Falls in patients with macular diseases and visual impairment during the COVID-19 pandemic

Author: Chin Pey Yap (United Kingdom)

Co-authors: Cara Mitchell, Faruque Ghanchi

Purpose

To assess the incidence of falls among patients with visual impairment and undergoing antiVEGF treatment for Age related macular degeneration (AMD), Diabetic macular edema (DME) and retinal vein occlusion (RVO) during the COVID-19 pandemic.

Setting/Venue

Macula clinic of a large teaching hospital in UK.

Methods

All patients who attended macula clinic between 15th February 2021 and 31st March 2021 were recruited in this study. At the clinic appointment, each patient was asked if (s)he had fallen in the previous twelve months (i.e. year of COVID-19 pandemic). All patients’ demographic data and their ocular diagnosis and visual acuity data were extracted from electronic patient records. Those who reported having fallen and agreed for telephone interview were subjected to semi structured questionnaire and details on number of falls, need for medical attention as well as patient’s opinion as to the cause of fall was collected.

Results

565 (Mean age 75.3) consecutive patients attending macula clinic over 6 weeks for their planned clinical care for macular diseases were included in the survey. 38 of 565 patients (6.7%) reported having fallen. 28 (75.7%) patients had less than four falls. Most patients- 23 (62.2%) did not have to seek medical attention for their fall(s) but 5 (14.7%) warranted hospital admissions. There were 18 (47.4%) AMD patients, 11 (28.9%) RVO patient and 7 (20%) DME patients who had fallen. From visual impairment point of view, 6 (15.8%) had visual acuity worse than 6/18 and 1 (2.6%) patient had visual acuity worse than 6/60. Half of the group 16 (50%) had visual acuity between 6/18 and 6/9. Most -28 (77.8%) patients did not think poor eyesight contributed to their falls. More than half (14, 56%) subjects attributed their falls to carelessness or rushing unnecessarily.

Conlusions

Patients with macular diseases and vision impairment are at risk of falls. The incidence of falls 6.7% in our patient population is lower than in previously reports. Most patients attributed ‘carelessness’ rather than vision impairment to their falls. Patients with macular diseases should be appraised of the risks of falls and advised to be mindful of risk of complacency.

Financial Disclosure

N/A