Vision Loss and Fall Risk: What You Need to Know

Even slight changes to your eyesight can greatly increase your fall risk. Eye doctors explain how you can lower your odds of that happening.

You may have accepted that squinting is simply a part of getting older. Or that you need to stash a pair of reading glasses in every room. But you may not realize that age-related vision changes can more than double your risk for slips and trips.

“Vision plays a crucial role in balance, mobility and environmental navigation,” says Catherine Heyman, O.D. She is the founding dean of the School of Optometry at High Point University in North Carolina. “When it is impaired, it can greatly increase the risk of falls.”

Knowing how your vision is related to fall risk is an important first step toward staying steady on your feet. Here’s a closer look at how vision changes can lead to tumbles, plus what you can do to protect yourself both at home and on the go.

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Your Eyesight and Fall Risk

Sometimes normal, age-related vision changes can make you more prone to falling. Here’s why:

• Duller sight can make it harder for you to spot stumbling blocks. Think lamp cords or a bunched-up bathroom rug.
• You might have a harder time with depth perception, which is your ability to see objects in three dimensions, including how big or far away they are. That can lead to missteps on stairs or uneven surfaces.
• If you have trouble seeing contrasting colors, poor night vision or need time to adjust to low lighting, that can cause problems too, Dr. Heyman explains.

Keeping your glasses or contact lenses updated can help combat these issues. But bifocals or multifocal glasses may also pose hidden hazards. “They can affect spatial awareness and depth perception,” says Dr. Heyman, “especially when you’re looking through different parts of the glasses while moving.”

Certain common age-related eye conditions can factor in, too. These include:

• Cataracts: These are cloudy areas of the eye’s lens that can make your vision blurry or hazy. They’re a normal part of aging, affecting nearly 50% of adults 75 and older.
• Age-related macular degeneration (AMD): This is a disease that affects central, or straight-ahead, vision. It may make it harder to see details clearly, impacting your ability to read, drive or recognize faces.
• Glaucoma: This is a problem marked by increased pressure in the eye. It can cause peripheral (side) vision loss.
• Diabetic retinopathy: This happens when blood vessels in the eyes are damaged, potentially leading to vision loss and blindness. It can develop if diabetes is not managed properly.

Having age-related vision loss also raises your risk for other serious health problems that can make you more likely to fall. These include heart disease, stroke and diabetes — even if you haven’t developed retinopathy.

“Chronic conditions can lead to mobility and balance issues and loss of muscle tone and strength,” says James Dello Russo, O.D, an optometrist with offices in New York, New Jersey and Connecticut. “These physical limitations can lead to falls.”

Many of the prescriptions used to treat these conditions can also cause side effects like muscle weakness or dizziness, which can cause you to feel more unstable.

Staying Steady if You Have Vision Loss

Being proactive about your eye health and your home environment can help you stave off falls. Try these five tips for staying on your feet.

1. See your eye doctor regularly. A yearly eye exam helps you manage existing eye problems and catch new ones sooner, possibly even before they cause symptoms or develop into serious issues. It’s also a chance to make sure your glasses or contact lens prescription is up to date, says Dr. Dello Russo.
2. Enhance your home’s lighting. Brighten up dark areas to help you get around easier. “Night lights in bedrooms, bathrooms and hallways can help,” Dr. Heyman says. Consider installing motion-sensor lights that automatically turn on when you enter a room.
3. Use contrast and color in your home. Put brightly colored tape on steps, doorways and floor transitions to make them easier to see, Dr. Heyman recommends. Another tip is to install dark light switches if you have light-colored walls, so they stand out more and are easier to find.
4. Do balance and strengthening exercises. Staying strong improves your balance and mobility. Yoga, Pilates and lifting weights can all help you stay steady on your feet.
5. Wear sturdy, non-slip shoes. Comfy, well-fitting sneakers offer traction and stability, so they’re a smart choice for all older adults. They can be especially good for people with visual changes who may have trouble spotting fall hazards, says Dr. Dello Russo.

When to Seek Help

There are many steps you can take to stay independent if your vision is impaired. But severe vision loss can make it difficult to safely live alone. Deciding when you — or a loved one — has reached that point isn’t easy. It may be worth seeking expert input from your primary care physician and eye doctor. Together, you can find the solution that works best for you.

Recommended reading: Fall Prevention: The SilverSneakers Guide
4 Things Your Eyes Can Reveal About Your Health

See our sources:
Vision impairment and fall risk: Centers for Disease Control and Prevention
Age-related vision changes and strategies to stay safe: National Institute on Aging
Cataracts: National Eye Institute

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