Visual field loss and falls requiring hospitalisation: results from the eFOVID study

Area of Science:

• Ophthalmology
• Gerontology
• Public Health

Background:

• Visual fields are critical for maintaining balance and navigating environments.
• Impaired vision, particularly visual field loss, poses a significant risk to older adults.
• Falls are a leading cause of injury and hospitalization in the elderly population.

Purpose of the Study:

• To investigate the relationship between varying degrees of visual field loss and the incidence of falls necessitating hospital admission.
• To identify specific visual field loss thresholds associated with increased fall risk in adults aged 50 and above.

Main Methods:

• A retrospective cohort study utilizing a Western Australian ophthalmology database linked to hospitalization records (1990-2019).
• Participants aged 50+ were categorized based on visual field loss severity (mild, moderate, severe) using mean deviation index.
• Generalized linear negative binomial regression was employed to analyze the association between visual field loss and falls, adjusting for confounders like age and comorbidities.

Main Results:

• Severe visual field loss (mean deviation index < -12.01 dB) was significantly associated with a 14% increased rate of falls requiring hospitalization.
• Advanced age (80+ years), comorbid conditions, and diabetes were also linked to higher fall hospitalization rates.
• Previous cataract surgery showed a protective effect, associated with a 13% decrease in falls requiring hospitalization.

Conclusions:

• Severe visual field loss is an independent risk factor for falls leading to hospitalization in older adults.
• Continuous clinical surveillance of visual field status is essential for identifying at-risk individuals.
• Implementing targeted injury prevention strategies is crucial for mitigating fall-related hospitalizations in older adults with visual impairment.