Visual function assessment in patients sustaining fractures due to simple fall

Siddharth Agrawal

Purpose: To assess visual functions in patients sustaining fractures due to a simple fall and comparing them with age matched controls in Indian population.

Methods: 100 consecutive(new and follow up) patients attending the OPD of Department of Orthopedics, CSM Medical University, Lucknow, India with a history of simple fall (fall due to tripping, slipping, colliding against an obstacle or stepping on an uneven surface) in the previous 3 months and having fracture/s on examination were included. Patients having fractures under the influence of alcohol, due to a fall from height, in road traffic accidents or in brawls were excluded. Patients unable to cooperate for visual assessment due to their physical or mental impairment were also excluded.

The visual assessment included uncorrected and best corrected visual acuities (UCVA and BCVA), refraction,examination of anterior and posterior segments, contrast senstivity on Pelli Robson chart and full field charting (120) on Humphreys Visual Field analyzer.
The same functions were assessed in 100 age matched controls taken from the general population. A comparison between the visual functions of cases and controls was done using standard statistical tests.

Results: The incidence of fractures due to simple falls was more in the elderly (Mean Age 66.6 years, Range 32 to 86 years) and in females (66%). The BCVA and visual fields were significantly inferior in cases compared to controls (p<0.05).

Conclusions: Poor visual functions are associated with falls leading to fractures in the elderly. Regular visual screening and prompt management of subnormal visual functions may prevent grevious injuries and associated morbidity.