Poor Vision and Senior Falls: An Ophthalmologist’s Perspective

By Mark Ruchman M.D. | Published 11/25/2020 0

poor vision senior falls eye exam

Photo source: iStock

More than ever, seniors need to be vigilant about their vision. Not only is it an essential sense, but poor vision presents another risk: preventable falls. Unfortunately, we live in the age of COVID which makes it harder for older adults to maintain their health, including their eye health. This article reviews the reasons why it is more important than ever that seniors get regular vision care

The health risks of social isolation 

There are millions of older adults living alone, a grim fact amplified by the COVID-19 pandemic. Family members are visiting older relatives less. And when they do, they may keep their distance to limit virus exposure and spread.

Seniors are also frequenting their doctors less, to maintain distance and safety during this time.

Although social distancing measures are necessary, older adults living alone face challenges to their health and well-being. In fact, self-isolation increases feelings of loneliness, a risk factor for other medical conditions.

It may also increase the risk and consequences of falls in this population. Isolated elders may be unable to get up after a fall leading to prolonged time on the floor and a delay in getting medical care. As a consequence, they can develop preventable complications, including the following:

  • skin breakdown
  • dehydration
  • kidney failure

The link between falls and poor eyesight 

Deteriorating vision, reduced muscle mass (known as sarcopenia), and problems with balance often accompany aging. All of these factors contribute to the risk of falls in the elderly. In fact, falls are the leading cause of injuries for older people.


According to the National Council on Aging:  

  • An older adult is treated in the emergency room every 11 seconds for a fall
  • Every 19 seconds, an older adult dies from a fall. 

In addition to the physical cost, injuries caused by falls can come at a steep economic price. Each year, about $50 billion is spent on non-fatal fall injuries and $754 million is spent on fatal falls. Further, as the population continues to age, this cost is expected to increase substantially.

Related content:
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According to a widely-cited Pennsylvania State University College of Medicine study, by the age of 65, one in three individuals has some form of a vision-reducing eye condition. These include

  • age-related macular degeneration (AMD)
  • cataracts
  • glaucoma
  • diabetic retinopathy
  • poor depth perception
  • loss of peripheral vision
  • slower adjustment to lighting changes
  • other vision obstructions 

All of these changes increase the probability of a fall.

Reducing the risk of eye disease in seniors

While vision problems related to aging cannot be completely avoided, there are some measures that older adults can take to reduce their risk of eye disease and maintain eye health as they age:

  • Lifestyle adjustments

Both quitting smoking and maintaining a healthy weight can reduce the risk of developing eye diseases. This is because smoking increases the risk of certain eye diseases, including cataracts, AMD, and diabetic retinopathy. And, being overweight is associated with cataracts and increases in intraocular pressure.

Eating nutritious foods, maintaining a healthy weight, and increasing physical activity are all essential for vascular health and, therefore, support good eye health. 

Wearing sunglasses while outside protects eyes from the negative effects of UV light and can also benefit one’s eyesight, particularly if started early and used consistently.

  • Routine eye exams

Vision screening and early intervention are essential for improved clinical outcomes. Because of this, comprehensive routine eye exams are one of the most important steps for the early diagnosis of associated vision problems.

A comprehensive eye exam should include the following:

      • visual acuity testing
      • measurement of intraocular pressure to screen for glaucoma
      • examination of external eye structures (lids, lashes, tear ducts, cornea)
      • slit-lamp examination of the eye’s interior to look for cataracts
      • A thorough evaluation of the back of the eye to look for changes to the blood vessels, optic nerve, macula, and retina suggest conditions that may negatively affect eyesight. 

Vision care solutions to protect eyesight and prevent falls

The good news is that many of the chronic conditions that adversely affect eyesight can be detected through routine eye exams, often before patients exhibit symptoms.

Many people think managed vision care is comprised of annual eye exams to ensure one’s eyeglass prescriptions are correct. However, it is so much more. While seeing clearly is tremendously important, comprehensive vision care goes way beyond prescriptions for glasses. It is essential to both getting ahead of eye conditions and mitigating their impact on vision.

Eye exams allow eye care professionals to take a non-invasive look at the body’s blood vessels. This helps them catch serious systemic diseases early.

Additionally, eye exams help ensure people have access to the right eyesight corrections, such as:

  • progressive lenses for clearer vision at multiple distances
  • anti-reflective coatings to reduce glare
  • blue light protection

Regular eye exams allow eye care professionals to directly address specific eyesight problems and ensure patients can properly see their surroundings unobstructed or blurred.

Related content: Why You Should Have Regular Eye Exams

With many eye care providers moving towards telemedicine, seniors should explore all the eye care services available to them. Comprehensive eye exams must be done in-person. However, starting the conversation and prioritizing eye health can be a great first step for seniors as we navigate through this pandemic.

Why seniors? And why now?

It is a reality that as people age, their eyesight will decline. Although some vision deterioration is normal as one gets older, there are conditions that if untreated, can affect seniors’ lifestyles. Serious vision conditions like AMD, cataracts, diabetic retinopathy, and glaucoma can alter how seniors go about their lives including their ability to drive, cook, and exercise.

Managing one’s vision is key, especially now, as seniors navigate the pandemic and rely on their independence to meet their daily needs.

Older adults with impaired vision are also likely to suffer from other chronic illnesses that increase the risk of falling. This includes conditions such as stroke, diabetes, and heart disease. Further, management of these conditions often involves the use of prescription medications that themselves have side effects, including dizziness and muscle weakness that make falls more likely.

Compounding the issue, seniors living alone may be taking on additional physical tasks that present a risk of falls. Here are some examples:

  • changing a lightbulb on the ceiling
  • using a chair to reach for an item placed on a high shelf
  • climbing a ladder to clean gutters
  • slipping on a recently mopped floor

Together, these and other types of issues lead seniors to be the age demographic most likely to fall and to sustain injuries.

Further, the reality of elders falling becomes graver when family members and friends are less likely to be able to support seniors in their day-to-day lives.

The bottom line

All seniors should reflect on the impact their vision has on overall health, fall risk, and their ability to maintain independence and safety. Now is the time to make lifestyle and health decisions that can prevent or delay the onset or progression of degenerative vision problems, such as diabetic retinopathy and age-related macular degeneration. Regular eye examinations are an important step.

Mark Ruchman M.D.

Website: https://versanthealth.com/

Mark Ruchman, M.D.,, is a graduate of Yale University’s Medical College and completed his residency in Opthalmology and a fellowship in Ophthalmic Plastic & Reconstructive Surgery at Wills Eye Hospital in Philadelphia. He also was a Phi Beta Kappa graduate of Williams College, graduating Magna Cum Laude.

He is a board-certified, fellowship-trained ophthalmologist and ophthalmic plastic surgeon in Waterbury, CT. He has over forty years’ experience as a practicing ophthalmologist and more than thirty decades’ experience in managed eye care, including policy development, technology assessment, quality improvement, and utilization management.

Since 2018, Dr. Ruchman has served as the Chief Medical Officer of Versant Health, a managed vision care, and benefits company. His work has appeared in several peer-reviewed manuscripts since 1974 and he also regularly contributes thought leadership pieces in health and benefits trade outlets (e.g., ThinkAdvisor, BenefitsPro, Opthalmology Times, etc.).

He is the current Director of the International Eye Foundation, the nation’s oldest charitable foundation devoted to reducing blindness and promoting healthy vision. He is a member of the American Society of Ophthalmic Plastic Reconstructive Surgeons and a Fellow of the American Academy of Opthalmology.

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