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Led by Deeble Scholar, Dr Kam Chun (Terry) Ho, lecturer of Optometry and Vision Science at the University of Canberra, and Adj AProf Rebecca Haddock, Executive Director of Knowledge Exchange at the Australian Healthcare and Hospitals Association, the Deeble Institute for Health Policy Research, Australian Healthcare and Hospitals Association, has released its Issues Brief which investigates the role of eye care practitioners in falls prevention among older adults. 

Falls are a leading cause of hospitalised injuries and injury-related deaths among older Australians. Impaired vision significantly increases the risk of falls, with approximately 75% of older adults admitted to hospitals following a fall having a correctable vision problem. 

‘The most common vision problems that contribute to falls among older adults include cataracts, uncorrected refractive errors, glaucoma, diabetic retinopathy and age-related macular degeneration (AMD). So, it goes without saying that addressing these conditions through regular eye care and timely interventions is crucial to mitigating fall risks,’ said Dr Terry Ho. 

More specifically, the prevalence of vision impairment among residents in aged care facilities is significantly higher than that of elderly Australians residing in the community. 

Recognising the urgency of this issue, Optometry Australia (OA) remains committed to advocating for aged care residents and their rights to receive optimal eye care without encountering any unnecessary obstacles or workarounds.  

‘While strides have been made in improving eye care provision in these residential care settings, significant gaps persist, hindering the health and wellbeing of those living within their walls. Further, the repercussions of vision loss are manifold, contributing to heightened risks of falls, hip fractures and diminished independence and quality of life,’ said Sarah Davies, Director of Optometry Advancement at OA. 

In line with our efforts to engage with key policymakers and industry stakeholders to catalyse meaningful change, we have established an Aged Care Eye Health Advisory Group to provide expert guidance and support in addressing the unique primary eye care needs of aged care residents.  

This advisory group will play a pivotal role in informing Optometry Australia’s policy positions and initiatives related to optometric services within aged care settings.’  

Dr Ho goes further to say that the guidelines developed by Optometry Australia for falls prevention among older adults are based on the best available evidence.  

However, despite the critical role optometrists play, incorporating falls prevention into standard optometric practice and raising awareness among other health professionals requires considerable effort and systemic change. 

‘Optometrists face several challenges in integrating falls prevention into routine care. Referrals from general practitioners to optometrists remain low and multidisciplinary care plans, which have been shown to significantly reduce fall-related hospitalisations, often exclude eye care practitioners as part of the team,’ said Dr Ho. 

Additionally, there is also general lack of awareness and integration of vision care into broader falls prevention strategies among healthcare providers. Communication barriers and the absence of established referral pathways further complicate interdisciplinary collaboration.  

Patients often bear the burden of coordinating their care across providers, leading to gaps in information and reduced effectiveness of fall prevention efforts. 

To better support falls prevention involving eye care practitioners, Dr Ho believes key policy changes and funding enhancements are needed. 

‘The next steps for enhancing the role of eye care practitioners in falls prevention should include evaluating the effectiveness of current guidelines, integrating optometrists into multidisciplinary teams, improving patient education, and advocating for policy changes and increased funding.’  

Addressing the multifactorial causes of falls among older adults requires coordinated efforts involving optometrists, general practitioners, ophthalmologists and allied health professionals.  

By enhancing funding, integrating multidisciplinary care models and implementing evidence-based guidelines, we can significantly reduce falls and improve the overall well-being of older Australians. 

Deeble Institute recommendations: 

  1. Develop and implement a data quality feedback tool for My Health Record and a suitable digital platform for optometrists. 
  2. Standardise medical terminologies and diagnostic coding systems for Falls Risk Assessment. 
  3. Enhance quality control and data-driven decision-making in eye care.
  4. Integrate optometrists into multidisciplinary falls prevention programs. 
  5. Implement a comprehensive monitoring and evaluation framework.
  6. Standardise the cataract referral process and integrate community and hospital care. 
  7. Set targets for reducing waiting times for second-eye cataract surgery. 
  8. Enhance funding for public ophthalmology services. 
  9. Increase funding for outreach cataract surgeries. 

You can read the Deeble Institute for Health Policy Research, Australian Healthcare and Hospitals Association Issues brief in full here. 

Optometry Australia is working with the Department of Optometry and Vision Sciences at The University of Melbourne to develop an Aged Care Position Statement as a foundation for developing an aged care advocacy plan and prioritise organisational efforts across various ongoing projects in aged care. 

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Acknowledgement of Country

In the spirit of reconciliation Optometry Australia acknowledges the Traditional Custodians of country throughout Australia and their connections to land, sea and community. We pay our respects to their Elders past and present and extend that respect to all Aboriginal and Torres Strait Islander peoples today.