Vision, functional and cognitive determinants of motor vehicle incidents in older drivers

Background: The proportion of older individuals in the driving population is predicted to increase in the next 50 years. This has important implications for driving safety as abilities which are important for safe driving, such as vision (which accounts for the majority of the sensory input required for driving), processing ability and cognition have been shown to decline with age. The current methods employed for screening older drivers upon re-licensure are also vision based. This study, which investigated social, behavioural and professional aspects involved with older drivers, aimed to determine: (i) if the current visual standards in place for testing upon re-licensure are effective in reducing the older driver fatality rate in Australia; (ii) if the recommended visual standards are actually implemented as part of the testing procedures by Australian optometrists; and (iii) if there are other non-standardised tests which may be better at predicting the on-road incident-risk (including near misses and minor incidents) in older drivers than those tests recommended in the standards. Methods: For the first phase of the study, state-based age- and gender-stratified numbers of older driver fatalities for 2000-2003 were obtained from the Australian Transportation Safety Bureau database. Poisson regression analyses of fatality rates were considered by renewal frequency and jurisdiction (as separate models), adjusting for possible confounding variables of age, gender and year. For the second phase, all practising optometrists in Australia were surveyed on the vision tests they conduct in consultations relating to driving and their knowledge of vision requirements for older drivers. Finally, for the third phase of the study to investigate determinants of on-road incident risk, a stratified random sample of 600 Brisbane residents aged 60 years and were selected and invited to participate using an introductory letter explaining the project requirements. In order to capture the number and type of road incidents which occurred for each participant over 12 months (including near misses and minor incidents), an important component of the prospective research study was the development and validation of a driving diary. The diary was a tool in which incidents that occurred could be logged at that time (or very close in time to which they occurred) and thus, in comparison with relying on participant memory over time, recall bias of incident occurrence was minimised. Association between all visual tests, cognition and scores obtained for non-standard functional tests with retrospective and prospective incident occurrence was investigated. Results: In the first phase,rivers aged 60-69 years had a 33% lower fatality risk (Rate Ratio [RR] = 0.75, 95% CI 0.32-1.77) in states with vision testing upon re-licensure compared with states with no vision testing upon re-licensure, however, because the CIs are wide, crossing 1.00, this result should be regarded with caution. However, overall fatality rates and fatality rates for those aged 70 years and older (RR=1.17, CI 0.64-2.13) did not differ between states with and without license renewal procedures, indicating no apparent benefit in vision testing legislation. For the second phase of the study, nearly all optometrists measured visual acuity (VA) as part of a vision assessment for re-licensing, however, 20% of optometrists did not perform any visual field (VF) testing and only 20% routinely performed automated VF on older drivers, despite the standards for licensing advocating automated VF as part of the vision standard. This demonstrates the need for more effective communication between the policy makers and those responsible for carrying out the standards. It may also indicate that the overall higher driver fatality rate in jurisdictions with vision testing requirements is resultant as the tests recommended by the standards are only partially being conducted by optometrists. Hence a standardised protocol for the screening of older drivers for re-licensure across the nation must be established. The opinions of Australian optometrists with regard to the responsibility of reporting older drivers who fail to meet the licensing standards highlighted the conflict between maintaining patient confidentiality or upholding public safety. Mandatory reporting requirements of those drivers who fail to reach the standards necessary for driving would minimise potential conflict between the patient and their practitioner, and help maintain patient trust and goodwill. The final phase of the PhD program investigated the efficacy of vision, functional and cognitive tests to discriminate between at-risk and safe older drivers. Nearly 80% of the participants experienced an incident of some form over the prospective 12 months, with the total incident rate being 4.65/10 000 km. Sixty-three percent reported having a near miss and 28% had a minor incident. The results from the prospective diary study indicate that the current vision screening tests (VA and VF) used for re-licensure do not accurately predict older drivers who are at increased odds of having an on-road incident. However, the variation in visual measurements of the cohort was narrow, also affecting the results seen with the visual functon questionnaires. Hence a larger cohort with greater variability should be considered for a future study. A slightly lower cognitive level (as measured with the Mini-Mental State Examination [MMSE]) did show an association with incident involvement as did slower reaction time (RT), however the Useful-Field-of-View (UFOV) provided the most compelling results of the study. Cut-off values of UFOV processing (>23.3ms), divided attention (>113ms), selective attention (>258ms) and overall score (moderate/ high/ very high risk) were effective in determining older drivers at increased odds of having any on-road incident and the occurrence of minor incidents. Discussion: The results have shown that for the 60-69 year age-group, there is a potential benefit in testing vision upon licence renewal. However, overall fatality rates and fatality rates for those aged 70 years and older indicated no benefit in vision testing legislation and suggests a need for inclusion of screening tests which better predict on-road incidents. Although VA is routinely performed by Australian optometrists on older drivers renewing their licence, VF is not. Therefore there is a need for a protocol to be developed and administered which would result in standardised methods conducted throughout the nation for the screening of older drivers upon re-licensure. Communication between the community, policy makers and those conducting the protocol should be maximised. By implementing a standardised screening protocol which incorporates a level of mandatory reporting by the practitioner, the ethical dilemma of breaching patient confidentiality would also be resolved. The tests which should be included in this screening protocol, however, cannot solely be ones which have been implemented in the past. In this investigation, RT, MMSE and UFOV were shown to be better determinants of on-road incidents in older drivers than VA and VF, however, as previously mentioned, there was a lack of variability in visual status within the cohort. Nevertheless, it is the recommendation from this investigation, that subject to appropriate sensitivity and specificity being demonstrated in the future using a cohort with wider variation in vision, functional performance and cognition, these tests of cognition and information processing should be added to the current protocol for the screening of older drivers which may be conducted at licensing centres across the nation.

