Visual field loss increases risk of falls in older adults

Visual field loss (specifically peripheral visual fields) is the primary vision component that increases the risk of falls, according to a study published this month in Investigative Ophthalmology and Vision Science, a peer-reviewed monthly publication of the Association for Research in Vision and Ophthalmology (ARVO).

The authors of "Visual Field Loss Increases the Risk of Falls in Older Adults: The Salisbury Eye Evaluation" (http://www.iovs.org/cgi/content/full/48/10/4445) Ellen Freeman, Beatriz Munoz, Gary Rubin and Sheila West - looked at deficits in different components of vision to see if any were more closely linked with falls than others. The study primarily took place at Johns Hopkins School of Medicine's Wilmer Eye Institute in Baltimore, MD.

For each 10 percent loss in the visual field, people in the study experienced an 8 percent higher chance of falling after adjustment for other risk factors for falls. For example, persons with bilateral glaucoma, who on average would miss 48 points in the total visual field, would have 46 percent higher odds of falling.

The researchers used data from 2,375 people who participated in the Salisbury Eye Evaluation (SEE) over 20 months. SEE tested visual acuity, contrast sensitivity, visual field and stereoacuity at baseline. Participants recorded falls on a calendar that they sent to SEE each month.

The authors found that visual fields were associated with the risk of falling, while the other three components, after adjustments for demographics, were not. When they looked at the central and peripheral fields together, only the peripheral visual field was statistically significant.

Dr Freeman and her colleagues speculate that visual field reduction is most likely related to the risk of falls, at least in part, because of its affects on postural stability and aspects of mobility, which in turn is linked with the ability to maneuver around objects.

The authors conclude that people with visual field loss may benefit from mobility training to navigate the environment more safely and reduce the risk of falling.