Considering previous evidences about contribution of visual impairment (VI) to increased rate of falling among elderlies and its burden on the community, we investigated the association of improved VI after cataract surgery and risk of falling in adults over 50 years old in Gorgan.

This was a retrospective cohort study on 100 patients referred to ophthalmology clinics of Golestan University of Medical Sciences. All were diagnosed with significant VI due to cataract and were scheduled for surgery 12 months before entering the study. Patients with movement disabilities (bedridden, needing walker or crutch) were excluded. 50 patients took cataract surgery at that time, and 50 didn’t take the surgery due to personal issues. Both groups were evaluated for their systemic condition and presence of underlying disease using Charlson comorbidity index (CCI), Instrumental Activities of Daily Living (IADL), VI severity and the prevalence of falls during a 12-month period.

Both groups were matched in terms of demographic characteristics (age, sex), IADL and CCI scores. Patients who took the surgery had no VI (i.e. visual acuity (VA) higher than 5/10), while 62% and 38% of those who refused the surgery had moderate-to-severe VI (VA =<2/10) and mild VI (VA >2/10 and =<5/10) respectively. After controlling for demographics and major confounding variables by multivariate regression analysis, rate of falling was significantly lower among those who took cataract surgery (12% VS 32%, P=0.01). Among patients with cataract, severity of VI was a significant predictor for falling (P<0.001).

We showed that the rate of falling was much higher among visually impaired patients due to cataract compared to those with improved vision after cataract surgery (OR=2.667). VI has a significant role in the likelihood of falls in elderly, and cataract surgery can improve vision of patients and thereby reduce rate of falls.