Bearing-only SLAM : a vision-based navigation system for autonomous robots

To navigate successfully in a previously unexplored environment, a mobile robot must be able to estimate the spatial relationships of the objects of interest accurately. A Simultaneous Localization and Mapping (SLAM) sys- tem employs its sensors to build incrementally a map of its surroundings and to localize itself in the map simultaneously. The aim of this research project is to develop a SLAM system suitable for self propelled household lawnmowers. The proposed bearing-only SLAM system requires only an omnidirec- tional camera and some inexpensive landmarks. The main advantage of an omnidirectional camera is the panoramic view of all the landmarks in the scene. Placing landmarks in a lawn field to define the working domain is much easier and more flexible than installing the perimeter wire required by existing autonomous lawnmowers. The common approach of existing bearing-only SLAM methods relies on a motion model for predicting the robot’s pose and a sensor model for updating the pose. In the motion model, the error on the estimates of object positions is cumulated due mainly to the wheel slippage. Quantifying accu- rately the uncertainty of object positions is a fundamental requirement. In bearing-only SLAM, the Probability Density Function (PDF) of landmark position should be uniform along the observed bearing. Existing methods that approximate the PDF with a Gaussian estimation do not satisfy this uniformity requirement. This thesis introduces both geometric and proba- bilistic methods to address the above problems. The main novel contribu- tions of this thesis are: 1. A bearing-only SLAM method not requiring odometry. The proposed method relies solely on the sensor model (landmark bearings only) without relying on the motion model (odometry). The uncertainty of the estimated landmark positions depends on the vision error only, instead of the combination of both odometry and vision errors. 2. The transformation of the spatial uncertainty of objects. This thesis introduces a novel method for translating the spatial un- certainty of objects estimated from a moving frame attached to the robot into the global frame attached to the static landmarks in the environment. 3. The characterization of an improved PDF for representing landmark position in bearing-only SLAM. The proposed PDF is expressed in polar coordinates, and the marginal probability on range is constrained to be uniform. Compared to the PDF estimated from a mixture of Gaussians, the PDF developed here has far fewer parameters and can be easily adopted in a probabilistic framework, such as a particle filtering system. The main advantages of our proposed bearing-only SLAM system are its lower production cost and flexibility of use. The proposed system can be adopted in other domestic robots as well, such as vacuum cleaners or robotic toys when terrain is essentially 2D.

A Vision Based Target Detection System for Docking of an Autonomous Underwater Vehicle

This paper describes the development and preliminary experimental evaluation of a visionbased docking system to allow an Autonomous Underwater Vehicle (AUV) to identify and attach itself to a set of uniquely identifiable targets. These targets, docking poles, are detected using Haar rectangular features and rotation of integral images. A non-holonomic controller allows the Starbug AUV to orient itself with respect to the target whilst maintaining visual contact during the manoeuvre. Experimental results show the proposed vision system is capable of robustly identifying a pair of docking poles simultaneously in a variety of orientations and lighting conditions. Experiments in an outdoor pool show that this vision system enables the AUV to dock autonomously from a distance of up to 4m with relatively low visibility.

