Learn 8 practical tips to reduce the risk of falls for people with wet age-related macular degeneration.
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Blurry vision, blank spots, wavy lines — all are characteristic of wet age-related macular degeneration (AMD), which is an eye disease. Wet AMD can interfere with your ability to see details that are straight ahead of you.
These symptoms can not only make it more difficult to carry out your daily tasks, but also increase your risk of an injury. Research shows that people who have an eye disease such as AMD are more likely to experience falls and fractures of the hip, spine, and lower leg, compared with people without an eye condition. In one study, about 37 percent of the participants with AMD experienced a fall, compared with around 21 percent of those without AMD.
With a little prep work, though, there are ways to reduce your odds of a fall. Here are eight steps to try.
1. Declutter Your Home
If you have wet AMD, get rid of anything that’s simply taking up space, because unnecessary items might turn out to be fall hazards. “Make sure you know where everything is that you need, and ensure there’s nothing scattered on your floors,” says Sarju Patel, MD, MPH, an ophthalmologist with Retinal Consultants Medical Group in Sacramento, California.
If you need help organizing or storing your belongings, ask a loved one. Focus on removing items from the floor, including cords or throw rugs (or tape them to the ground). In addition, move any furniture out of highly trafficked pathways, and plan to leave it that way to maintain a familiar environment.
2. Invest in Good Lighting
If you have wet AMD, you may be losing your contrast sensitivity, which is your ability to distinguish the outlines of objects and differences in shading and pattern. That alone is a huge contributor to fall risk, says Dr. Patel. In fact, having trouble with contrast sensitivity has been shown to be a risk factor for any fall, even in people whose near and far vision acuity is otherwise clear or sharp.
One way to improve contrast issues is to enhance your home’s lighting. “You need nice, bright lighting,” says Patel. Sure, you can add a lamp or two in your living room or bedroom, but you may also want to shop for LED light bulbs if your budget allows. Some specialized LED lights allow you to adjust the brightness to match the task at hand (reading versus walking around, for example). This will help provide a useful — and, therefore, safer — amount of brightness. You can also apply lighting strips to enhance contrast in important areas of your home, such as on the stairs and in bathrooms.
3. Change Up Your Walking Style
Years ago, you may have been able to cruise around your home, speeding from task to task. But that may be dangerous for you now, especially if your contrast sensitivity has gotten worse. In that case, “relearning” how to walk can help tremendously, says Patel. Here are three things to focus on:
Avoid rushing. Hurrying around — in both familiar and unfamiliar places, such as your home or a new grocery store — can set you up for a fall.
Lift your feet off the ground when you walk.If you tend to shuffle your feet, you may be more likely to trip over something.
Work with a physical or occupational therapist. They can help you develop optimal walking techniques.
4. Reexamine Your Medications
Certain medications — beta blockers, psychiatric medications, erectile dysfunction drugs — may be associated with light sensitivity and problems with color vision. Others, such as cardiovascular drugs and antidepressants, can cause orthostatic hypotension, a condition that can cause you to feel lightheaded and dizzy upon standing. These types of side effects can affect your vision and increase your fall risk.
If you take any of these medications, Patel recommends talking to the doctor who prescribed them about the risk of side effects such as vision-related symptoms or dizziness. If you’re experiencing symptoms already, they may be able to adjust your treatment regimen to reduce side effects. (Just make sure to talk to your doctor before making any changes.)
5. Use Eccentric Viewing
Eccentric viewing is a skill that R. Tracy Williams, OD, a low-vision specialist at Loyola University Medical Center in Maywood, Illinois, teaches to people who have AMD. This involves relearning where to focus your eyes to view something. “You don’t look dead center,” he explains. “You have to learn to look slightly above, below, in front, or past. This won’t give you perfect vision, but it will improve it.”
Eccentric viewing may not be right for everyone, though. Some research has found that it may be best for people with end-stage macular disease.
Before you try this technique, talk to your doctor. If you’re interested in learning more about eccentric viewing, you can recruit the help of a low-vision rehabilitation specialist.
