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Editors Selection IGR 14-2
Quality of Life: Influence of Vision on Falls and Injuries
Comment by Pradeep Ramulu on:
61415 Investigating the Influence of Visual Function and Systemic Risk Factors on Falls and Injurious Falls in Glaucoma Using the Structural Equation Modeling, Yuki K; Asaoka R; Tsubota K, PLoS ONE, 2015; 10: e0129316
Glaucoma has previously been associated with higher rates of falls and fall-related injuries, with as many as 50% of patients having been noted to fall in a given year. Yuki et al. Add to this literature by retrospectively examining fall rates in 365 Japanese POAG patients. They find a somewhat lower likelihood of falls in the prior year (15%), perhaps reflecting the relatively mild level of visual field damage (better and worse-eye MD of -2.7 and -6.4 dB in the fallers) and the retrospective design (in which some may not recollect their past falls).
Worse-eye visual acuity (VA) as the primary visual variable associated with falls
Unlike prior studies that have found visual field loss, particularly loss in the inferior field, to be a primary risk factor for falls, the current study identified worse-eye visual acuity (VA) as the primary visual variable associated with falls, though the difference in VA between fallers and fallers was very small (0.01 logMAR units). No association was observed between either better or worse-eye MD and the likelihood of a fall in the last year - a surprising finding given that the falls literature has generally shown that visual field loss is more predictive of fall risk than VA. This finding may again reflect the relatively early stage of disease in the study population, in which loss of acuity in one eye (and the depth perception deficits arising as a result) may be of greatest relevance. Finally, it is notable that 40% of persons falling experienced an injury, highlighting the significant risk to health associated with falling, and the need to address falls in our patients at higher risk.
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