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Qualitative, exploratory pilot study to investigate how people living with posterior cortical atrophy, their carers and clinicians experience tests used to assess vision
  1. Michael Bowen1,
  2. Harry Zutshi1,
  3. Martin Cordiner1,
  4. Sebastian Crutch2,
  5. Tim Shakespeare2
  1. 1 Department of Research, The College of Optometrists, London, UK
  2. 2 Dementia Research Centre, University College London, Institute of Neurology, London, UK
  1. Correspondence to Mr Martin Cordiner; martin.cordiner{at}


Objectives To investigate the experiences and views of people living with posterior cortical atrophy (PCA), their family carers and healthcare professionals of vision assessment tests.

Design A qualitative investigation using video recordings of vision assessments, semistructured interviews and audio recordings of a focus group. Interviews and focus group used broad, open questions around the topic to prompt and guide discussion. Video and audio recordings were transcribed, manually coded and analysed using framework analysis.

Setting University College, London’s Queen Square neurology centre provided the venues for all stages of the research.

Participants Participants living with PCA were one male and two females (age range 67–78 years). Health professional participants were a neurologist (male), two ophthalmologists (male) and an optometrist (female).

Primary and secondary outcomes (1) Experiences and attitudes of people living with PCA and health professionals to vision assessment tests, (2) views of health professionals and people living with PCA of whether some tests are more effective at discriminating between cortical vision problems and vision problems related to optical or ocular causes.

Results Patients were able to engage with and complete a number of tests. Their partners played a vital role in the process. Participants reported that simple, short tests were more effective than more subjective tests. Examples of tests that appeared to be more problematic for the patient participants were the Amsler Grid and visual field analysis.

Conclusions Although limited in scope and execution, the project suggests that some vision assessment tests are likely to support health professionals to discriminate between cortical and optical/ocular causes of visual impairment. It supports existing evidence that there are vision assessments that people with dementia can engage with and complete. We identify areas of importance for future research and make tentative suggestions for clinical practice.

  • mental health
  • neuro-ophthalmology
  • primary care
  • vision
  • optometry

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

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  • Contributors All of the co-authors were involved from the outset in the design and development of the project and the research protocol. MB codrafted the manuscript with HZ and reviewed and approved the final draft for submission. MC redrafted the manuscript and approved the final draft for submission. SC reviewed drafts of the manuscript and approved the final draft for submission. TS reviewed drafts of the manuscript and approved the final draft for submission. HZ undertook the interviews and led the Focus Group as part of the project, codrafted the manuscript and reviewed and approved the final draft for submission.

  • Funding This work was funded by the College of Optometrists and University College London. TS was supported by an Alzheimer’s Research UK Research Fellowship. SC was supported by a grant from ESRC/NIHR (ES/L001810/1).

  • Competing interests None declared.

  • Ethics approval The study was approved by the Queen Square Research Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The unedited transcripts of the interviews are held by the College. They are not currently publicly available.

  • Patient consent for publication Not required.

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