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Falls and Fractures

Vision loss or low vision can make it harder to get around, and especially if you have vision loss in one eye only, it can affect depth perception and balance, making you feel a bit unsteady. Along with vision impairment comes the very real danger of falling and possibly fracturing a bone, especially as one gets older.

The risk of falls and fractures

Falls are the main cause of accidental injury and death in older adults, and one in three adults falls each year.1 The risk of falls and fractures naturally increases as one gets older: muscle weakness, gait or balance problems, low blood pressure, medications, and hearing loss can all contribute to the risk of falling.2 Along with this, bone density often decreases with age, and when you fall, weakened bones are more likely to fracture. This can lead to hospital stays, significant disability, or even death.2

It’s important, then, to take steps to reduce your risk of falls and fractures if you have macular degeneration – even if your vision loss is not severe. Putting preventative measures in place is never a bad thing and can save you time and work later on.

Risk and AMD

Adjusting to a change in visual acuity can take some time, and depending on the severity, might require some functional changes to be made in the way you do things around the house or ways that you do everyday activities. Visual impairment increases your risk of falls, especially in the first five years of experiencing a visual change.3 Unilateral vision impairment (vision impairment in one eye) especially resulted in an increased risk of fractures over the course of five years compared to those with normal vision.3

What can you do?

Impaired vision doesn’t necessarily mean you have to give up living independently or have to move. There are things you can do to reduce your risk of falls and fractures. If the fall risk is considerable, talk with your doctor about whether it’s safe to live independently. If they say it’s okay, you can work with an occupational therapist trained in assisting individuals with low vision, and adapt your home to your changing visual needs.

Make adjustments in your home

Things you can do at home to reduce your risk of falls and fractures include4:

  • Making sure there is enough lighting in your home, especially in rooms with a lot of furniture and in stairwells
  • Remove area rugs; if you keep them, tape them down to avoid slippage or rolled edges
  • Don’t wax floors; use nonskid products
  • Push in chairs at desks and tables
  • Place any electrical cords near the perimeter of the room and tape them down
  • Place mirrors strategically so the lights don’t reflect off of them, creating glare
  • Install grab bars and handrails where needed

Maintain bone health

To reduce your risk of fractures, make sure your bones are healthy and strong. Eat foods rich in calcium like broccoli, yogurt, almonds, milk, and spinach, and you can even consider a calcium supplement with vitamin D if your doctor recommends it. Regular physical activity, quitting smoking, and minimizing alcohol consumption are also things that can help keep your bones healthy and strong.2 Talk with your general practitioner about whether a supplement is safe for you to take, and how you can help build your bone strength and keep your bones healthy.

Talk with your doctor

Macular degeneration and its resulting vision loss can increase your risk of falls, and subsequently, increase your risk of fractures, as well. Talk with your eye doctor about a referral to an occupational therapist specializing in low-vision clients, and discuss steps to increase your bone health with your general practitioner. Remember, just because you have an increased risk of falls and fractures, does not necessarily mean you will fall or have a fracture. These are just things to keep in mind as your vision changes, and it can be beneficial to be mindful of ways you can help reduce your risk of falling or fracturing a bone.

Jaime R. Herndon | December 2018
  1. Safari LN, Kwon OS. Aging vision and falls: A review. J Physiol Anthropol. 2018; 37(1): 11. Doi: 10.1186/s40101-018-0170-1. Accessed November 14, 2018.
  2. National Institutes of Health: National Institute on Aging. Prevent Falls and Fractures. 2017. https://www.nia.nih.gov/health/prevent-falls-and-fractures. Accessed November 14, 2018.
  3. Hong T, Mitchell P, Burlutsky G, Samarawickrama C, Wang JJ. Visual impairment and the incidence of falls and fractures among older people: Longitudinal findings from the Blue Mountains Eye Study. Invest Ophthalmol Vis Sci. 2014; 55(11): 7589-93. Doi: 10.1167/iovs.14-14262. Accessed November 14, 2018.
  4. American Foundation for the Blind. Creating a Comfortable Environment for People with Low Vision. 2018. http://www.afb.org/info/low-vision/living-with-low-vision/creating-a-comfortable-environment-for-people-with-low-vision/235. Accessed November 14, 2018.