rock-cairn_baw-2016By now, we have all seen the video of Hillary Clinton “losing her balance” and needing assistance getting into her waiting car.    What a coincidence that this happened just days before Balance Awareness Week.  In fact, Representative Johnson from Texas introduced a resolution in the House of Representatives last week, calling attention to “Balance Awareness Week” and the need for greater awareness of vestibular disorders. For people over the age of 65, dizziness is very common and very scary.

Balance and staying upright is something most of us take for granted, until something happens and we find ourselves feeling wobbly and fearful of falling.  What most people don’t realize, is that vision is intimately tied to the vestibular system and balance.  For example, whenever you move your head, you do not perceive the world as moving.  That’s because your vestibular and visual systems work together to keep the image on your retina stable.  This is called the Vestibular Ocular Reflex (VOR).  If something causes a disruption in either system and they become uncoupled, the result is dizziness, loss of balance and an increased risk of falling.

What can cause disruptions to these systems and the VOR?  There are many reasons why a person’s sense of balance may become impaired.  In Ms. Clinton’s case, she was sick. Other causes include concussion and other forms of brain injury, medications, lack of physical activity, and sensory impairments including visual impairment.  

A recent article published in the journal Preventative Medicine examined the association between sensory impairments, balance, and difficulty with falls among adults aged 40-85. Visual impairment was associated with a much greater chance of reporting difficulty with falling.  Add to that difficulty with other sensory systems (such as a hearing loss) and the odds of having difficulty with balance are increased.

The good news is developmental optometry can help.  First, providing patients with the most appropriate spectacles can maintain the integrity of their visual system.  And for those patients with an impaired VOR, vision therapy can often help enormously.  Once these patients can keep their balance and lose their fear of falling, a healthy lifestyle can help them maintain these improvements.