People with vision loss are almost twice as likely to experience multiple falls as those with normal vision. For those with vision loss, everyday tasks such as grocery shopping or navigating crowded spaces can be a source of anxiety. Limited vision also may mean risking a fall away from home, leading many to become homebound and isolated.
Changes in Vision as We Age
Most seniors experience the following normal vision changes that are associated with the aging process. In addition, there are age-related eye conditions that will result in vision impairment.
- Increased need for light:
- This is a result of a smaller pupil and aging lens. A senior requires four to ten times more light than a younger person.
- Reduced visual acuity:
- After age 60, our ability to see clearly declines. This makes it hard to see steps, or you may not be able discern a curb at the end of a sidewalk. If you have reduced visual acuity, you may be more sensitive to glare.
- Increased sensitivity to glare:
- Even though you may need a brighter light source than a younger person, your vision can be reduced by glare. Examples include sunlight shining through a window then reflecting off shiny surfaces, glass tables, waxed floors, or bright light from unshielded bulbs.
- Difficulty adapting to light and dark:
- You may not be able to adjust to different light levels, especially in low light. This makes walking to the bathroom at night a significant fall risk.
- Reduced contrast sensitivity:
- A loss of sensitivity to detect contrast effects your ability to recognize objects or faces, textures and patterns.
- Decreased depth perception:
- You may find it difficult to determine how close or how far away an object is. This makes the detection of how high or low a step is very difficult. You may have trouble estimating the height of a step and misplace your foot, leading to a trip or fall. You may think that carpet is uneven and alter your balance and walking to accommodate the misperception. It also makes it difficult to perceive objects in areas of shadows, low light or bright lights.
- Seeing spots that block central vision due to age-related macular degeneration:
- This makes it hard to detect obstacles in your path, and difficult to walk across streets or a parking lot.
- Decreased visual field due to glaucoma:
- Your peripheral vision is very important to driving or walking. If you have peripheral field loss and are looking straight ahead, your lack of peripheral vision will not alert you to dangers coming at you. People with peripheral vision loss also experience night blindness, meaning vision might okay during day but impaired at night.
- Visual changes due to medications:
- Evaluate all medications with your health care team when you notice changes in vision. Even medications you have been on long-term may be affecting your vision.
Ways to Reduce Your Risk of Falls Due to Vision Changes
You want to be able to move about confidently and safely and to detect dangerous obstacles such as tripping hazards, stairs, curbs, moving vehicles, or people in enough time to react safely.
View Falls as Controllable
For those with vision loss, falling may be inevitable. Knowing this keeps many feeling like it’s too risky to leave the house. Learning how to recover from a fall unassisted can help alleviate fear and regain the confidence to leave the house again.
Correct Visual Problems
- Get an annual eye exam.
- Correct problems with new glasses and keep them clean at all times.
- Optimal lighting conditions include more than one light source in a room and higher wattage light bulbs.
- Use even lighting throughout home.
- Install night lights to navigate in dark rooms and hallways.
- Use natural light from windows.
- Give yourself extra time to adjust when going from a well-lit to a dimly-lit room.
- Pause to adjust to the change between dark to bright environments.
- Do not wax your floors.
- Wear sunglasses outdoors.
- Avoid directly facing the sun.
- Cover bulbs with a shade.
- Stairs: Use bright, non-skid paint or tape to contrast the edge of each step.
- Floors: Use colored tape across thresholds when floors are of different heights.
- Furniture and Carpeting: Remove clutter and keep pathways clear. Selecting contrasting colors or patterns in furniture and flooring can help.
Improve Bathroom Safety
- Install grab bars.
- Use brightly colored rugs that are secure on the floor with rubber non-skid backings.
Low Vision Rehabilitation Evaluation
Studies show that people start losing independence when their corrected visual acuity drops to 20/60 or worse. Most health insurances cover low vision rehabilitation examinations. A low vision specialist can evaluate the degree and type of vision loss you have, prescribe appropriate low vision aids, recommend non-optical adaptive devices, and help you learn how to use them.
Finding a Low Vision Specialist
To find a low vision specialist near you, go to www.whatislowvision.org and click on “find a low vision specialist.”
If You Do Not Have Insurance Coverage
EyeCare America, a public service foundation of the American Academy of Ophthalmology (AAO), has several programs designed to meet the needs of those who don’t have vision insurance. To find out more about EyeCare America’s programs, call (877) 887-6327. If you are eligible, you will receive the name of a volunteer eye doctor in your community, along with instructions for making an appointment.