Visual Impairment and Postural Sway among Older Adults with Glaucoma

Black, Alex, Wood, Joanne M., Lovie-Kitchin, Jan E., & Newman, Beth M. (2008) Visual Impairment and Postural Sway among Older Adults with Glaucoma. Optometry and Vision Science, 85(6), pp. 489-497.

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Purpose. To investigate the effect of visual impairment on postural sway among older adults with open-angle glaucoma. Methods. This study included 54 community-dwelling participants with open-angle glaucoma, aged 65 and older. Binocular visual field loss was estimated from merged monocular Humphrey Field Analyzer visual field results and retinal nerve fiber layer (RNFL) thickness was obtained from the Stratus Optical Coherence Tomographer. Postural sway was measured under four conditions: eyes open and closed, on a firm, and a foam surface. Data were collected for additional vision measures (visual acuity and contrast sensitivity), physical performance measures (self-reported physical activity levels and 6-min walk test), and demographic measures (age, gender, body mass index, and medical history). Multivariate linear regressions, adjusting for confounding factors, were performed to determine the association between visual loss and postural sway. Results. Participants with greater binocular visual field loss or thinner RNFL thickness showed increased postural sway, both on firm and foam surfaces, independent of age, gender, body mass index, and physical performance levels. These visual loss measures were significant predictors of postural sway, explaining almost 20% of its variance on the foam surface. Furthermore, participants with greater inferior hemifield visual field loss showed increased postural sway on the foam surface. Increasing glaucomatous visual impairment was accompanied by a steady decrease of the visual contribution to postural control. Conclusion. Among older adults with glaucoma, greater visual field loss or thinner RNFL thickness is associated with reduced postural stability. This postural instability may be a contributing factor in the increased risk of falls among older adults with glaucoma.

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ID Code: 15454
Item Type: Journal Article
Refereed: Yes
Additional Information: The contents of this journal can be freely accessed online via the journal's web page (see Official URL above) 12 months after publication.
Keywords: glaucoma, visual field, postural sway, balance, ageing, OAVJ
DOI: 10.1097/OPX.0b013e31817882db
ISSN: 1538-9235
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > OPTOMETRY AND OPHTHALMOLOGY (111300) > Vision Science (111303)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Copyright Owner: Copyright 2008 Lippincott Williams & Wilkins
Deposited On: 04 Nov 2008 00:00
Last Modified: 01 Mar 2012 00:48

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