Visual field loss and falls requiring hospitalisation: results from the eFOVID study

Abstract

Abstract Background Visual fields are important for postural stability and ability to manoeuvre around objects. Objective Examine the association between visual field loss and falls requiring hospitalisation in adults aged 50 +. Methods Older adults aged 50+ with and without visual field loss were identified using a fields database obtained from a cross-section of ophthalmologists’ practices in Western Australia (WA). Data were linked to the Hospital Morbidity Data Collection and WA Hospital Mortality System to identify participants who experienced falls-related hospitalisations between 1990 and 2019. A generalised linear negative binomial regression model examined the association between falls requiring hospitalisation for those with and without field loss, based on the better eye mean deviation (mild: −2 to –6 dB, moderate: −6.01 dB to –12 dB, severe < −12.01 dB) in the most contemporaneous visual field test (3 years prior or if not available, 2 years after the fall), after adjusting for potential confounders. Results A total of 31 021 unique individuals of whom 6054 (19.5%) experienced 11 818 falls requiring hospitalisation during a median observation time of 14.1 years. Only mean deviation index of <−12.01 dB (severe) was significantly associated with an increased rate of falls requiring hospitalisations by 14% (adjusted IRR 1.14, 95% CI 1.0–1.25) compared with no field loss, after adjusting for potential confounders. Other factors included age, with those aged 80+ having an increased rate (IRR 29.16, 95% CI 21.39–39.84), other comorbid conditions (IRR 1.49, 95% CI 1.38–1.60) and diabetes (IRR 1.25, 95% CI 1.14–1.37). Previous cataract surgery was associated with a decreased rate of falls that required hospitalisations by 13% (IRR 0.87, 95% CI 0.81–0.95) compared with those who did not have cataract surgery. Conclusion The findings highlight the importance of continuous clinical monitoring of visual field loss and injury prevention strategies for older adults with visual field loss.