Among older adults with AMD, increased visual impairment was significantly associated with an increased incidence of falls and other injuries. Reduced contrast sensitivity was significantly associated with both increased rates of falls and other injuries, while reduced visual acuity was only associated with increased fall rate. These findings have important implications for the assessment of visually impaired older adults.
Falls are common among older adults with glaucoma and occur more frequently in those with greater visual impairment, particularly in the inferior field region. This finding highlights the importance of the inferior visual field region in falls risk and assists in identifying older adults with glaucoma at risk of future falls, for whom potential interventions should be targeted.
Among older adults with glaucoma, greater visual field loss or thinner RNFL thickness is associated with reduced postural stability. This postural instability may be a contributing factor in the increased risk of falls among older adults with glaucoma.
Purpose: Reduced mobility can have a serious impact on quality of life. Though previous studies have demonstrated that some vision measures relate to the mobility of subjects with simulated and true low vision, the relationship between residual vision and mobility is not clear. We investigated the relationship between clinical vision measures and mobility performance under different illumination levels for subjects with retinitis pigmentosa (RP). Methods: Binocular visual acuities, letter contrast sensitivities and static central threshold visual fields were measured on 10 subjects with RP and nine age-matched control subjects. Mobility performance was measured on an indoor mobility course at high and low illuminances and was assessed by percentage preferred walking speed (PPWS) and number of errors. Results: The RP group showed significantly reduced PPWS and greater numbers of errors than the control group. The reduction in illumination resulted in significantly worse error and PPWS scores. Unlike the control group, the presence of a glare source did not reduce the PPWS of the RP group under high illumination. Multiple regression analyses showed that the average visual field extent was the most significant predictor of mobility; letter contrast sensitivity and visual acuity added to the regression models for the low illumination measures to account for up to 75 per cent of the variation in mobility performance. Conclusions: People with RP have worse mobility than people with normal vision, more so under reduced illumination levels. Visual field extent was the strongest predictor of mobility performance.( C h Exp Optom 1996; 80: 1: 1-12)
Falls occur in about one third of older people living independently in the community every year. This can lead to significant physical, psychological and financial costs to the individual and the community. While the risk factors for falls in older people are multifactorial, poor vision is considered to be an important contributing factor. The aim of this review is to evaluate current research linking impaired visual function with falls and to review current intervention strategies for the prevention of falls in older individuals. The evidence from the current literature indicates that impairment of visual functions, such as visual acuity, contrast sensitivity, visual fields and depth perception, is associated with an increased risk of falls. Recent studies have also demonstrated that falls can be reduced following cataract surgery as a visual intervention. Optometrists need to be aware of these associations and through appropriate treatment, referral and/or education, they can play a major role in optimising visual function in older people, as part of a multidisciplinary approach to falls prevention.
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