title: Quantifying Fall-Related Hazards in the Homes of Persons with Glaucoma.
abstract: To characterize fall-related hazards in the homes of persons with suspected or diagnosed glaucoma, and to determine whether those with worse visual field (VF) damage have fewer home hazards.
  
  
  
  Cross-sectional study using baseline (2013-2015) data from the ongoing Falls in Glaucoma Study (FIGS).
  
  
  
  One-hundred seventy-four of 245 (71.0%) FIGS participants agreeing to the home assessment.
  
  
  
  Participants' homes were assessed using the Home Environment Assessment for the Visually Impaired (HEAVI). A single evaluator assessed up to 127 potential hazards in 8 home regions. In the clinic, binocular contrast sensitivity (CS) and better-eye visual acuity (VA) were evaluated, and 24-2 VFs were obtained to calculate average integrated VF (IVF) sensitivity.
  
  
  
  Total number of home hazards.
  
  
  
  No significant visual or demographic differences were noted between participants who did and did not complete the home assessment (P > 0.09 for all measures). Mean age among those completing the home assessment (n = 174) was 71.1 years, and IVF sensitivity ranged from 5.6 to 33.4 dB (mean = 27.2 dB, standard deviation [SD] = 4.0 dB). The mean number of items graded per home was 85.2 (SD = 13.2), and an average of 32.7 (38.3%) were identified as hazards. IVF sensitivity, CS, and VA were not associated with total home hazards or the number of hazards in any given room (P > 0.06 for all visual measures and rooms). The bathroom contained the greatest number of hazards (mean = 7.9; 54.2% of graded items classified as hazardous), and the most common hazards identified in at least 1 room were ambient lighting <300 lux and exposed light bulbs. Only 27.9% of graded rooms had adequate lighting. IVF sensitivity, CS, and VA were not associated with home lighting levels (P > 0.18 for all), but brighter room lighting was noted in the homes of participants with higher median income (P < 0.001).
  
  
  
  Multiple home fall hazards were identified in the study population, and hazard numbers were not lower for persons with worse VF damage, suggesting that individuals with more advanced glaucoma do not adapt their homes for safety. Further work should investigate whether addressing home hazards is an effective intervention for preventing falls in this high-risk group.
authors.affiliation: Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Andrea V
authors.initials: AV
authors.lastname: Yonge
authors.affiliation: Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Bonnielin K
authors.initials: BK
authors.lastname: Swenor
authors.affiliation: Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Rhonda
authors.initials: R
authors.lastname: Miller
authors.affiliation: Center for Innovative Care in Aging, School of Nursing, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Victoria
authors.initials: V
authors.lastname: Goldhammer
authors.affiliation: Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Sheila K
authors.initials: SK
authors.lastname: West
authors.affiliation: Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland.
authors.forename: David S
authors.initials: DS
authors.lastname: Friedman
authors.affiliation: Center for Innovative Care in Aging, School of Nursing, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Laura N
authors.initials: LN
authors.lastname: Gitlin
authors.affiliation: Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland. Electronic address: pramulu@jhmi.edu.
authors.forename: Pradeep Y
authors.initials: PY
authors.lastname: Ramulu
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000061:Accidents, Home / Q000706:statistics & numerical data*; D000368:Aged; D015350:Contrast Sensitivity / Q000502:physiology; D003430:Cross-Sectional Studies; D005260:Female; D005901:Glaucoma / Q000453:epidemiology* / Q000503:physiopathology; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D016016:Proportional Hazards Models; D011788:Quality of Life; D018570:Risk Assessment; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D014786:Vision Disorders / Q000503:physiopathology*; D014792:Visual Acuity / Q000502:physiology; D058609:Visual Field Tests; D014794:Visual Fields / Q000502:physiology