Bed-side vision screening in the prevention of falls after hip fracture surgery

Abstract text (incl. references and figure legends)

Introduction

A second fall is a frequent, unwanted event with serious consequences, during the rehabilitation period after hip fracture surgery. Poor vision is a known risk factor for falls and can be treated in many cases. In the current study, we compared visual acuity (VA) and stereovision (SV) in patients with a subsequent fall-related traumatic hip injury (study group) and age-matched controls. We aimed to differentiate age-related visual decline from decreased vision with a mobile application for bedside screening (EuvisionTab®).

Material & Methods

In the study group 40, while in the control group 71 patients were examined (mean age: 74.7 yrs., range: 60-96). Monocular VA was examined on a tablet; the threshold was estimated by the Best-PEST algorithm. SV testing was performed by low dot density EuvisionTab random dot stereograms with static and dynamic stimuli. For the VA age-dependent reference ranges were established. For the EuvisionTab stereotests the fail-pass criterium was 6 correct out of 10 randomly presented stereo-E optotypes.

Results

There was a significant stepwise decrease for VA with age. Significantly different monocular VA values were found between the study and control groups using T-test (at p<0.01), and 12/40 patients of the study group fell outwit reference ranges. In the control group, SV was stable across ages, while members of the trauma group performed significantly worse on both tests, with a larger difference in the case of the dynamic EuvisionTab SV test.

Conclusions

Results show, that EuvisionTab can be a useful tool for detecting of impaired vision in the elderly and may prevent further falls and injuries. In the study, the tests performed well for bedside screening, and since their use does not require the contribution of an eye specialist, they can also be part of the examination by a nurse.

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The research was financed by the Thematic Excellence Program 2021 Health Sub-programme of the Ministry for Innovation and Technology in Hungary, within the framework of the EGA-16 project of the University of Pécs. Authors Eszter Mikó-Baráth and Gábor Jandó are owners of Euvision Ltd., which is planning to commercialize this product in the future with a license from the University of Pécs.