If you’re older than 65 or care for someone who is, you should know that falls are the leading cause of injury among this age group, according to the Centers for Disease Control and Prevention.

One of the main reasons that older adults are so prone to falls? Poor eyesight. In fact, having vision problems doubles your risk of a fall.

But the reverse is true too. Falling can lead to issues with your eyesight. And those vision problems can crop up gradually after the fall, says Richard G’Sell, O.D., an optometrist who practices at America’s Best Contacts & Eyeglasses in St. Louis, Missouri.

“Vision and brain function are very closely linked,” says Dr. G’Sell. So, a fall that leads to a bump on the head can affect your eyes.

It’s not just hitting your head that can mess with your eyesight though, says Dr. G’Sell. The jarring act of falling itself enough to cause vision problems, too.

So, what’s the connection between eyesight and falls? And what sorts of symptoms should you be looking out for? Read on for the answers.

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The Eye-Brain Connection

Taking a tumble can cause lots of injuries, whether it’s a broken hip or a scraped knee. But it can also cause a traumatic brain injury (TBI). In fact, falls are the number one cause of brain injuries, especially among people older than 75.

When you have a TBI — or a concussion, which is a mild TBI — your brain gets shaken inside your skull from a blow to your head or body. This is especially true if you fall in such a way that your head or your neck rocks back and forth.

“With people over 65, the muscles in their neck aren’t as strong, so they’re going to be affected more violently on a fall,” says Dr. G’Sell.

TBIs can cause chemical changes in the brain that can affect the cells, especially those involved in vision. After all, what we “see” depends on the eyes taking in images and the brain processing them. That’s why 90% of people with TBIs also have vision problems, according to the American Optometric Association.

You don’t have to lose consciousness to have a concussion. In fact, that happens less than 10% of the time, an Australian study found. But even a slight concussion can cause issues with your eyesight for months afterward, says Dr. G’Sell.

Eye Symptoms to Look Out for After a Fall

Whether or not you hit your head when you fell, the experience can mess with your eyes.

Here are some of the symptoms you might notice.

Blurry Vision

You might dismiss blurry vision because you assume you just need a stronger prescription, says Dr. G’Sell. But it’s actually a common sign of TBIs and concussions.

An optometrist might send you to a neurologist for an MRI, especially if the pupils in your eyes are different sizes. That could be a sign of a brain bleed.

Brain bleeds from falls are especially common in people over age 65, particularly for those on blood thinners, which increase the risk of a brain bleed after a TBI.

If your vision is blurred right after a fall and your pupils are different sizes, call 911 or head to the emergency room.

Double Vision

This is another sign of a concussion or TBI. “If you’re seeing double, an MRI may be necessary to rule out any brain bleeding or brain swelling,” says Dr. G’Sell.

If you’re experiencing double vision after a recent fall, call your eye doctor and/or your primary care physician and follow their advice.

Caregivers should be on the lookout for signs that their loved one is compensating for their double vision.

“Very often a person will compensate by tilting their head to the side or leaning it over to the side to line up the eyes where the image stays solid,” says Dr. G’Sell.

If this symptom doesn’t go away, it doesn’t mean you’re stuck seeing double forever.

“Sometimes that can be taken care of just by introducing a prism into the prescription,” says Dr. G’Sell. A prism can help shift light in such a way that your perception of double vision is brought back to normal.

Seeing Flashes of Light

This could be a sign of a retinal tear or detachment, says Dr. G’Sell. The retina is the part of the eye in the back that acts like a camera.

Another sign of a tear or detachment: Suddenly seeing floaters or spots, or more of them than you have before.

Some retinal tears or detachments are a result of a direct hit to the eye. But even a minor spill where you hit your head can affect the retina and cause it to detach. A fall can also cause the vitreous fluid (the jelly-like substance in the eye) to pull away from the retina, taking a bit of the retina with it.

If you experience any of these symptoms after a fall, call 911 or have someone take you to the emergency room. If doctors do confirm a retinal tear or detachment, you’ll need surgery to reattach your retina — and it needs to be done quickly. Otherwise, you could lose your eyesight.

Problems Reading or Tracking Moving Objects

Head injuries can affect the way your eyes work and move together. You might notice the following signs:

• When your eye moves, it’s over- or undershooting. You may have trouble reading words or you lose your place as you read, says Dr. G’Sell.
• You have trouble following things that move, such as the other cars on the road as you drive.

Optometrists can uncover eye movement issues with simple tests. And a vision therapist can help you recover.

“A vision therapist can work with the patient to help improve motor skills with their eyes — their visual and tracking skills,” says Dr. G’Sell.

An Australian study found that vision therapy helped nearly 90% of patients with TBIs, usually over the course of 10 to 30 sessions.

Lights or Glare Really Bother You Now

If your TBI caused your pupils to dilate, then you’ll be sensitive to light, says Dr. G’Sell. And if you managed to fall in such a way that you hit your eye and damaged your cornea, that could also cause light sensitivity, he says.

You might be so sensitive to lights or glare that you wear dark lenses even while you’re inside. Tinted or photochromic prescription lenses might help you feel better while you heal.

You Have More Headaches

People with normal vision don’t have any trouble shifting their focus to see things clearly as they move toward them or away from them. In fact, it’s second nature, thanks to the seamless way the brain and eyes work together.

If you’ve had a TBI though, that ability is disrupted. You might find yourself straining your eyes as you shift your focus because it’s taking your eyes longer to adjust to something that’s coming toward you. And that can cause headaches and tired eyes.

If your injury made you sensitive to light, you could also develop headaches in bright places.

You’re Dizzy, Having Balance Issues, or Are Bumping into Things

You might think you’re just getting clumsier as you age. But if you fell, balance issues are another sign that you may have a concussion. Your brain and eyes are sending mixed signals, which affects your perception of fixed objects.

For instance, you might think a room is in front of you when it’s actually off to the left. So, you walk on the right side, or bump into things on your right side. This condition is called perceptual midline shift.

Vision therapy can help with this. So can wearing glasses with prism lenses along with your regular prescription lenses.

If you’ve taken a recent fall and notice any of these symptoms, it’s a good idea to give your eye doctor a call. Optometrists are aware of how falls can affect your eyesight, and they’ll know the best way to help.

If a neurological problem could be causing your symptoms, your optometrist can refer you to a neurologist. Or they might send you to the emergency room if they suspect you may have a brain bleed.

But oftentimes, your optometrist can prescribe special glasses or provide vision therapy (or a referral). And that may be enough until you heal up and get back to seeing normally.

See our sources
Vision loss after a fall: Centers for Disease Control and Prevention
Traumatic brain injury stats: CDC MMWR Surveillance Summaries
Concussion overview: American Optometric Association
Study on visual disturbances after a concussion: Australian Journal of General Practice
Overview of unevenly sized pupils: MedlinePlus
Facts about traumatic brain injuries: Centers for Disease Control and Prevention
Vitreous detachment after a fall: American Academy of Ophthalmology
Perceptual midline shift overview: Brain Injury Association of America