Ophthalmology, April 2017
Yonge et al. characterized fall-related hazards in homes of people with suspected or diagnosed glaucoma and assessed whether people with worse visual field (VF) damage have fewer home hazards. The researchers found multiple hazards in the homes of this study population, and the numbers of hazards were not fewer in the homes of those with advanced VF deficits.
Participants in the ongoing Falls in Glaucoma Study (FIGS) were recruited from individuals aged 60 years or older who presented at the Wilmer Eye Institute glaucoma clinic, who were diagnosed with glaucoma or were glaucoma suspects, and who were able to perform VF testing. At baseline, all FIGS participants underwent a comprehensive assessment of visual function, including visual acuity (VA), Humphrey 24-2 VF testing, and contrast sensitivity (CS). The primary metric for VF was integrated visual field (IVF), an average calculated across several VF points.
Among the 245 participants, 174 (71%) agreed to allow a trained evaluator to visit their homes and perform the Home Environment Assessment for the Visually Impaired (HEAVI). This instrument measures 46 distinct items each in various areas of the home (up to a maximum of 127 possible hazards), including hazards related to handrails, lighting, flooring, and furniture.
The mean number of items graded per home was 85.2, and the evaluator identified an average of 32.7 (38.3%) as hazards. Among areas, bathrooms had the greatest number of hazards; and the most common hazard in all rooms related to lighting (inadequate illumination or exposed bulbs).
The researchers found no significant association between total home hazards or number of hazards in any given room and IVF sensitivity, CS, or VA. Further, although IVF sensitivity, CS, and VA were not associated with home lighting levels, brighter room lighting was noted in the homes of participants with higher median income.
The researchers concluded that home hazards were common in this study population and that hazard numbers were not lower for those with worse VF damage. These findings suggest that people with more advanced glaucoma do not adapt their homes for safety; and, thus, further work is needed to develop interventions to reduce fall hazards in this high-risk group.
The original article can be found here.