Falls are the leading cause of accidental injury and death among older adults. One of three adults over the age of 65 years falls annually. Older patients with vision impairment are 1.7 times more likely to fall, and 1.9 times more likely to have multiple falls and experience hip fractures. It is well documented that people today tend to have a reduced life expectancy after a serious fall injury. Visual information plays a critical role in balance control, and being able to tell where you are in relation to another object. Conditions like cataract (clouding of the lens in the eye), refractive error (the need for proper eyeglasses to correct vision), glaucoma (a degenerative disease of the nerve which provides sight, the optic nerve) and macular degeneration (a retinal condition causing loss of central vision) all contribute to a decline in vision after age 50. Often the decline is silent and people do not even realize that their vision is getting worse. Even in patients who are using eyeglasses, an incorrect prescription or improper use of a bifocal can increase the likelihood of misjudging a step and falling.

What can patients do to minimize the risk of themselves or an aging family member falling?

• Get annual eye exams. Don’t wait until vision is poor before getting checked.
• If eyeglasses are prescribed, use them!
• If you are confirmed to have cataracts and need surgery, consider options that reduce your need for eyeglasses afterward. There is a strong association between bifocal use and increased falls in the elderly.
• Stop smoking. It stimulates earlier and faster cataract growth, and increases the risk for macular degeneration
• Make sure hearing is optimized as well, with annual hearing (audiology) tests.

Many people avoid medical exams because they are afraid to know if something is wrong. Remember that disability from injuries can cause loss of independence and other life-changing consequences. This not only affects the injured person, but also the family members who must take care of them. Empowerment comes with doing everything possible to stay in your best health!