Smoking – Smoking doubles the risk of AMD.

 

Treatment

There is currently no known cure for Macular Degeneration. Risk can be reduce and possibly slow the progression once diagnosed. For example, one can pursue lifestyle changes like Food and Recipes Good for Macular Degeneration, exercise, avoiding smoking, and protecting your eyes from ultraviolet light, which aggravates Macular Degreneration.

Diabetic Retinopathy  American Family Physician

Diabetic retinopathy (DR) is a common complication of diabetes. It is the leading cause of blindness in American adults and significant cause of vision problems  in the older adult population. The prevalence of diabetic retinopathy rises with increasing duration of diabetes. However, significant diabetic retinopathy may be observed in the elderly at the time of diagnosis or during the first few years of diabetes.

It is characterized by progressive damage to the blood vessels of the retina, the light-sensitive tissue at the back of the eye that is necessary for good vision. 

The longer a person has diabetes the greater his/her chances of developing retinopathy.  Regular eye examinations are necessary.  The risks of DR are reduced through disease management that includes good control of blood sugar, blood pressure, and lipid abnormalities.

Blepharitis –  affects eyelids

Symptoms:

  • Redness, itching, burning, and generalized irritation
  • Discharge (especially in the mornings)
  • Scratchy sensation
  • Tearing
  • Temporary blurred vision
  • Can lead to stye formation
  • People with the skin condition known as “rosacea” tend to have blepharitis and dysfunction of these oil glands
  • Treatment – see the doctor

Vision – Changes in the Home

  • Brighten the home
  • Decrease glare (I.e., sheer draperies to let in light but cut glare)
  • Evenly distribute light using two lights when possible
  • Use diffused light
  • Use sunglasses with 100% UV protection
  • Use night lights in the bedroom, hallways and bathroom
  • Place reflective or colored tape on the edges of steps
  • Assistive Devices for Vision Loss

Magnifying glasses

  • Large number calculator, Clocks, telephones
  • Dialing aids for  the phone
  • Large print books, catalogues, bills and newsletters
  • Voice activated computers

Written materials

  • Must be printed clearly
  • At least a 12 point font size
  • Bright colors: red, yellow, orange
  • Increase the lighting if necessary

Hearing   National Institute on Aging Hearing Loss

  • 1/3 of people over 60 experience significant hearing loss
  • Lose clarity more than volume
  • High pitched sounds become fuzzy. Difficulty hearing some women’s voices
  • Difficult to distinguish one consonant from another

Signs and Symptoms Suggesting Hearing Loss

  • Turns up the volume on the TV or radio
  • Often asks to have information in a conversation repeated
  • Misunderstands what others say
  • Conversation becomes difficult

Impact of Hearing Loss

  • Psychological/behavioral: may neglect to do something important because they did not hear it
  • Social: may withdraw
  • Emotional: may become irritable or depressed

Hearing Aids

  • Few people who need
    hearing aids wear them
  • Perceived stigma
  • Various levels of quality and
    fit for each person
  • Small adjustment knobs on smaller ones difficult for people with stiff fingers
  • Takes time to get used to them

Period of Adjustment for Hearing Aids

  • Sounds can be overwhelming, distorted and chaotic
  • Might not be able to identify once familiar sounds

Assistive devices for Hearing

  • Devices on the phone to amplify sounds
  • Headphones for the television or radio
  • Vibrating alarm clocks
  • Doorbells and telephones that flash instead of ring
  • Cell phone ear pieces

Making Conversations Easier when you know about a hearing impairment

  • Use simple, direct sentences
  • Speak clearly at a steady, normal pace
  • Speak slightly louder than normal
  • Reduce confusion by turning down the TV or reducing other background noise
  • Make eye contact or get the person’s attention in some other way
  • Stand near the person when talking
  • Face the individual if possible
  • Use gestures and facial expressions
  • Speak at a normal volume if the person wears a hearing aid
  • Speak clearly, but don’t exaggerate lip movements
  • Rephrase comments if asked to repeat something
  • Introduce the topic before talking about it in detail (“Mom, about your doctor’s appointment on Tuesday…”)

On the Telephone

  • Cup your hand around the mouthpiece, especially when there is background noise
  • Keep sentences simple and short
  • Keep the topic of the conversation clear
  • Avoid chewing, eating or covering your mouth
  • Verify that you and the person are understanding one another
  • Try saying the same thing in different words
  • Check for understanding
  • Give instructions slowly and ask him/her to repeat, when necessary

Changes in taste, smell, and touch National Institute on Aging Smell and Taste

Taste 

Some loss of taste and smell is natural with aging, especially after age 60.

  • Most people over 60 have lost 50% of their taste buds
  • Most people in their 70s have 1/6 of the taste buds of a 20-year-old

Signs of loss of taste include complaints about food not tasting right and using excessive seasoning, especially salt. Loss of the sense of smell may interfere with the sense of taste which can cause reduced or increased appetite.

Loss of taste and smell can have a significant impact on quality of life, often leading to decreased appetite and poor nutrition. Sometimes loss of taste and smell contributes to depression. Loss of taste and smell also might tempt the use excess salt or sugar on food to enhance the taste — which could be a problem with high blood pressure or diabetes. However, other factors can contribute to loss of taste and smell, including:

  • Nasal and sinus problems, such as allergies, sinusitis or nasal polyps
  • Certain medications, including beta blockers and angiotensin-converting enzyme (ACE) inhibitors
  • Dental problems
  • Cigarette smoking
  • Head or facial injury or mass
  • Alzheimer’s disease
  • Parkinson’s disease

 

If necessary, a doctor might recommend consulting an allergist, an ear, nose and throat specialist (otolaryngologist), a neurologist, or other specialist.

Smell

Quitting smoking can help restore the sense of smell.

If someone is experiencing loss of taste and smell, consult a doctor. Although age-related taste and smell cannot be reversed, some causes of impaired taste and smell are treatable. A doctor might adjust medications if they’re contributing to the problem. Many nasal and sinus conditions and dental problems can be treated as well. 

Touch

  • Avoids touching or being touched
  • Unable to sense pain or overly-sensitive to touch or pressure
  • No response to being touched

Compensating and Accommodating for Sensory Loss

  • Ensure home and environment safety
  • Recognize changes in daily routines and habits and take action to help the person compensate for the loss
  • Suggest options:
  • If the person overly salts, suggest use low salt spices, herbs, and seasonings
  • Help identify foods that the person can enjoy
  • Purchase bath oils and soaps as gifts to encourage bathing
  • Recommend the use of gloves to protect the person who has lost the sense of touch to protect the hands and footwear to protect the feet

 

Resources For Caregivers

Call

  • 2-1-1 throughout Texas. Provides information and access to health and human service information for all ages
  • 1-800-252-9240 to find local Texas Area Agency on Aging
  • 1-800-677-1116 – Elder Care Locator to find help throughout the U.S.

Online

  • www.benefitscheckup.org for an online way to determine benefits for which someone qualifies

Permission is granted to duplicate any and all parts of this program to use in education programs supporting family members caring for elders. Please give us credit

References: Family Caregiver Education, Area Agency on Aging, Revised by Zanda Hilger, 2021