Profile of Falls and Its Associated Factors among Adults with Visual Impairment: A Cross-sectional Study from a Tertiary Eye Hospital

Background: Falls among adults with visual impairment (VI) are underreported or underrepresented compared to elderly falls.

Objectives: To report falls among the young, middle-aged, and elderly adults with VI.

Materials and methods: This cross-sectional study recruited subjects from a tertiary eye care center with VI aged ≥18 years based on clinical records. Occurrence and characteristics of falls in the past year were obtained over telephone. Falls and fear of falling were considered the primary and secondary outcomes, respectively.

Results: Of the 888 subjects, 18% (n = 160) reported having fallen at least once, and among them, 45.6% (n = 73) had multiple falls. Overall, fallers were more among the "young" (21.1%) than the "middle-aged" (16.0%) and the "elderly" (17.3%). Risk of falling was more among the blind (odds ratio (OR): 7.1; 95% confidence interval [CI]: 2.8-18.4, P < 0.001) than other categories of VI. Retinitis pigmentosa (RP) (OR: 4.4; 95% CI: 1.5-12.9, P = 0.007) and glaucoma (OR: 3.5; 95% CI: 1.3-9.8, P = 0.016) showed increased risk of falls. Overall "fear of falling" was reported by 11.3% (n = 100), out of which 30% (n = 48) were by fallers. Side vision difficulty was predominantly associated with falling, followed by staircase and night vision difficulties as perceived by subjects. Most of the falls happened outdoors and overall 38.8% had an injury after falls.

Conclusion: This study reported unique trend of increased occurrence of falls among the young with VI compared to older age groups. RP and glaucoma being peripheral vision loss causing diseases and increased severity of VI were more associated with falls and fear of falling.