FEB 12, 2019
Glaucoma
This paper evaluated the locations, circumstances and outcomes of glaucoma patients’ falls.
Study design
This prospective cohort study included 142 patients with suspected or diagnosed glaucoma with 20/40 vision or better; the mean age was 71 years old. All participants completed monthly calendars reporting falls over a 2-year period. Researchers collected location, circumstance and injury data via a 30-item questionnaire. Patients were stratified based on the degree of visual field defect (normal, mild-moderate or severe).
Outcomes
A total of 330 falls were reported and occurred evenly between indoor and outdoor locations. Many of the falls happened near the home; 117 of these occurred indoors and 73 were outdoor. Rate of injuries, however, was similar between indoor and outdoor falls (30% vs. 48%; P=0.19). For falls occurring within the home, the most frequent locations were the stairs (25%) and bedroom (19%). Participants reported tripping (44%), slipping (31%), uneven floors (24%) and poor vision (16%) as the most common causes for falls.
A multivariate analysis revealed that the amount of visual field damage did not predict whether a fall would result in injury or if hospitalization was needed. Only floor type and number of comorbidities affected the likelihood of injury (both P<0.05).
Limitations
Data was retrospectively collected at the end of each month, possibly limiting the amount of accurate details recounted by the patient. The study design may have also introduced a selection bias because individuals willing to participate in the study may have prior mobility issues and therefore not accurately reflect all glaucoma patients.
Clinical significance
Falls experienced by elderly glaucoma patients occur in similar locations and circumstances as the general population. They often occur in or near a patient’s home and usually associate with trips, slips and uneven floors. The degree of visual field damage, however, did not correlate with the number or severity of fall.