New Patterns in Global Television : Peripheral Vision

Over recent decades, the flow of television programmes and services between nations has prompted concerns about `Cultural Imperialism', the idea that the powerful metropolitan nations at the centre of the world system are breaking down the integrity and autonomy of the peripheral countries. New Patterns in Global Television challenges that notion by showing that some of the countries outside the traditionally dominant centres have now developed strong television industries of their own, and have been expanding into regional markets, especially - but not exclusively - where linguistic and cultural similarities exist. This book brings together contributions from specialist researchers on the most dynamic of these regions: Latin America, India, the Middle East, Greater China and, in the English-speaking world, Canada and Australia. It provides the first comprehensive overview of the new patterns of flow in international television programme exchange and service provision in the satellite era, patterns unrecognised by the perspective of the prevailing theoretical orthodoxies in international communication research and policy.

Sunglasses, traffic signals, and color vision deficiencies

Purpose: To determine (a) the effect of different sunglass tint colorations on traffic signal detection and recognition for color normal and color deficient observers, and (b) the adequacy of coloration requirements in current sunglass standards. Methods: Twenty color-normals and 49 color-deficient males performed a tracking task while wearing sunglasses of different colorations (clear, gray, green, yellow-green, yellow-brown, red-brown). At random intervals, simulated traffic light signals were presented against a white background at 5° to the right or left and observers were instructed to identify signal color (red/yellow/green) by pressing a response button as quickly as possible; response times and response errors were recorded. Results: Signal color and sunglass tint had significant effects on response times and error rates (p < 0.05), with significant between-color group differences and interaction effects. Response times for color deficient people were considerably slower than color normals for both red and yellow signals for all sunglass tints, but for green signals they were only noticeably slower with the green and yellow-green lenses. For most of the color deficient groups, there were recognition errors for yellow signals combined with the yellow-green and green tints. In addition, deuteranopes had problems for red signals combined with red-brown and yellow-brown tints, and protanopes had problems for green signals combined with the green tint and for red signals combined with the red-brown tint. Conclusions: Many sunglass tints currently permitted for drivers and riders cause a measurable decrement in the ability of color deficient observers to detect and recognize traffic signals. In general, combinations of signals and sunglasses of similar colors are of particular concern. This is prima facie evidence of a risk in the use of these tints for driving and cautions against the relaxation of coloration limits in sunglasses beyond those represented in the study.

Effect of presbyopic vision corrections on perceptions of driving difficulty

Objectives: As the population ages, more people will be wearing presbyopic vision corrections when driving. However, little is known about the impact of these vision corrections on driving performance. This study aimed to determine the subjective driving difficulties experienced when wearing a range of common presbyopic contact lens and spectacle corrections.----- Methods: A questionnaire was developed and piloted that included a series of items regarding difficulties experienced while driving under daytime and night-time conditions (rated on five-point and seven-point Likert scales). Participants included 255 presbyopic patients recruited through local optometry practices. Participants were categorized into five age-matched groups; including those wearing no vision correction for driving (n = 50), bifocal spectacles (n = 54), progressive spectacles (n = 50), monovision contact lenses (n = 53), and multifocal contact lenses (n = 48).----- Results: Overall, ratings of satisfaction during daytime driving were relatively high for all correction types. However, multifocal contact lens wearers were significantly less satisfied with aspects of their vision during night-time than daytime driving, particularly regarding disturbances from glare and haloes. Progressive spectacle lens wearers noticed more distortion of peripheral vision, whereas bifocal spectacle wearers reported more difficulties with tasks requiring changes of focus and those who wore no optical correction for driving reported problems with intermediate and near tasks. Overall, satisfaction was significantly higher for progressive spectacles than bifocal spectacles for driving.----- Conclusions: Subjective visual experiences of different presbyopic vision corrections when driving vary depending on the vision tasks and lighting level. Eye-care practitioners should be aware of the driving-related difficulties experienced with each vision correction type and the need to select corrective types that match the driving needs of their patients.

