3 Common Eye Diseases That Raise Risk of Falls

Other factors leading to falls

Complicating matters: Older adults are already at an increased risk of falls. According to a report from the Centers for Disease Control and Prevention, 1 in 4 people age 65 and older reported falling in 2020; worse yet, accidental falls are the leading cause of injury and injury-related deaths in that age group. Vision loss isn’t the only culprit.

“Several diseases can accompany the aging process that worsen the interaction between vision loss and injury,” says Michelle Andreoli, M.D., comprehensive ophthalmologist at Northwestern Medicine and spokesperson for the American Academy of Ophthalmology. “Diabetes, high blood pressure and other diseases that are more common with age can make injury worse, as well as worsen vision.” ​​

What’s more, some medications commonly taken by older adults — including certain drugs that treat heart disease, diabetes, anxiety and depression — can increase the risk of falls, as the JAMA study noted. The loss of muscle mass that comes with age also figures in, affecting agility. And then there’s the practical consequence of having bladder control issues that cause you to rush to the bathroom, tripping over, say, an electrical cord or slipping on a throw rug. ​

All of the above are risk factors on their own, but they contribute to the increased risk of falls in people with vision loss. The vision-impaired participants in the JAMA study all had poorer health and a higher level of multiple health conditions at the outset, as compared to their visually unimpaired counterparts. “The interaction between various health conditions can have a compounding effect on a person’s overall stability and mobility,” Brissette says.

How to stay safe

The good news: You don’t have to accept falls as a natural part of aging. For one thing, cataracts, AMD and glaucoma are all preventable or treatable. Early detection, though, is key. As the study notes, people in the initial stages of eye disease often have zero noticeable symptoms, and progression can be gradual. Both cataracts and AMD, for instance, usually affect just one eye at first. With glaucoma, peripheral vision is affected, but the brain compensates by filling in what’s missing.

“If vision declines slowly, sometimes people have a hard time noticing their decline,” Brissette says. But that doesn’t mean early-stage eye disease carries no risk of falls. It “may impact contrast sensitivity, making it difficult for people to discern changes in lighting and detect potential hazards, especially in low-light conditions,” she says. “People in the early stages of eye disease may not have fully adapted to changes and as a result, they may be less skilled at compensating for vision loss, making them more vulnerable to falls.”

That’s why it’s critical for people 65 and over to have a comprehensive eye exam every year or two, as recommended by the American Academy of Ophthalmology. “Eye diseases that affect vision are more common with age,” Andreoli says. “Timely diagnosis and management is essential to controlling some of these diseases.”