Vision and hearing impairments are common in older adults and are often comorbid with dementia. These conditions exacerbate the impact of dementia, and outcomes for those with dual sensory impairment are considerably worse than for people with single sensory impairment. This narrative review synthesises current evidence on the intersection of vision, hearing, and cognitive impairment, outlining prevalence, and psychosocial, physical, and functional consequences of sensory loss in older populations. Many Australians with dementia age in place; however, sensory interventions are often underutilised in home-based aged care settings, despite benefits for quality of life, responsive behaviours and functioning in daily life. Barriers to effective vision and hearing care include a lack of routine sensory assessments, limited integration of optometry and audiology services in home care packages, and insufficient training of home care staff. Dementia- and hearing impairment-friendly eyecare, embedded within person-centred, interdisciplinary models, is essential to accommodate cognitive and hearing needs. Optometrists are well-positioned to lead these efforts, particularly through home-based services that support ageing in place. Implementation of national and international recommendations for integrated sensory care could enhance quality of life, independence, and cognitive health in older adults.

Limbal stem cell deficiency (LSCD) is traditionally regarded as a rare ocular surface disorder characterised by impaired corneal epithelial regeneration. Emerging evidence suggests that pterygium, a common fibrovascular lesion extending onto the cornea, may involve focal limbal epithelial or niche dysfunction. This narrative review examines clinical, histopathological and biological evidence relevant to the relationship between pterygium and focal limbal dysfunction. The peripheral light focusing hypothesis provides a biologically plausible explanation for the characteristic nasal predilection of pterygium through localised ultraviolet-related stress at the limbus, further influenced by environmental and anatomical factors. Histopathological studies have reported altered expression of limbal epithelial-associated markers in pterygium tissue, supporting possible disturbance of limbal barrier function and epithelial homoeostasis. However, these findings remain supportive rather than definitive and should be interpreted alongside established inflammatory, fibrovascular and ultraviolet-related models of pterygium pathogenesis. Pterygium may be usefully reconsidered within the framework of focal limbal dysfunction, particularly in recurrent or biologically aggressive cases. This perspective may broaden current understanding of ocular surface disease and support continued interest in limbal-preserving and regenerative strategies, including carefully defined limbal epithelial reconstruction approaches in selected contexts aimed at reducing recurrence and restoring ocular surface stability. However, current evidence remains insufficient to justify formal reclassification of pterygium as established localised LSCD or to mandate practice-changing therapeutic conclusions.

Soft contact lens wear in children offers an appealing alternative to spectacles and has emerged as an area of significant interest, particularly within the context of the increasing prevalence of myopia. However, despite the advantages and growing acceptance of soft contact lens wear in children, spectacles remain the predominant method of vision correction for this group. This narrative literature review highlights the benefits of soft contact lens wear for children - as well as the challenges that face its wider acceptance - and aims to provide eye care professionals with a timely resource to aid in addressing parental concerns and misconceptions about the appropriateness of soft contact lenses for children. Parental concerns may include misunderstandings about handling, safety, compliance, and comfort, and many parents may not be aware of the extent to which children can benefit from soft contact lens wear. Soft contact lens wear provides children with an improved quality of life and improved satisfaction with vision correction since it helps children to enjoy a wide range of physical activity and improves self-perceptions of both appearance and social acceptance. Soft contact lenses also seem a good mode for myopia control as more consistent use could make them a more effective treatment than spectacles, which children often remove. Various factors are considered when choosing a mode of vision correction; this narrative review provides an overview of the current research on the benefits and limitations of soft contact lens wear for children compared with spectacle wear.