Balance problems, gait deficits, and visual impairment are all well-known risk factors for increased falls, particularly among older adults who are already at a higher risk for (and have a greater prevalence of) glaucoma. What remains unclear is why people with greater visual field damage fall more frequently and what relationship balance and gait deficits have to do with more frequent falls in that population. 

Authors of a 2020 study, published in Investigative Ophthalmology and Visual Science, examined whether or not visual field loss led to changes in balance and gait that resulted in increased fall risk for glaucoma patients.* 

What they did

For this prospective longitudinal study, researchers enrolled 239 participants with glaucoma, or suspected glaucoma, and gathered baseline data on:

• Falls
• Balance
• Gait
• Vision

They collected follow-up data over 24 months and analyzed it for possible associations between:

• Balance
• Gait
• Average daily steps
• Rate of falls per step

Researchers also analyzed integrated visual field sensitivity data concerning falls. 

What they found

Study results showed that:

• There was a 44.8% chance of falling at least once over the first 12 months of follow-up. 
• There was a 17.7% probability of falling two or more times. 
• Gait deficits were more strongly associated with fewer daily steps. 
• Worse balance was more strongly associated with fall rates per year. 
• Integrated visual field sensitivity remained an independent predictor of falls per step. 
• Neither gait nor balance explained the link between visual field damage and fall rates.

What it means

The findings demonstrated that gait and balance problems were independent risk factors for falling, and their impact on fall risk was not significantly higher for people with greater visual field loss. This means that visual field damage and its consequences may be the primary risk factors for increased falls in glaucoma patients. 

While balance and gait were “clearly important predictors of falls in the current study…they did not…explain the association between visual field damage and the risk of falling,” wrote Aleksandra Mihailovic, Senior Biostatistician at the Wilmer Eye Institute at Johns Hopkins University, and her fellow study authors in their conclusion. 

“Future research should specifically address other potential causes of falls that, in conjunction with changes in balance and gait, could more fully explain the relationship between visual field damage and falls among glaucoma patients,” the researchers stated.

*Burba, K., & Malloy, K. (2020, Sep. 15). Frequent Falls in Glaucoma Patients Loosely Associated with Balance, Gait Measures. Primary Care Optometry News. https://www.healio.com/news/optometry/20200914/frequent-falls-in-glaucoma-patients-loosely-associated-with-balance-gait-measures

Any sources from outside of Prevent Blindness do not imply an endorsement from Prevent Blindness. The contents of the material used are the responsibility of the authoring organization, Responsum Health.