The effect of Amblyopia on motor and psychosocial skills in children

Background/Aims: In an investigation of the functional impact of amblyopia on children, the fine motor skills, perceived self-esteem and eye movements of amblyopic children were compared with that of age-matched controls. The influence of amblyogenic condition or treatment factors that might predict any decrement in outcome measures was investigated. The relationship between indirect measures of eye movements that are used clinically and eye movement characteristics recorded during reading was examined and the relevance of proficiency in fine motor skills to performance on standardised educational tests was explored in a sub-group of the control children. Methods: Children with amblyopia (n=82; age 8.2 ± 1.3 years) from differing causes (infantile esotropia n=17, acquired strabismus n=28, anisometropia n=15, mixed n=13 and deprivation n=9), and a control group of children (n=106; age 9.5 ± 1.2 years) participated in this study. Measures of visual function included monocular logMAR visual acuity (VA) and stereopsis assessed with the Randot Preschool Stereoacuity test, while fine motor skills were measured using the Visual-Motor Control (VMC) and Upper Limb Speed and Dexterity (ULSD) subtests of the Brunicks-Oseretsky Test of Motor Proficiency. Perceived self esteem was assessed for those children from grade 3 school level with the Harter Self Perception Profile for Children and for those in younger grades (preschool to grade 2) with the Pictorial Scale of Perceived Competence and Acceptance for Young Children. A clinical measure of eye movements was made with the Developmental Eye Movement (DEM) test for those children aged eight years and above. For appropriate case-control comparison of data, the results from amblyopic children were compared with age-matched sub-samples drawn from the group of children with normal vision who completed the tests. Eye movements during reading for comprehension were recorded by the Visagraph infra-red recording system and results of standardised tests of educational performance were also obtained for a sub-set of the control group. Results Amblyopic children (n=82; age 8.2 ± 1.7 years) performed significantly poorer than age-matched control children (n=37; age 8.3 ± 1.3 years) on 9 of 16 fine motor skills sub-items and for the overall age-standardised scores for both VMC and ULSD items (p<0.05); differences were most evident on timed manual dexterity tasks. The underlying aetiology of amblyopia and level of stereoacuity significantly affected fine motor skill performance on both items. However, when examined in a multiple regression model that took into account the inter-correlation between visual characteristics, poorer fine motor skills performance was only associated with strabismus (F1,75 = 5.428; p =0. 022), and not with the level of stereoacuity, refractive error or visual acuity in either eye. Amblyopic children from grade 3 school level and above (n=47; age 9.2 ± 1.3 years), particularly those with acquired strabismus, had significantly lower social acceptance scores than age-matched control children (n=52; age 9.4 ± 0.5 years) (F(5,93) = 3.14; p = 0.012). However, the scores of the amblyopic children were not significantly different to controls for other areas related to self-esteem, including scholastic competence, physical appearance, athletic competence, behavioural conduct and global self worth. A lower social acceptance score was independently associated with a history of treatment with patching but not with a history of strabismus or wearing glasses. Amblyopic children from pre-school to grade 2 school level (n=29; age = 6.6 ± 0.6 years) had similar self-perception scores to their age-matched peers (n=20; age = 6.4 ± 0.5 years). There were no significant differences between the amblyopic (n=39; age 9.1 ± 0.9 years) and age-matched control (n = 42; age = 9.3 ± 0.38 years) groups for any of the DEM outcome measures (Vertical Time, Horizontal Time, Number of Errors and Ratio (Horizontal time/Vertical time)). Performance on the DEM did not significantly relate to measures of VA in either eye, level of binocular function, history of strabismus or refractive error. Developmental Eye Movement test outcome measures Horizontal Time and Vertical Time were significantly correlated with reading rates measured by the Visagraph for both reading for comprehension and naming numbers (r>0.5). Some moderate correlations were also seen between the DEM Ratio and word reading rates as recorded by Visagraph (r=0.37). In children with normal vision, academic scores in mathematics, spelling and reading were associated with measures of fine motor skills. Strongest effect sizes were seen with the timed manual dexterity domain, Upper Limb Speed and Dexterity. Conclusions Amblyopia may have a negative impact on a child’s fine motor skills and an older child’s sense of acceptance by their peers may be influenced by treatment that includes eye patching. Clinical measures of eye movements were not affected in amblyopic children. A number of the outcome measures of the DEM are associated with objective recordings of reading rates, supporting its clinical use for identification of children with slower reading rates. In children with normal vision, proficiency on clinical measures of fine motor skill are associated with outcomes on standardised measures of educational performance. Scores on timed manual dexterity tasks had the strongest association with educational performance. Collectively, the results of this study indicate that, in addition to the reduction in visual acuity and binocular function that define the condition, amblyopes have functional impairment in childhood development skills that underlie proficiency in everyday activities. The study provides support for strategies aimed at early identification and remediation of amblyopia and the co-morbidities that arise from abnormal visual neurodevelopment.

