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Watch Your Step! Vision Care Helps Prevent Falls

Adding vision care to your health toolkit is vital to your overall well-being

By Carol Levine

On my first solo trip to an appointment last winter, I confidently stepped out of a taxi when I found myself sprawled inelegantly on the sidewalk. After several surgeries, on that day I was already weak from bed rest, but I also had not looked down when falling. I might have seen the broken pavement and avoided the fall altogether.

An older man getting an eye exam. Next Avenue, vision, fall prevention
Every year, one in four Americans 65 and older experiences a fall, a risk that doubles for those with impaired vision and other chronic conditions like diabetes, stroke, or heart disease.   |  Credit: Getty

Indeed, falls can result in acute injury, decreased mobility, and worsened chronic illnesses. The Centers for Disease Control and Prevention (CDC) reports that more than 12 million Americans aged 40 years and older have vision impairments, which is expected to double by 2050. 

Assuredly, vision care is an essential element in fall prevention.

In addition, every year, one in four Americans 65 and older experiences a fall, a risk that doubles for those with impaired vision and other chronic conditions like diabetes, stroke, or heart disease. 

Assuredly, vision care is an essential element in fall prevention. Studies of older adults consistently report fears of falling and losing one's vision as an unwelcome prelude to losing one's independence. Moreover, fear of falling can be a risk factor for falls, as people reduce exercise and ordinary activities and become weaker and more likely to fall.

However, there are strategies for reducing risk and slowing the progression of vision impairment, but why aren't these implemented more often? The most significant obstacles seem to be the absence of professionals trained in this specialty as part of routine medical and home care and the ever-present issue of costs. 

'Eye Health as a Public Health Issue'

The CDC acknowledges the gap in public health programs and vision care: "Unfortunately, vision health is rarely included in public health programs designed to prevent or manage chronic diseases because of limited resources and competing priorities."

"As a result, most public health agencies lack the framework or guidelines they need to appropriately address vision and eye health as a public health issue." In light of this, what can individuals and families do if government agencies do not have the answers? Quite a lot, it appears.

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Fall Prevention and Vision Care Essentials

The essentials of fall prevention and vision care are just one of the critical elements of fall prevention. Many websites include common recommendations such as regular exercise, asking a pharmacist to identify medications that may have side effects such as dizziness and muscle weakness, and removing throw rugs or taping them in place.

Adding vision care to your fall prevention toolkit is vital, starting with your primary health care provider.

Other recommendations include adding lighting to rooms and hallways and having handrails on stairs and grab bars in bathrooms installed by a qualified carpenter.

These are all crucial steps, but even if you have done them all for yourself or someone you care for, there is more to do.

Adding vision care to your fall prevention toolkit is vital, starting with your primary health care provider. According to Dr. Christy Worsoe, "keeping one's balance requires all the body's sensory systems to function well."

Worsoe, who teaches physical therapy at CUNY Hunter College in New York, added, "sensory systems often fail due to aging, age-related illnesses, and medications. If this happens, vision offers extra importance to maintain balance."

Further, ask your doctor or nurse to evaluate your vision with regular eye exams. If you already use prescription glasses, have them checked at least once a year to make sure that no changes are needed. If you notice problems in your vision, tell the primary provider, who may refer you to a specialist for added tests.

When it comes to different types of "eye doctors," these are not to be confused. An ophthalmologist is a medical doctor (MD) trained to manage serious vision problems, which may require medications and surgery. An optometrist is also a doctor (OD) qualified to do vision exams and prescribe eyeglasses. Lastly, an optician is a skilled technician who fills prescriptions and may collaborate with the optometrist or ophthalmologist to manage the specific case.

Many people are appropriately concerned about the costs of vision care, which can vary widely depending on who provides the care, whether insurance covers vision care, and the location. Also, state rules govern who is certified to provide this service, so it is necessary to determine how your state regulates credentials and costs.

Original Medicare does not cover routine eye care, but if it involves an eye disease, it will be covered as "medically necessary." Also, Medicare Advantage plans often promote coverage of services not available in original Medicare, such as dental and vision care.

I now know that preventing falls includes looking ahead to see what is right in front of me, eyes and all!

Medicare Advantage plans vary in scope, so if you have ongoing vision problems, it is essential to find precisely what your plan covers and which providers are included in the plan. Medicaid may cover some vision care, but check with the state office to determine what is covered and what you will have to pay privately.

Some private insurance companies cover vision care. One of these plans may suit your needs and budget but be sure to check with state agencies and the Better Business Bureau to identify the ones that do not have many complaints.

Besides, a social worker may be able to help find a charitable organization in your area that helps with obtaining vision care and glasses for people who have limited incomes.

My embarrassing fall helped me realize my need for more exercise, especially balance and strength. I have consulted an eye doctor and am being monitored regularly. I now know that preventing falls includes looking ahead to see what is right in front of me, eyes and all!

Carol Levine is a Senior Fellow at the United Hospital Fund in New York and a freelance writer. She was awarded a MacArthur Fellowship for her AIDS policy and ethics work and named a 2016 Next Avenue Influencer in Aging. Read More
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