Learning
Dementia and vision
Vision changes in dementia are often the brain, not the eyes. Knowing what's happening helps you make the world less frightening.
Updated 2026-02-27
Common visual changes
- Depth perception loss — dark floors look like holes; bright water reflections look like obstacles.
- Contrast sensitivity drops — they can't distinguish similar tones (white toilet on white floor).
- Peripheral vision narrows — they walk into things on the side.
- Misperceptions — coats on chairs become people, patterned floors become movement.
- Hallucinations — seeing people or animals that aren't there (especially in Lewy body and late Alzheimer's).
Adjust the environment
- High-contrast plates and tableware — red plate, white food.
- Toilet seat in a contrasting color.
- Solid-color floors. Remove patterned rugs.
- Bright, even lighting — older eyes need 2-3x more light than yours.
- Cover mirrors if they trigger fear or confusion.
- Remove or cover dark mats — they look like holes.
- Place black mat in front of exit doors — discourages exit by 'looking like a hole.'
Routine eye care
- Annual eye exam — diabetes, glaucoma, macular degeneration are still common.
- Cataract surgery is still appropriate in early-to-middle dementia — improved vision often improves cognition.
- Up-to-date glasses prescription.
- Hearing aids — yes, hearing aids. Hearing loss compounds visual confusion.
Frequently asked questions
- Should we cover the mirrors?
- If they're scared by their reflection or talk to it endlessly, yes. Otherwise, leave them. Many dementia patients enjoy seeing themselves.
- Are hallucinations always a problem?
- If they're not scary or distressing, often no treatment needed. If they're frightening or driving behavior, talk to the doctor about pimavanserin or low-dose antipsychotics.
Every dementia journey is different.
Memory Lane Care helps you understand what applies to your loved one, what to expect next, and which resources fit your family's situation.
Related across the journey
Memory Lane connects every part of dementia care. Here's how this topic threads into the rest.
Behavior Guidance
Paying for Care
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