Age-related eye disease and risk of falling: a review

Abstract

Falls in older people are common events and are associated with decreased quality of life and huge health costs. Visual impairment is a risk factor for falls. Some common causes of visual impairment in older people, such as cataract and presbyopia (age-related long-sightedness), can be treated relatively simply, so this review will focus on two common, irreversible visual diseases in older people: glaucoma and age-related macular degeneration (AMD). Risk of falls in people with these conditions seems to be related to failing to detect hazards, and to postural instability caused by missing visual input. Decreased contrast sensitivity has been suggested as the strongest predictor for falls in AMD. Binocular visual field (VF) loss, especially in the inferior VF and in the periphery, seems to be most closely associated with an increased fall risk in glaucoma; however, more research is needed to better understand which precise aspects of vision are the best predictors of fall risk. In the meantime, those with impaired vision, whether treatable or not, should be advised on how to reduce fall risk factors. A useful intervention could be directly highlighting the risk of falling to people with glaucoma and AMD.