Published: 08/01/2004, Volume II4, No. 5886 Page 25

I read with interest HSJ's feature on reducing the incidence of falls ('Shifting the balance', pages 2829, 27 November). The College of Optometrists and the British Geriatrics Society have recently produced recommendations for visual assessment in all those who suffer from falls.

Visual impairment - such as poor visual acuity, reduced visual field, impaired contrast sensitivity and cataracts - is strongly associated with falls and hip fractures.Adding treatment of poor vision to exercise and hazard management in the home produced an additional 14 per cent reduction in the annual fall rate, compared to no intervention.

All older people undergoing a falls assessment should be screened for visual impairment, and those people identified as suffering from visual impairment should have a full eye examination by an optometrist.

All older people should be encouraged to have regular eye checks - NHS examinations are available free of charge to all those aged 60 and over.

Details of the full document can be found at www. college-optometrists. org/ college/releases/2003/ 25_11_2003. htm Dr Susan Blakeney Optometric adviser Royal College of Optometrists