Researchers who investigated fall rates among glaucoma patients found that most accidents occur at home. The risk of a miss-step resulting in a fall is higher at home, and patients with greater visual field (VF) damage are more likely to fall for each step taken both at and away from home.1
This prospective, observational cohort study investigated where and how often glaucoma patients fall and how VF damage affects fall rates per year and per step at and away from home. Fall data for 225 glaucoma patients and suspects was collected via calendars, fall location was classified through follow-up questionnaires and steps taken were estimated using accelerometer and GPS data.1
The researchers found that participants took more steps outside of their homes than in their homes (2,366 vs. 1,524) and that the difference in steps did not vary with VF sensitivity. They note that 57% of falls occurred at home, with each home step twice as likely to result in a fall compared with each away step. The team adds that worse VF sensitivity was not associated with a higher rate of home falls per year or away falls per year but was associated with a higher rate of home falls per step and away falls per step.1
The study concludes that patients should be counseled on home environmental modification efforts to prevent falls. Clinicians should also encourage physical activity in the visually impaired.1 In a commentary for Practice Update, Paul B. Freeman, OD, one of the authors of the study, notes that the risk of falls in the home may increase due to inattention to fall hazards and walking independently.2
“These results suggest the importance of reviewing fall risks with patients and their family members or caretakers and encouraging preventive measures where most falls occur,” Dr. Freeman says.2
1. Freeman PA, Sassani JW, Yanoff M. Predictors of falls per step and falls per year in patients with glaucoma. Am J Ophthalmol. January 23, 2019. [Epub ahead of print].
2. Predictors of falls per step and falls per year in patients with glaucoma. Practice Update. January 23, 2019.