9 Tips and Exercises to Avoid Falls When You Have Low Vision

Have your vision checked regularly to make sure your prescription is up to date. And though your bifocals and progressive lenses — with different areas of correction for near and distance vision — may be fine for reading, wearing them constantly can increase your risk of falling. A study published in the British Medical Journal found that single-lens distance glasses were associated with 40 percent fewer falls outdoors in highly active wearers near 80 years of age, compared with multifocal glasses. So it can’t hurt to keep a spare pair of single-vision distance glasses on hand for when you go out.

Also be careful when you get new glasses with a big change in prescription; while you’re adjusting to the difference, your balance can be thrown off-kilter by causing objects to appear closer or farther than they are, according to a 2014 study published in the journal Optometry and Vision Science.

4. Work those legs

Age-related muscle weakness can contribute to falls. Focus on exercises that build strength and flexibility. Sit-to-stand exercises strengthen the quadriceps — the group of muscles that cover the front and sides of the thigh, which are some of the most important muscles for preventing falls. Ankle mobility is equally important because if the muscles and tendons that surround the joint are stiff, you have less range of motion, making it harder to maintain your balance. (See sidebar for exercises.)

5. Improve your reaction time

How quickly you’re able to react to a situation — say, trying to right yourself when you step onto a patch of ice or after a stumble — decreases over time. That’s why power exercises (basically, strength exercises done faster) are important. “Increasing power will help you to react more quickly because you are training your body to move more quickly,” Beach explains. “That is critical with falling, when you have to take that quick step or make that quick adjustment.”

“Lunges are also great for lower-body strength and, when done with increasing speed, can increase power,” Beach adds.

6. Practice proprioception

Good balance depends not only on vision but on proprioception, a fancy word that basically means the ability to sense the position and movement of your body in your environment. Much of our proprioceptive information comes from the bottoms of our feet. Practicing standing on uneven surfaces or something that’s a little compliant — say, a garden mat, balance mat or square cushion — in bare feet while doing the dishes can help you focus more on that proprioceptive information and less on visual information.

7. Try tai chi

This gentle form of martial arts is another great way to improve proprioception and balance. “When you’re practicing the movements, you’re shifting your weight from one foot to the other to maintain balance. By doing this, you become more aware of the position of your body in space, something we become less aware of as we age,” says Michael Irwin, a professor of behavioral sciences and director of the Mindful Awareness Research Center at UCLA. Tai chi also creates a kind of “softening,” according to tai chi fitness expert Scott Cole. “You learn to sink into the earth and feel the connection with your feet,” which can help you negotiate uneven surfaces.

8. Get help for depression

A 2015 Australian study of older adults found that depressive symptoms and antidepressant use were associated with a greater fall risk, independent of antidepressant medication use. “People may not be thinking clearly, or they may not be eating or drinking enough,” says Baker. “Malnutrition and dehydration can lead to falls.” Excessive fear of falling, which is frequently associated with depression, can also lead to an impairment of balance. A study of community-living adults ages 60 to 97, published in The Journals of Gerontology, found that fear of falling in older adults was associated with changes in gait — specifically, a significantly slower gait speed and shorter stride length.

“Individuals that have fallen are often worried about future falls, especially if they had a fall with an injury,” says Thomas Caprio, M.D., professor of medicine and geriatrics at the University of Rochester Medical Center & Geriatric Assessment Clinic. “It’s OK to be cautious. The problem is, many times people unconsciously begin to restrict their activity. They go out of the house less, they limit areas — for example, avoiding stairs — and suddenly get into a cycle where they lose muscle strength and have a decrease in their overall endurance. Suddenly, they’re at much higher risk for falls — the same thing they were worried about to begin with. Also, when they don’t go out and engage with other people, they become socially isolated, which can lead to depression. It becomes a kind of self-fulfilling prophecy.”

So consider therapy or speak with your doctor about other treatment options for depression.

9. Watch the meds

“One of the first places I start looking when it comes to reducing falls is at the medication a patient is taking,” Caprio says. “Certain drugs can have side effects like dizziness, sleepiness or a general feeling of imbalance. They can also interact with each other and contribute to unsteadiness.” Common culprits include benzodiazepines, such as Valium and Xanax, commonly used to treat anxiety. “They affect the nervous system, and their mechanism is similar to alcohol, so they can make a person unsteady,” he says. (Also, of course, watch the alcohol.)

Another class of drugs that can affect balance are some of the antihistamines (commonly used for allergies), as well as certain medications for overactive bladder, such as oxybutynin; these anticholinergic drugs, which work by relaxing the bladder muscles, can lead to overall muscle weakness and falls.

Barbara Stepko is a longtime health and lifestyle writer, and former editor at Women’s Health and InStyle. Her work has appeared in The Wall Street Journal, Parade and other national magazines.