Understanding the attitudes, activities and needs of optometrists in the prevention of falls among older adults

Background/ Purpose: In 2001, the American Geriatrics Society (AGS) issued clinical guidelines on the prevention of falls among older adults, recommending a vision exam for certain individuals. Little is known about the knowledge, attitudes and behaviors of vision professionals pertaining to fall prevention.

Methods: An anonymous survey was administered to optometrists, assessing their awareness of the AGS guidelines, attitudes on the vision management of fallers, knowledge of fall risk assessment, comfort discussing falls, referrals received for falls, frequency of eliciting a fall history, and perceived needs for better managing patients experiencing falls.

Results/Outcomes: Surveys were completed by 149 optometrists involved in the clinical care of older adults. None were aware of the AGS guidelines; 93% never received a referral for falling; and 82% reported taking a fall history on less than 10% of older patients. Ninety percent felt they had an important role in fall prevention: most agreed or strongly agreed that older adults fallers should be considered for mono-focal lenses (72%), those with cataracts should be referred for surgical evaluation (80%), and 95% felt fallers should have their medication reviewed. Forty percent reported they were uncomfortable or unsure of their comfort discussing falls and 82% reported they needed more education to manage patients who have fallen.

Conclusions: This survey indicates gaps in communication of the clinical guidelines for falls prevention across medical disciplines and a potential under-referral of fallers for a vision exam. The findings highlight a need for improved integration of fall prevention efforts into visual health services.