/ /

  • linkedin
  • Increase Font
  • Sharebar

    Risks of falls in glaucoma patients

    Poor gait quality within glaucoma patients can lead to compromised balance, falls

    During my residency, I had the fortune of spending several days in a secondary-care pediatric eye clinic with Scott Richter, OD, of New York. I learned much during my time there, but one notion that stuck with me more than the others was the exam starts as soon as the clinician observes the patient walking down the hallway to the exam room.

    Taking note of a patient’s behavior can provide a multitude of clues on the patient’s current condition. Perhaps the most apparent observational feature would be a patient’s gait.

    It is often said halfheartedly that looking at a patient’s shins gives ODs more information of visual impairment than looking at the patient’s visual field study. While this statement is factually inaccurate, it does well to point out the notion of observing a patient.

    Previously from Dr. Casella: New concepts in diagnosis and treatment

    Impact of gait quality

    One study suggests compromise of balance control is associated with the severity of one’s glaucoma.1 Study investigators systematically quantified the balance of 24 glaucoma patients and 24 controls. They concluded that the subjects in the glaucoma group tended to have differences in their balance when compared to the control group.

    These differences were associated with visual and somatosensory contributions to balance and were more apparent with worsening of glaucoma—as determined by binocular mean deviation scores from Humphrey 24-2 SITA strategy visual field studies.

    Related: How alcohol consumption correlates with glaucoma

    Another study of 54 open-angle glaucoma patients aged 65 or older produced similar results when examining postural sway.2 This study incorporated retinal nerve fiber layer (RNFL) thickness as measured by optical coherence tomography (OCT). Both metrics had an association with the outcome measures of the study.

    A recent, larger study (N=239) looked to determine differences in gait within glaucoma patients and glaucoma suspects.3 The subjects walked at a normal pace on an electronic walkway with and without carrying a cup or a tray. Having a worse visual field was associated with a greater variability in stride and a greater left-to-right drift within subjects carrying a cup or tray while walking.

    Benjamin P. Casella, OD, FAAO
    Dr. Casella, a 2007 graduate of University of Alabama at Birmingham School of Optometry, practices in Augusta, GA, with his father in ...


    You must be signed in to leave a comment. Registering is fast and free!

    All comments must follow the ModernMedicine Network community rules and terms of use, and will be moderated. ModernMedicine reserves the right to use the comments we receive, in whole or in part,in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

    • No comments available

    Optometry Times A/V