Could Your Bifocals Trip You Up?

Related topics: Fall Prevention, Safety

Senior woman looking at her glasses

Preventing falls is a top senior safety goal. You're probably familiar with the list of ways to help older adults avoid a debilitating fall: Remove hazards in the home, such as throw rugs and clutter. Ask the doctor to review all the medications you take. Get plenty of exercise, including activities that improve balance. Wear sturdy, properly fitted shoes. Don't drink too much alcohol. Have regular eye exams and keep your glasses prescription up to date.

That last item is very important. Visual impairment is a major fall risk. But did you know that a common type of vision correction could potentially raise the risk of falling?

As we grow older, the lens of our eye becomes less flexible, making it harder to focus on things that are close up. We can wear reading glasses to compensate—but if we are also nearsighted, we also need a different prescription to see things that are far away. Some people have two pairs of glasses, one for distance and one for close-up. But most prefer to have multifocal lenses in their glasses. Bifocals provide clear vision for distance and close-up. Trifocals also have a third, middle range (for the distance of, say, a computer screen). Progressive lenses cover all the ranges with no lines or gaps, a convenient solution when we're switching our focus—for instance, when we're driving and need to see our hands, the instrument panel, and the road ahead of us. Or perhaps we are reading a book at the beach, looking up to focus on a person near us, then gazing out on the ocean.

However, fall prevention experts warn that bifocals, trifocals and multifocal (progressive) lenses may actually increase the risk of falling. A study appearing in Optometry and Vision Science, a journal of the American Academy of Optometry, found that the visual blurring caused by the near-vision portion of bifocals or multifocals could cause a senior to trip and fall. Said the publication's editor, Anthony Adams, OD, Ph.D., "Falls for the elderly can be quite serious in consequence, so adopting strategies for avoiding falls is very important. Our authors highlight the difficulty that bifocal and multifocal prescription glasses may create for the elderly, particularly if they gaze past the stepping point."

The problem stems from the fact that using our eyes while walking is a two-part process. We need to be looking ahead so we can see where we’re going and avoid hazards coming up. On the other hand, we need to watch our feet so we don't trip over debris, fall off a curb, or slip on a patch of ice. Yet when we look through the bottom area of our multifocal glasses, the view of our feet and the ground is blurred.

The study authors, who are from Queensland University of Technology in Australia, found that this blur caused seniors in their study to experience "understepping errors"—not taking a large enough step, which could be very dangerous on uneven pavement or stairs. Study author Alex A. Black, BAppSc, Ph.D., said that seniors who wear bifocals should be very mindful to watch their step. He said, "Our findings support the benefits of gaze training to maintain gaze position on stepping locations when undertaking precision stepping tasks and to improve stepping accuracy and minimize the risk of slips and trips."

Ask your doctor for advice about walking with bifocal or multifocal lenses. Be especially careful during the adjustment period. There's a learning curve as you learn how to hold and move your head to see objects properly. Report any problems you're having with the prescription or the fit of your glasses.

And it may be that you need an alternate pair of glasses for an extra measure of safety. Dr. Black's team says that seniors could benefit from getting a second pair of glasses with only distance vision to wear while walking or otherwise active.


 May Is Healthy Vision Month. Check out this month's wordfind puzzle, which is all about ways we can protect our eyesight as we grow older.

Source: IlluminAge Communication Partners; copyright 2017.