Sources of binocular suprathreshold visual field loss in a cohort of older women being followed for risk of falls (an American Ophthalmological Society thesis).
OBJECTIVE
To determine the sources of binocular visual field loss most strongly associated with falls in a cohort of older women.


METHODS
In the Study of Osteoporotic Fractures, women with severe binocular visual field loss had an increased risk of two or more falls during the 12 months following the eye examination. The lens and fundus photographs of the 422 women with severe binocular visual field loss, plus a random sample of 141 white women with no, mild, or moderate binocular visual field loss--47 white women with no binocular visual field loss, 46 white women with mild binocular visual field loss, and 48 white women with moderate binocular visual field loss--were evaluated for lens opacities, glaucomatous optic nerve damage, age-related macular degeneration, and diabetic retinopathy.


RESULTS
Eighty-four percent of the women with severe binocular visual field loss had ocular disease in one or both eyes. Bilateral cataracts and glaucomatous optic nerve damage were the most common sources of this severe binocular visual field loss. Approximately 15.2% of women had no evidence of lens opacities, glaucomatous optic nerve damage, age-related macular degeneration, or diabetic retinopathy.


CONCLUSIONS
Severe binocular visual field loss due primarily to cataracts, glaucoma, and age-related macular degeneration explains 33.3% of the falls among women who fell frequently. Because binocular visual field loss may be treatable and/or preventable, screening programs for binocular visual field loss and subsequent referral for intervention and treatment are recommended as a strategy for preventing falls among the elderly.
Coleman
Anne Louise
AL
Department of Ophthalmology, Jules Stein Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, USA.
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D002386:Cataract / Q000150:complications; D005260:Female; D005451:Fluorescein Angiography; D050723:Fractures, Bone / Q000453:epidemiology; D007839:Functional Laterality; D005901:Glaucoma / Q000150:complications; D006801:Humans; D008268:Macular Degeneration / Q000150:complications; D012307:Risk Factors; D014786:Vision Disorders / Q000150:complications*; D015348:Vision, Binocular; D015354:Vision, Low / Q000150:complications*; D014794:Visual Fields