Is your brain certain that 60 is the new 40, but your eyes aren’t quite convinced?

You’re not alone. By the time you hit your 60s, your eyesight just isn’t what it used to be. Chances are, you already need reading glasses to see the fine print. (Thank you, presbyopia!) 

If you’re wearing bifocals or progressive lenses, guess what? Your risk of tripping has jumped 2.3 times, according to Daniel H. Chang, M.D., an ophthalmologist in Bakersfield, Calif., who specializes in the surgical vision needs of patients.

That’s because these lenses can alter your depth perception ever so slightly, making it more likely that you’ll misjudge a step. They also make it tougher to spot differences in color contrasts.

As the years pass, other age-related sight problems may start to kick in as well. No surprise: The more trouble you have seeing clearly, the more prone you are to slips, trips, and full-on tumbles. 

In fact, vision problems are among the top contributors to falls among the elderly, according to research at Teachers College, Columbia University’s Department of Health and Behavior Studies. The researcher examined dozens of studies to see what role vision plays in falls, in order to start a conversation and raise awareness around the issue. 

Why all the concern? One in four Americans age 65 and older reports falling each year, leading to some 3 million emergency room visits, according to the Centers for Disease Control and Prevention. Falls result in more than 800,000 hospitalizations each year.

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The Connection Between Vision and Balance 

“Vision is one of the key sensory inputs that helps us stay upright,” says Elizabeth A. Phelan, M.D., director of the University of Washington Medicine Fall Prevention Clinic at Harborview Medical Center in Seattle. “Any condition that impairs your eyesight can potentially lead to a fall. That makes regular vision care one of the most important things you can do to reduce your chances of falling.”

Plus, your vision is closely connected to your sense of balance. Don’t believe it? Just try standing on one leg with your eyes open—and then with your eyes closed. Notice the difference? A recent study of older adults showed that vision-related balance control is one of the major risk factors for falling. 

Luckily, your optometrist can help you keep your vision sharp—and avoid debilitating tumbles—which makes him one of the most important members of your fall-prevention team. 

“Just getting your prescription updated goes a long way toward keeping your vision clear and avoiding falls,” says John Perez, O.D., an optometrist at America’s Best Contacts & Eyeglasses in Layton, Utah. “It’s such a simple step, but missing it can have really serious consequences.” 

The American Optometric Association recommends yearly eye exams for people age 65 and older. But if you notice that your vision is getting a little fuzzy, don’t wait for next year’s appointment—get in touch with your eye doctor right away.

What to Discuss with Your Eye Doctor

During your eye exam, have an honest conversation. If you’ve had any recent falls or problems with balance, be sure to bring that up, advises Dr. Chang. 

“When someone trips and falls,” he says, “they typically don’t think to blame their bifocal glasses or complain to their eye doctor.”

Your eye doctor also won’t get a report from the ER if you end up there with a fall-related injury. But that information can be important in helping determine what kinds of lenses or other treatment will help you stay active. 

At your appointment, David Damari, O.D., president of the Association of Schools and Colleges of Optometry, says to expect your eye doctor to check you for age-related vision problems that can make you more prone to falling, including the following conditions: 

• Glaucoma, which can damage the optic nerve, usually affects your peripheral vision first. “When you don’t have good peripheral vision, it’s easy to trip over obstacles or miss the first or last stair,” says Dr. Damari.
• Cataracts cloud your eye’s lens and will impact your ability to perceive shades of gray and distinguish colors. “We count on shadows and colors to tell us how far away something is, or where it is in space,” he says. Without those cues, it’s easy to miss a step and take a tumble.
• Age-related macular degeneration, meanwhile, chips away at your ability to see things that are directly in front of you, which can throw off your balance.

But it’s more than just scary-sounding eye diseases, insists Michelle Andreoli, M.D., an ophthalmologist in Chicago and a spokesperson for the American Academy of Ophthalmology.

“Any vision problem can also cause problems with depth perception and awareness of your environment,” she explains. “That’s the most important thing to think about when maintaining balance among seniors.

“Good balance isn’t just being able to stay upright,” she continues. “If you don’t have good depth perception, it can be difficult—and dangerous—to go up or down the stairs, or to step over a curb, or even to navigate around the furniture in your house.” 

And the best way to maintain good depth perception, Dr. Andreoli says, is by keeping up with your eye exams. 

Smart Solutions to Keep You Safe

As usual, eye doctors are the experts. “There are so many workable solutions,” says Dr. Chang. 

Everybody’s needs are different, but eye doctors have a bag of tricks that includes a variety of options, including multifocal lenses for getting around the house, distance glasses for going outside, special prism lenses, and even corrective surgery. Your eye doctor will help you make the best choices for you.

Plus, eye doctors can offer a lot of really good practical advice. “Even a little bit of vision impairment can lead to a fall,” says Dr. Phelan, “It’s important to address other contributors to falls in your home. Take a look around your house to see what you can do to reduce your risk.”

Here are some important tips:

• Keep your staircase safe. Be sure there’s a railing to hold on to, and try placing friction strips on each step of all of the staircases in your house.
• Shine a light. Add good, diffuse lighting to stairways. And make sure hallways are well lit for late-night bathroom visits.
• Clear a path. Get rid of stuff that’s easy to trip over, like carpeting with curled edges and loose throw rugs or runners. Replace wobbly furniture with sturdy pieces that don’t move easily.