Low Vision

The care of low-vision patients is termed vision rehabilitation, and optometrists have an essential role to play in the provision of vision rehabilitation services. Ideally, if patients stay with one optometrist or practice, their low-vision care becomes part of a continuum of eye care, from the time when they had normal vision. If progressive vision loss occurs, the role of the optometrist changes from primary eye care only to one of monitoring vision loss and gradually introducing low-vision care, especially magnification and advice on lighting and contrast, in conjunction with other vision rehabilitation professionals.

Computer vision onboard UAVs for civilian tasks

Computer vision is much more than a technique to sense and recover environmental information from an UAV. It should play a main role regarding UAVs’ functionality because of the big amount of information that can be extracted, its possible uses and applications, and its natural connection to human driven tasks, taking into account that vision is our main interface to world understanding. Our current research’s focus lays on the development of techniques that allow UAVs to maneuver in spaces using visual information as their main input source. This task involves the creation of techniques that allow an UAV to maneuver towards features of interest whenever a GPS signal is not reliable or sufficient, e.g. when signal dropouts occur (which usually happens in urban areas, when flying through terrestrial urban canyons or when operating on remote planetary bodies), or when tracking or inspecting visual targets—including moving ones—without knowing their exact UMT coordinates. This paper also investigates visual serving control techniques that use velocity and position of suitable image features to compute the references for flight control. This paper aims to give a global view of the main aspects related to the research field of computer vision for UAVs, clustered in four main active research lines: visual serving and control, stereo-based visual navigation, image processing algorithms for detection and tracking, and visual SLAM. Finally, the results of applying these techniques in several applications are presented and discussed: this study will encompass power line inspection, mobile target tracking, stereo distance estimation, mapping and positioning.

Comparison of high-speed videokeratoscopy and ultrasound distance sensing for measuring the longitudinal corneal apex movements

Two different methods to measure binocular longitudinal corneal apex movements were synchronously applied. High-speed videokeratoscopy at a sampling frequency of 15 Hz and a customdesigned ultrasound distance sensor at 100 Hz were used for the left and the right eye, respectively. Four healthy subjects participated in the study. Simultaneously, cardiac electric cycle (ECG) was registered for each subject at 100 Hz. Each measurement took 20 s. Subjects were asked to suppress blinking during the measurements. A rigid headrest and a bite-bar were used to minimize undesirable head movements. Time, frequency and time-frequency representations of the acquired signals were obtained to establish their temporal and spectral contents. Coherence analysis was used to estimate the correlation between the measured signals. The results showed close correlation between both corneal apex movements and the cardiopulmonary system. Unraveling these relationships could lead to better understanding of interactions between ocular biomechanics and vision. The advantages and disadvantages of the two methods in the context of measuring longitudinal movements of the corneal apex are outlined.

Design of automatic vision-based inspection system for solder joint segmentation

Purpose: Computer vision has been widely used in the inspection of electronic components. This paper proposes a computer vision system for the automatic detection, localisation, and segmentation of solder joints on Printed Circuit Boards (PCBs) under different illumination conditions. Design/methodology/approach: An illumination normalization approach is applied to an image, which can effectively and efficiently eliminate the effect of uneven illumination while keeping the properties of the processed image the same as in the corresponding image under normal lighting conditions. Consequently special lighting and instrumental setup can be reduced in order to detect solder joints. These normalised images are insensitive to illumination variations and are used for the subsequent solder joint detection stages. In the segmentation approach, the PCB image is transformed from an RGB color space to a YIQ color space for the effective detection of solder joints from the background. Findings: The segmentation results show that the proposed approach improves the performance significantly for images under varying illumination conditions. Research limitations/implications: This paper proposes a front-end system for the automatic detection, localisation, and segmentation of solder joint defects. Further research is required to complete the full system including the classification of solder joint defects. Practical implications: The methodology presented in this paper can be an effective method to reduce cost and improve quality in production of PCBs in the manufacturing industry. Originality/value: This research proposes the automatic location, identification and segmentation of solder joints under different illumination conditions.

