In our ongoing commitment to addressing the diverse needs of older adults in care settings, we are thrilled to share insights from our recent interview with optometrist Jason McCain. With years of experience in the field, Jason sheds light on the challenges and opportunities surrounding visual impairment among older adults. 

Let’s delve into some key takeaways from our conversation.

Please share your background (where you grew up, your education, and your experience).

I was born and raised near Detroit, Michigan. I was always interested in biology from an early age and knew I would pursue a career in the medical field. I earned a Bachelors in Biology at the University of Michigan. Go Blue! I earned my Doctorate of Optometry at the Illinois College of Optometry and graduated in 1998. Since graduating, I have worked in many clinics in Michigan, Massachusetts, and Ohio, providing primary care optometric services. I’ve currently been practicing in Dayton, Ohio, for the past 15 years.

I enjoy biking, swimming, and running, and occasionally will put them all together by participating in Mini Triathlon events. Some more relaxing activities I enjoy are reading Science Fiction and Fantasy novels, playing pool, watching college sports, or hanging out with friends.

So, let’s get started. One of the biggest challenges older adults face is vision limitation. What are some common vision changes/challenges older adults experience?

By far, the two most common visually limiting conditions I see in my elderly patients are cataracts and macular degeneration. In the field, we say, “Everyone gets cataracts; you just have to live long enough.” Cataracts cause a general haze/blurriness/glare to vision that eventually cannot be corrected with glasses. Fortunately, cataract surgery has come a long way and is a relatively quick outpatient surgery with an extremely low risk of complications and predictably successful outcomes. Most patients regain their potential for 20/20 vision after cataract surgery.

Macular degeneration can be a much more sight-threatening condition. Even though we have come a long way in diagnosing and treating macular degeneration, it is still a challenge. Most treatment goals are aimed at saving what vision a patient has left and slowing the progression. Despite treatment, many patients progress to a Low-Vision condition.

Balancing aesthetics with practicality can be difficult in healthcare and congregate senior living settings. What are some simple environmental modifications communities can make to better serve their visually impaired residents/clients? For example, removing throw rugs or ensuring sufficient handrails can help.

Environmental modifications can greatly increase functionality and decrease the risk of injury for those with low vision, especially the elderly. Lighting is very important for those with low vision. Bright light sources will aid in activities and make environments easier to navigate. LED lighting strips along hallways and entryways, etc.

What about suggestions for signage and reading material? Is there an ideal font size and style? Contrasting color choices? 

Black print on a white background is always best, as this offers the most contrast. For signage, bigger is better. The font size that is comfortable for reading is more specific for each person. Ideally, it should be large enough to see comfortably but not so large that it limits the amount of text displayed.

What are some of the emotional aspects of vision loss you’ve seen in your practice? 

The emotional and mental aspects of vision loss are often overlooked. As with any disability, the loss of functionality and independence can lead to depression. Many elderly patients with vision loss can no longer engage in activities they once enjoyed.

I once chaired a Low Vision Support Group at a retirement community. The residents who attended appreciated the information, but attendance was low despite the need. Do you find support groups helpful for those experiencing vision challenges? Do you know why people might be resistant to attending one? 

Yes, support groups are extremely helpful. They are a great way to exchange information and ideas on dealing with emotional and practical challenges facing those with low vision. However, many patients, especially those in retirement or assisted living facilities, are reluctant to attend. Some patients believe that they cannot be helped. Many are resigned to their condition. Some may be embarrassed or self-conscious about asking for help. Others may feel that they are unable to learn new strategies and techniques, especially those involving technology.

Continuing with the support group theme, do you have any tips for getting one started or any resources a community can use to develop a strong support group/network for their residents?

Retirement and Assisted Living communities would benefit from contacting low-vision specialists. Sponsoring a low-vision specialist to visit these communities would allow them to demonstrate hands-on devices and techniques to aid those with low vision.

I’ve seen everything from basic magnifiers to technology to help people with low vision. Are there any new visual aid innovations you suggest? 

Simple low-vision devices such as magnifiers and light sources are often enough to help. However, many elderly patients may be unaware of newer technology in low vision. Some examples are prismatic high mag reading glasses, Telescopic lenses, and closed-circuit TV magnifiers.

What advice would you give to a nursing home or retirement community for working with people with low vision?

Nursing homes, Assisted Living, and Retirement communities could greatly improve the quality of life for their low-vision patients by simply raising awareness. Periodic vision screenings are a great way to identify those in need. Establishing relationships with local eye specialists and sponsoring their visits to these communities would greatly help. Your local Eye Doctor is often your key to access. If they cannot help you directly, they can suggest and refer you to those who can.

Though not necessarily related to visual impairment, are there any quotes that are important to you or speak to you?

“Many of our elderly family members have given up on the activities they enjoy because they believe they cannot be helped.”

“Asking for help does not make you weak; it makes you human.” 

We thank Dr. McCain for sharing his expertise and invaluable insights into the world of vision challenges older adults face. As we strive to enhance the quality of care in nursing homes and assisted living facilities, we encourage you to explore our upcoming course, “Working with Residents Who Are Visually Impaired,“ designed to equip caregivers with the knowledge and skills to support visually impaired residents effectively.