Locations, Circumstances, and Outcomes of Falls in Patients With Glaucoma

Purpose: To characterize the locations, circumstances, and outcomes of falls in patients with varying degrees of glaucoma. Design: Prospective cohort study. Methods: Patients with suspected or diagnosed glaucoma completed monthly calendars reporting falls. After each fall, a 30-item questionnaire was administered to determine fall location, circumstances, and injury. Mean deviation on visual field (VF) testing was used to categorize glaucoma severity. Main outcome measures were fall locations, circumstances, and outcomes. Results: One-hundred forty-two patients experienced 330 falls. Falls were most likely to occur in/around the home (71%), and this likelihood did not vary significantly with severity of VF damage (P >.2). The most commonly cited fall circumstances were tripping (43.6%), slipping (31.3%), uneven flooring (23.5%), and poor vision (15.9%). The circumstances related to falls did not vary by severity of VF damage (P >.2), except for poor vision, which was more frequently cited in individuals with more advanced VF damage (P =.001). Forty-three percent of falls resulted in some injury; and the likelihood of injury did not vary by severity of VF loss (P =.60) or any other factor except floor type and number of comorbidities (P <.05 for all). Falls in persons with more severe glaucoma were more likely to result in a fracture (9.4%) or an emergency room visit (18.8%), though these associations did not persist in multivariable models (P >.5 for all). Conclusions: Glaucoma patients fall mostly in/around the home and demonstrate similar fall circumstances across the spectrum of disease severity, suggesting that current fall prevention interventions, particularly those emphasizing home modification, may be an adequate starting point to prevent falls in this high-risk-group.