Optometrists' practice of falls prevention care for community dwelling older adults: A mixed methods systematic review.

backgroundCommunity optometrists are primary eye care professionals who are well positioned to provide assessment and treatment for vision-related falls prevention. The aim of this mixed methods review was to synthesise the best available evidence for community optometrists' practice of falls prevention assessment and treatment for community dwelling older adults.

methodsA mixed methods systematic review utilised the convergent integrated approach in accordance with the Joanna Briggs Institute (JBI) guidelines and was conducted following a published protocol. Four databases, Ovid MEDLINE, Embase, Scopus and CINAHL Complete, and grey literature were searched from January 1980 to November 2025. Quantitative, qualitative and mixed methods studies that investigated community optometrists' practice of falls prevention screening, assessments, treatment or providing falls prevention advice to community dwelling older adults were eligible for inclusion. Two independent reviewers utilised standardised methods to search, screen, and code the studies included. Methodological quality of studies was assessed by two independent reviewers using JBI critical appraisal tools. Data synthesis followed the JBI convergent integrated approach.

resultsFrom 3853 articles screened, 11 articles (seven quantitative, one qualitative and three mixed methods studies) and four reports met the inclusion criteria. Two analytical themes were identified: (i) there was limited evidence that optometrists practiced falls risk screening and assessment, although they were aware and knowledgeable about the association between vision impairments and falls; (ii) there was sparse evidence for optometrists providing falls prevention treatment. There was limited evidence that optometrists were conducting key ocular assessments relevant for identifying falls risk such as depth perception or contrast sensitivity, and scant evidence of falls screening. There was some evidence for the practice of tailored spectacle prescription, but scant evidence for providing falls prevention advice. There was evidence for optometrists providing effective falls prevention treatment within a multidisciplinary team, but no evidence that identified if optometrists referred patients to other health professionals for falls prevention care.

conclusionsFurther research that investigates how community optometrists as primary care health professionals can systematically practice falls prevention care is urgently required. PROSPERO REGISTRATION NUMBER: CRD 42024539668.