6. Improve Your Balance and Strength
As you lose vision, you can also lose your balance. That’s where a training program can come in. Some research has shown that following a core stability program — designed to improve balance and body stability — for six weeks may help reduce fall risk in people who are blind or visually impaired.
7. Ask a Friend
If you’re running around — whether that’s simply going to lunch or heading to the airport to travel — Williams recommends enlisting the help of a “seeing friend.”
“Ask for their elbow, and take it,” says Dr. Williams, who adds that they should tell you anytime you’re approaching a curb or set of stairs. Use them as your guide. “Teach the person how to help you.”
It may feel strange or out of place at first, but asking for assistance in this way can mean going wherever you want to go, with a lot less risk of falling.
8. Learn How to Fall
Yes, the best thing is to do what you can to decrease your fall risk in the first place. But even with the best-laid plans, there’s still a chance of falling, especially when wet AMD progresses.
To reduce the risk of fracturing a bone during a fall, practice falling “correctly.” Start by bringing your arms into your body and falling on your shoulder, without reaching your arm out, says Patel. You can also find programs that teach you how to do this. Check with low-vision centers, or ask your healthcare team to help you locate a resource nearby.
What’s more, tell your doctor if you have fallen. “Eye visits tend to be short, but making your provider aware of any falls is important,” Patel says. “Many times we find out from other family members. You can say something like ‘I fell twice over the last few months. Is there anything that can help?’” Chances are, your doctor will be able to offer some suggestions.
The Takeaway
Wet AMD can interfere with your ability to see straight ahead, which leaves you susceptible to falls and fractures.
To avoid tripping hazards, clear as much as you can from your floors, including cords, furniture, and other items.
To head off a fall, practice picking up your feet when you walk. Try to avoid shuffling whenever possible.
He earned his medical degree from Dartmouth. He completed an ophthalmology residency at the NYU Grossman School of Medicine, where he was chief resident, followed by a fellowship in uveitis and ocular inflammatory disease at the Francis I. Proctor Foundation for Research in Ophthalmology at the University of California in San Francisco.
Dr. Tsui is committed to advancing the field of ophthalmology. His research focuses on utilizing state-of-the-art ophthalmic imaging technology to improve the diagnosis and monitoring of uveitis. He is a co-investigator in several multicenter clinical trials investigating therapeutics for uveitis. He is the author of over 80 peer-reviewed publications and has given talks at national and international conferences.
Along with his clinical and research responsibilities, Tsui teaches medical students and residents. He is on the Association for Research in Vision and Ophthalmology's professional development and education committee, as well as the advocacy and outreach committee, which seeks to increase funding and awareness of vision research. He also serves on the editorial board of Ophthalmology and the executive committee of the American Uveitis Society.
Jessica Migala is a freelance writer with over 15 years of experience, specializing in health, nutrition, fitness, and beauty. She has written extensively about vision care, diabetes, dermatology, gastrointestinal health, cardiovascular health, cancer, pregnancy, and gynecology. She was previously an assistant editor at Prevention where she wrote monthly science-based beauty news items and feature stories.
She has contributed to more than 40 print and digital publications, including Cosmopolitan, O:The Oprah Magazine, Real Simple, Woman’s Day, Women’s Health, Fitness, Family Circle, Health, Prevention, Self, VICE, and more. Migala lives in the Chicago suburbs with her husband, two young boys, rescue beagle, and 15 fish. When not reporting, she likes running, bike rides, and a glass of wine (in moderation, of course).
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Rivasi G et al. Drug-Related Orthostatic Hypotension: Beyond Anti-Hypertensive Medications. Drugs & Aging. September 7, 2020.
Rubin GS et al. Eccentric Viewing Training for Age-Related Macular Disease: Results of a Randomized Controlled Trial (the EFFECT Study). Ophthalmology Science. March-April 2024.
Salar S et al. The Effects of Balance and Core Stability Training on Postural Control in People With Visual Impairment: A Systematic Review. British Journal of Visual Impairment. September 2023.