Image synthesis based on a model of human vision

Modern computer graphics systems are able to construct renderings of such high quality that viewers are deceived into regarding the images as coming from a photographic source. Large amounts of computing resources are expended in this rendering process, using complex mathematical models of lighting and shading. However, psychophysical experiments have revealed that viewers only regard certain informative regions within a presented image. Furthermore, it has been shown that these visually important regions contain low-level visual feature differences that attract the attention of the viewer. This thesis will present a new approach to image synthesis that exploits these experimental findings by modulating the spatial quality of image regions by their visual importance. Efficiency gains are therefore reaped, without sacrificing much of the perceived quality of the image. Two tasks must be undertaken to achieve this goal. Firstly, the design of an appropriate region-based model of visual importance, and secondly, the modification of progressive rendering techniques to effect an importance-based rendering approach. A rule-based fuzzy logic model is presented that computes, using spatial feature differences, the relative visual importance of regions in an image. This model improves upon previous work by incorporating threshold effects induced by global feature difference distributions and by using texture concentration measures. A modified approach to progressive ray-tracing is also presented. This new approach uses the visual importance model to guide the progressive refinement of an image. In addition, this concept of visual importance has been incorporated into supersampling, texture mapping and computer animation techniques. Experimental results are presented, illustrating the efficiency gains reaped from using this method of progressive rendering. This visual importance-based rendering approach is expected to have applications in the entertainment industry, where image fidelity may be sacrificed for efficiency purposes, as long as the overall visual impression of the scene is maintained. Different aspects of the approach should find many other applications in image compression, image retrieval, progressive data transmission and active robotic vision.

The performance of a prolonged reading task by students with low vision

Purpose: Students often read for long periods and prolonged reading practice may be important for developing reading skills. For students with low vision, reading at a close working distance imposes high demands on their near visual functions, which might make it difficult to sustain prolonged reading. The aim of this study was to investigate the performance of a prolonged reading task by students with low vision. Method: Forty students with low vision, aged from eight to 20 years and without any intellectual, reading or learning disability, were recruited through the Paediatric Low Vision Clinic, Buranda, Queensland. Following a preliminary vision examination, reading performance measures—critical print size (CPS), maximum oral reading rates (MORR), near text visual acuity— were recorded using the Bailey-Lovie text reading charts before and after a 30-minute prolonged reading task. Results: The mean age of the participants was 13.03 ± 3 years. The distance and near visual acuities ranged between -0.1 to 1.24 logMAR and 0.0 to 1.60 logMAR, respectively. The mean working distance of the participants was 11.2 ± 5.8 cm. Most of the participants (65 per cent) in this study were able to complete the prolonged reading task. Overall, there was no significant change in CPS, MORR and near text visual acuity following the prolonged task (p > 0.05). MORR was significantly correlated to age and near text visual acuity (p < 0.05). Conclusions: In this study, students with low vision were able to maintain their reading performance over a 30-minute prolonged reading task. Overall, there was no significant increase or decrease in reading performance following a prolonged reading task performed at their habitual close working distances but there were wide individual variations within the group.

Visual impairment, postural stability and falls among older adults with glaucoma

Purpose: To investigate the impact of glaucomatous visual impairment on postural sway and falls among older adults.Methods: The sample comprised 72 community-dwelling older adults with open-angle glaucoma, aged 74.0 5.8 years (range 62 to 90 years). Measures of visual function included binocular visual acuity (high-contrast), binocular contrast sensitivity (Pelli- Robson) and binocular visual fields (merged monocular HFA 24-2 SITA-Std). Postural stability was assessed under four conditions: eyes open and closed, on a firm and on a foam surface. Falls were monitored for six months with prospective falls diaries. Regression models, adjusting for age and gender, examined the association between vision measures and postural stability (linear regression) and the number of falls (negative binomial regression). Results: Greater visual field loss was significantly associated with poorer postural stability with eyes open, both on firm (r = 0.34, p < 0.01) and foam (r = 0.45, p < 0.001) surfaces. Eighteen (25 per cent) participants experienced at least one fall: 12 (17 per cent) participants fell only once and six (eight per cent) participants fell two or more times (up to five falls). Visual field loss was significantly associated with falling; the rate of falls doubled for every 10 dB reduction in field sensitivity (rate ratio = 1.08, 95% CI = 1.02–1.13). Importantly, in a model comprising upper and lower field sensitivity, only lower field loss was significantly associated with the number of falls (rate ratio = 1.17, 95% CI = 1.04–1.33). Conclusions: Binocular visual field loss was significantly associated with postural instability and falls among older adults with glaucoma. These findings provide valuable directions for developing falls risk assessment and falls prevention strategies for this population.