Ophthalmic diseases in bedridden patients with severe dementia

Ophthalmologic examinations were performed on the 176 eyes of 88 bedridden patients with severe dementia. There were some pathologic changes in the external and anterior segments of 93 eyes. We observed infectious external and anterior segment eye diseases in 80 of these 93 eyes (86.0%). Fundus diseases were found in 34 eyes, but treatment was not necessary. Infectious eye diseases appeared to be the most prevalent ocular problem in these patients. Cultures of conjunctival swabs commonly demonstrated Staphylococcus aureus. No differences were noted in tear secretion rate or lysozyme concentrations in tears between eyes with and without infection. The blinking frequency was significantly reduced in infected eyes compared to normal eyes. Failure of the lacrimal drainage system was observed more often in infected eyes than in normal eyes. This study demonstrated that bedridden patients with severe dementia develop infectious eye diseases easily, to which stasis of tear flow seems to predispose. In caring for bedridden patients with severe dementia, ophthalmologists must be concerned with controlling infectious eye diseases.