[Visual impairment in elderly fallers].

OBJECTIVE

To study visual impairment and the etiology of visual loss in fallers and non-fallers in older patients.

PATIENTS AND METHOD

Cross-sectional study including two groups of patients: elderly patients admitted for a fall (group 1) and elderly individuals who did not report a fall during the 6 months before admission (group 2). Visual acuity was measured in both eyes of all participants. Complete ophthalmologic evaluation was performed in the fallers group.

RESULTS

The fallers group included 98 patients (mean age, 83.4 ± 6.3) and the non-fallers group included 106 patients (mean age, 79 ± 6.6). The fallers had lower vision than non-fallers (P<0.001). Visual impairment (visual acuity less than 20/40) was more frequent in the fallers (49.5% vs 15.3%, P<0.001). Causes of visual impairment in fallers were cataract (47.4%), association of cataract and age-related macular degeneration (17.5%), age-related macular degeneration without cataract (13.4%), and optic neuropathy (9.3%). Management of fallers was difficult, and only 17 of 48 eyes (35.4%) with cataract had undergone surgery.

CONCLUSION

Fallers have a higher prevalence of visual impairment and blindness. Vision may improve with surgery in half of these eyes. This study highlights the need for systematic ophthalmologic evaluation in this high-risk population in order to prevent falls.