Focus on falls

Vision and falls

Across the UK, falls are the most common cause of hospitalisation for people aged over 65, and of accidental death in those aged over 75. Undetected and untreated visual impairment plays a significant role in the high incidence of falls among older people. This prompted us to investigate ways in which we could reduce vision-related falls and encourage better connections between local falls services and community optometrists.

We have been working with the Local Optical Committee Support Unit (LOCSU) to support local optical committees (LOCs) and local eye health networks (LEHNs) in prioritising falls awareness. Our activities have included:

publishing Focus on Falls - a report outlining and promoting the pivotal role that improving vision has in preventing falls
briefing parliamentarians, key stakeholders and falls leads in the four nations
encouraging the development of a falls and vision pathway and recommending improved falls provision in the Map of Medicine for Low Vision
working with Thomas Pocklington Trust to distribute an easy-to-use tool for screening older people for poor vision to falls services teams across the UK. Contact olivier.deneve@college-optometrists.org for more information and to place an order
working with DOCET to incorporate findings from the report in their Ageing Eye CET materials
encouraging falls team to register on the UK-wide falls directory. This will help our members make contact, provide support and refer any patients identified as needing falls teams services.

I believe that there is much that can be done to support falls teams to reduce the unnecessarily high number of falls that could be related to vision. With a little effort we can make a huge difference to the safety and quality of life for our most vulnerable patients.

Olivier Deneve, College Policy Manager and Falls Project Lead

Falls Report

In May 2014, the College published Focus on Falls, which provides a picture of vision testing within falls services, highlighting any variations in care and suggests solutions to policy makers and the optometric profession. The report is based on interviews carried out with six falls services and an online survey, open to all falls teams across the UK.

The recommendations of the resulting College report, Focus on falls, have generated wide-ranging activity to raise awareness of the importance of regular eye examinations for those most at risk, and to support the inclusion of a vision check in the services offered by all UK falls teams.

Support for falls teams

The findings of our Focus on Falls report suggest that around 50% of UK falls teams currently assess patients' vision as a standard part of their service, although there is variation in the frequency and method of these checks. This variation is generally due to a lack of resource and capacity within a team. Most falls teams contacted advised that they would welcome support in performing vision checks and that referral between falls teams and optometrists would help improve the patient pathway and foster greater levels of clinical continuity. In response to these findings, we are developing ways to work with falls teams.

Eyes right? Order a free vision checking toolkit
The College is working with the Thomas Pocklington Trust to distribute the easy-to-use Eyes Right tool for checking vision. Developed by occupational therapist, Suzy England, it can be used by anyone but is especially useful for those working in a community setting. The toolkit includes a flip chart with pages suitable for reading close to and in the distance, an occluder to cover one eye while the other is being tested, a tape measure and clear instructions on how to carry out a test. Please note this is just an indicative sight test and does not replace a full eye examination or find underlying eye conditions.
Email:olivier.deneve@college-optometrists.org to place your order a free toolkit.

Find a local optometrist
Falls teams with concerns about a patients eye sight, should encourage them to book an eye examination. Use our Member Directory to find a College Member practising in your area, many have dementia-friendly practices.

Add your details to the Falls Directory
We have developed a Falls Directory and are encouraging our members to make contact with their local Falls Team when they identify risk. Please add your contact details to the directory and update them as necessary.

Get involved

Optometrists are in a good position to identify people who are at an increased risk of falling, for example elderly patients who have a change in their prescription and/or wear multifocal lenses. They can also help to reduce that risk by offering advice on prevention to patients and carers, and colleagues in other medical and care professions.

There are several ways in which members can get involved and help reduce the incidence of vision related falls among their most vulnerable patients:

Get in touch with your local falls team to discuss ways in which you can support them, perhaps through encouraging referral in both directions. Some services are already listed on our Falls Directory.
Use our Focus on Falls PowerPoint in presentations to falls teams and other health and professionals involved with the falls care pathway in your community.
Consider the visual risk factors for falls when assessing your patients using our Falls Checklist.
Order your free copies of our Ageing eyes and Falls leaflet. This helpful patient provides invaluable advice for at-risk patients and those caring for them. You can also direct patients to our public health information website - lookafteryoureyes.org.

For further information or to provide feedback, please contact olivier.deneve@college-optometrists.org

The falls presentation I made with the College’s resources had a high impact and was very well received. I was able to put a local stamp on this work and, with the College’s support, I felt well equipped to discuss this important topic with a multi-disciplinary team working to prevent falls in my area.

Claire Roberts MCOptom