Bedside vision check for falls prevention: assessment tool

Patients with poor vision are twice as likely to fall as those with normal eyesight yet the NAIF audit report 2015 found that less than half of older patients had a vision assessment when they went into hospital. This is thought to be due to clinicians struggling to find a workable, standardised approach to basic vision assessment that is achievable in an acute hospital setting.

Look out! Bedside vision check for falls prevention is an innovatively designed guide which aims to support busy clinical staff in assessing visual impairment in older people. It uses a mixture of questions and visual aids to help doctors, nurses and therapists check eyesight at the patient’s bedside. Results give an indication of the extent of any visual problems, known or unknown, that the patient may have.

The tool has been created through a collaboration between the Royal College of Physicians and the British and Irish Orthoptic Society, the College of Optometrists, the Royal College of Ophthalmologists, the Royal College of Nursing and NHS Improvement.

Created by medical professionals with expertise in vision and eye health, frontline staff and patients were involved in its design and testing. The tool provides a practical solution for all ward staff responsible for patient care. It is not intended to replace expert clinical assessment but, importantly, it can alert staff to potential concerns that can then be relayed to medical teams for further evaluation.

The bedside vision check tool supports learning previously provided in the FallSafe and CareFall elearning packages. The tool contains:

• suggested questions to ask a patient to check vision
• visual tests for distance and near vision
• information for clinicians about vision conditions common in older people.

The vision assessment tool is available to trusts and local health boards in England and Wales.

For further information or for a copy of the bedside vision assessment tool, please contact +44 (0)20 3075 1511 or email falls@rcp.ac.uk.

Further resources

The National Falls Prevention Coordination Group (NFPCG) has developed a suite of new resources to help reduce the incidence of falls related to vision-impairment in older people. The aim is to promote the importance of good eye health and vision with Healthcare professionals and increase the uptake of eye examinations by the public.

View the NFPGC resources via the links below:

• RCP Bedside Vision Check video (School of Health Sciences at the University of Liverpool)
• Posters for Opticians and other Healthcare professionals
• Posters for GP practices
• Letter for Healthcare professionals and Optometrists / Eye care professionals
• The importance of vision in preventing falls (a report from the College of Optometrists 2020)
• Thomas Pocklington ‘Eyes Right’ Toolkit video
• VISIBLE resource (Vision Screening to Improve Balance & Prevent Falls) created by Health Innovation Network (HIN) South London