Falls and Vision: Are You At Risk?
By Laura Vittorioso
“According to the National Council on Aging (NCOA) every 14 seconds an older adult is seen in the emergency department for a fall related injury. The chances of falling and of being seriously injured in a fall increases with age.”
Falls Prevention and Safety: As Polio survivors, we are more prone to falls and have become aware of some of the strategies to prevent falls; i.e.: Use of a mobility device such as a cane or walker, removing loose rugs, installing handrails and being aware of slippery surfaces such as black ice in winter. Maintaining eye health as we age is also critical for preventing falls. Age related eye changes are a big contributor to falls. Some of these changes include: early cataracts, reduced contrast sensitivity, increased difficulty with glare and the need for more light.
Considerations as We Age:
Cataracts: Most of us will develop cataracts. A cataract is simply the clouding of the lens. The lens is removed and a clear, plastic lens is inserted. Cataract surgery is now routine and easily managed in the recovery period. A developing cataract can produce a blurry image, usually in one eye first; sensitivity to glare and difficulty with reading.
Reduced Contrast: Contrast is the ability to detect subtle changes in the environment. For example, seeing a black curb on a black surface, seeing the first step on a similarly colored background or in low light, finding a toothpick on a multi-colored countertop. Contrast begins to fade in our late 60’s and 70’s and is often a reason why driving in bad weather or at night becomes difficult.
Glare: Our ability to handle glare on a bright sunny day decreases as we age. Sunglasses are now recommended for all ages to protect the eyes from harmful UV rays from the sun. There are many different tints to choose from, some of which will increase contrast, such as amber or yellow. Yellow sunglasses improve contrast greatly for night driving and poor weather such as fog or snow. Sunglasses particularly the wrap-around style or fit over style, also protect the eyes from dirt, dust and wind and can help conditions such as “dry eye” another effect of aging.
Light: It is estimated we need double the amount of light to read or perform fine motor tasks as we age. Overhead lighting in each room is important for fall prevention. In addition, task lighting such as a gooseneck-type reading lamp which can be positioned on the page of a book or a task can greatly improve function. There are a variety of lightbulbs to choose from … bright white LEDs or softer, more natural bulbs called “daylight.” The backlighting on an iPad or Kindle provides a very comfortable light for reading.
Medicare and Medicare Advantage plans cover an annual eye exam each year with an Optometrist.
The Optometrist is the professional who performs “refractions” for corrective lenses. An Optometrist is also trained to detect eye disease through dilation in order to see the back of the eye.
If the Optometrist suspects eye disease a referral will be made to an Ophthalmologist. The Ophthalmologist is a medical doctor specializing in eye disease and can perform eye surgeries.
Maintaining eye sight is a critical factor in falls prevention and overall function. While aging doesn’t mean that eyesight will be compromised, there are various factors of aging that can reduce visual function. The best preventative is to see an eye specialist once a year and to call if one notices any sudden or unusual changes in vision such as a flood of floaters, or a cut in central or peripheral vision.
If an eye doctor cannot be reached, it is best to go to the emergency room as time is of the essence with conditions such as a vein occlusion or retinal detachment.
Laura Vittorioso
Vision Rehabilitation Therapist