A clear vision to reduce falls
Research at the University of Bradford into the link between older people's vision and their likelihood of falling has led to new guidelines for optometrists and a change in the way spectacles are prescribed for older people at risk.
Falls are the leading cause of accidental death in older people, with around a third of people aged over 65 and half of those over 80 falling at least once a year. Treating elderly people following falls is estimated to cost the NHS more than £2.3 billion per year.
The Bradford team assessed how the kind of spectacles worn by elderly people affected the way they walked up and down stairs – which is when many falls take place. They found that people with single vision lenses adapted the way they walked to negotiate stairs more safely than those with bi- or varifocal lenses, even when they’d been wearing those type of glasses for many years.
The team also discovered the answer to an apparent paradox: although the link between falls and poor vision is well-established, when elderly people undergo cataract surgery or get new glasses to correct their vision, the number of falls may not improve and in some cases may actually increase. The Bradford researchers suggested that it is the sudden change in magnification caused by spectacles that causes the problem, and as a result optometrists are now recommended to make incremental changes in some prescriptions rather than correct vision in one big step.
The team’s findings have been incorporated into guidelines produced by the College of Optometrists and the British Geriatrics Society and endorsed by Age UK and the Royal College of General Practitioners. Visual impairment is also now included in NICE guidelines for the assessment and prevention of falls for older people. The findings formed part of a Which? Campaign, reported widely in the media, highlighting the unsafe practice of buying varifocals and bifocals online and the problems associated with higher-powered ready readers.
More about our vision science research.
- Professor David Elliott
- Dr John Buckley
- Andy Scally
- Louise Johnson
- David Whitaker