OBJECTIVES: Accidents, including falls, represent a significant global health burden and the risk of falling is associated with vision impairment. To understand the burden of accidents and falls in persons with cataracts, a structured literature review was conducted.

METHODS: The PubMed database was searched in June 2019, utilizing a combination of the following terms: falls, accident, crash, collision, cataract, astigmatism, presbyopia, refractive, multifocal, trifocal, bifocal, monofocal, intraocular lens (IOL). The search was not limited by language and included articles published in the last 15 years. From all relevant studies, the risk of falls/accidents, associated injuries, and associated healthcare resource utilization, were recorded.

RESULTS: Cataract patients have a high risk of falls and associated injuries. A reported 13%-40% of elderly persons with cataracts experienced ≥1 fall within 12 months prior to cataract surgery, and cataracts may increase the odds of multiple falls. Cataract patients experience injuries, which range from mild (eg, bruise) to severe (eg, hip fracture), in approximately 52% of falls, with hospital admission in up to 10% of cases. One large study with >1 million subjects reported a reduced risk of hip fracture after cataract surgery; however, the risk of fractures post-surgery was inconsistent across 5 studies. No identified studies reported on the association between IOL selection and risk of falls.

CONCLUSIONS: Prior to surgery, cataract patients are at risk for falls and fall-related injuries; however, the reported risk of falls following cataract surgery is inconsistent. Further research is needed to understand what variables (eg, IOL selection) may serve to mitigate the risk of falls and/or injuries within the context of current cataract practices.