Healthy Vision and Optimum Correction: Contributions to Safe Ambulation With Increasing Age

Falls are a major public health concern. In 2009 there were 2.2 million nonfatal falls in the elderly population treated in emergency rooms with close to 581,000 of these visits requiring hospitalization. It is estimated that the direct medical costs of falls were over 19 billion dollars in the year 2000. In general up to thirty percent of elderly over the age of 65, still living in the community, experience a fall each year. Studies have shown that from 10 to 40% of those residing at home are permanently placed in nursing facilities six to twelve months after experiencing a hip fracture. The risk for falls increases with age and changes in the visual system with normal aging are considered to be contributing to increases risk for falls with age. Uncorrected refractive errors or not wearing appropriate glasses also creates postural instability. Reports indicate that the use of multifocal lenses contributes to a higher risk of falls, but such work does not differentiate between bifocals, trifocals and progressive additions or account for glare and tint coatings as a variable. In normal aging visual engagement and attention is slowed and this in itself may contribute to increased mobility problems. Those that have multiple falls have impairments in many visual functions that are not considered normal aging including; acuity, depth perception, contrast sensitivity and visual field. Pathologies of the eye that have increasing frequency with aging such as glaucoma and age related macular degeneration also increase risk for falls.