Lisa Keay1, Anna Palagyi1, Peter McCluskey2, Ecosse Lamoureux3, Konrad Pesudovs4, Serigne Lo5, Rebecca Ivers1, Soufiane Boufous6, Nigel Morlet7, Jonathon Q Ng8, Fiona Stapleton9, Michelle Fraser7, Lynn Meuleners7. 1. Injury Division, The George Institute for Global Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia. 2. Save Sight Institute, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia. 3. Centre for Eye Research Australia, University of Sydney, Melbourne, Victoria, Australia Singapore Eye Research Institute, Singapore Duke-NUS Graduate Medical School, Singapore. 4. Department of Optometry and Vision Science, School of Medicine, Flinders University, Adelaide, South Australia, Australia. 5. Statistics Division, The George Institute for Global Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia. 6. Transport and Road Safety (TARS) Research, The University of New South Wales, Sydney, New South Wales, Australia. 7. Curtin-Monash Accident Research Centre (C-Marc), Faculty of Health Sciences,, Curtin University, Perth, Western Australia, Australia. 8. School of Population Health, The University of Western Australia, Perth, Western Australia, Australia. 9. School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia.
Abstract
BACKGROUND: Falls result in >$1 billion in treatment, disability, lost output and mortality each year in Australia and people with cataract are at increased risk. Previous research is inconclusive; one large Australian study using linked hospital data found no protective effect of cataract surgery. We aim to examine the impact of cataract-related vision impairment on falls risk and the additional effects of delays in access to surgery, refractive management (type of spectacles and changes to spectacle prescription) and the resulting level of function, particularly binocular function which can impact balance. METHOD/ DESIGN: A prospective, 24-month cohort study is planned involving over 700 patients aged 70 years or older with bilateral cataract presenting for surgery at five public hospital eye clinics in Sydney, Melbourne and Perth, Australia. The primary outcomes will be self-reported falls and falls requiring medical care, assessed objectively using administrative data sets. Secondary outcomes include community participation, quality of life, mood and depressive symptoms. McNemar's test will be used to evaluate differences in falls rate before, after first eye and after second eye cataract surgery. Generalised Estimating Equations linear regression analysis will be undertaken to examine factors associated with falls risk and the secondary outcomes. DISCUSSION: With limited resources to further shorten public waiting lists, there is a need to better understand an individuals' risk of fall injury or other negative consequences while waiting for surgery. The findings of this project will inform the development of strategies to reduce falls risk in the many older people with cataract. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
BACKGROUND: Falls result in >$1 billion in treatment, disability, lost output and mortality each year in Australia and people with cataract are at increased risk. Previous research is inconclusive; one large Australian study using linked hospital data found no protective effect of cataract surgery. We aim to examine the impact of cataract-related vision impairment on falls risk and the additional effects of delays in access to surgery, refractive management (type of spectacles and changes to spectacle prescription) and the resulting level of function, particularly binocular function which can impact balance. METHOD/ DESIGN: A prospective, 24-month cohort study is planned involving over 700 patients aged 70 years or older with bilateral cataract presenting for surgery at five public hospital eye clinics in Sydney, Melbourne and Perth, Australia. The primary outcomes will be self-reported falls and falls requiring medical care, assessed objectively using administrative data sets. Secondary outcomes include community participation, quality of life, mood and depressive symptoms. McNemar's test will be used to evaluate differences in falls rate before, after first eye and after second eye cataract surgery. Generalised Estimating Equations linear regression analysis will be undertaken to examine factors associated with falls risk and the secondary outcomes. DISCUSSION: With limited resources to further shorten public waiting lists, there is a need to better understand an individuals' risk of fall injury or other negative consequences while waiting for surgery. The findings of this project will inform the development of strategies to reduce falls risk in the many older people with cataract. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Authors: Lisa Keay; Kam Chun Ho; Kris Rogers; Peter McCluskey; Andrew Jr White; Nigel Morlet; Jonathon Q Ng; Ecosse Lamoureux; Konrad Pesudovs; Fiona J Stapleton; Soufiane Boufous; Jessie Huang-Lung; Anna Palagyi Journal: Med J Aust Date: 2022-06-15 Impact factor: 12.776