Visual Impairment Among Inpatients Who Experience Falls: A Retrospective Service Evaluation In A Uk Hospital

Published 2026 - 44th Congress of the ESCRS

Reference: PPE1.05 | Type: ESONT Abstract | DOI: 10.82333/k7eb-8c02

Authors: Dr Mitchell Titley*, Dr Babar Elahi ¹ , Dr Madiha Waseem ¹ , Mrs Soaad Gheleh ¹ , Mr Robert Cotter ¹ , Mr Craig Carman ¹ , Mrs Diane Lynch ¹

¹The Dudley Group NHS Foundation Trust,Dudley,United Kingdom

Purpose

Inpatient falls cause significant morbidity in older adults. Visual impairment is included in the NICE guideline (NG249) for multifactorial falls risk assessment, yet identification in acute care may be inconsistent. This service evaluation aimed to determine the proportion of inpatients who sustained a fall and had recorded visual impairment within Hospital Eye Service (HES) records, as well as desciptions of impairment types and demographic details.

Setting

Retrospective service evaluation at a UK acute general hospital in the West Midlands. Inpatient falls were identified via the Trust Datix reporting system and cross-referenced with local HES records. The project was classified as a service evaluation as per NHS Health Research Authority guidance.

Methods

Adult inpatients with documented falls (Nov 2023–Mar 2025) were identified. Duplicate entries were excluded. Cases were cross-referenced with HES records (available from 2019). Visual impairment was defined as binocular BCVA <0.3 LogMAR or BCVA ≥0.3 LogMAR with pathology likely to cause functional visual field loss. Proportions were calculated with 95% CIs. Logistic regression explored associations demographic associations.

Results

1,215 unique fallers were included. 106 patients had documented visual impairment (8.72%, 95%CI 7.26–10.45%). 46 had BCVA <0.3 LogMAR and 60 had preserved acuity with visual field loss. Glaucoma-related diagnoses predominated among field defects. Visual impairment increased with age (4.05% <65 years vs 16.22% ≥85 years). Increasing age was independently associated with impairment (aOR 1.05 per year, 95%CI 1.03–1.07).

Conclusions

Documented visual impairment was identified in 8.72% of inpatient fallers, with prevalence rising markedly with age. Over half had preserved acuity but diagnoses attributed to visual field loss, predominantly glaucoma-related. As only patients with available HES records could be identified, these findings likely represent an underestimation of the true burden, suggesting a substantial “iceberg” of unrecognised visual dysfunction and a potential health inequality within inpatient falls pathways.