期刊
OPTOMETRY AND VISION SCIENCE
卷 91, 期 6, 页码 593-601出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/OPX.0000000000000268
关键词
blurred vision; spectacle correction; falls; gait; postural control
资金
- Glenn A. Fry Award
- Atkinson Charitable Foundation
- College of Optometrists
- Dunhill Medical Trust
- Essilor International RD
- Federation of Ophthalmic & Dispensing Opticians
- Health Welfare Canada
- Health Foundation
- National Institute for Health Research
- PPP Foundation
- Vicon Motion Systems Ltd.
This article reviews the literature on how blurred vision contributes to falls, gait, and postural control and discusses how these are influenced by spectacle correction. Falls are common and represent a very serious health risk for older people. They are not random events as studies have shown that falls are linked to a range of intrinsic and extrinsic risk factors. Vision provides a significant input to postural control in addition to providing information about the size and position of hazards and obstacles in the travel pathway and allows us to safely negotiate steps and stairs. Many studies have shown that reduced vision is a significant risk factor for falls. However, randomized controlled trials of optometric interventions and cataract surgery have not shown the expected reduction in falls rate, which may be due to magnification changes (and thus vestibuloocular reflex gain) in those participants who have large changes in refractive correction. Epidemiological studies have also shown that progressive addition lens and bifocal wearers are twice as likely to fall as non-multifocal wearers, laboratory-based studies have shown safer adaptive gait with single-vision glasses than progressive addition lenses or bifocals, and a randomized controlled trial has shown that an additional pair of distance vision single-vision glasses for outdoor use can reduce falls rate. Clinical recommendations to help optometrists prevent their frail, older patients from falling are suggested.
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