Bifocal/varifocal spectacles, lighting and missed-step accidents

Good lighting and the correct use of spectacles generally improve vision and presumably reduce the risk of accidents. However, bifocal and varifocal spectacles can increase the risk of misjudging distances when negotiating underfoot hazards. In some circumstances, the portion of the lens used for close work may inadvertently be used where accurate judgement of distance is necessary. This paper reports results from two studies of patient interviews using the Merseyside Accident Information Model; the first a study of accidents which occurred during paid employment (1504 cases) and the second of 1326 accidents mainly in domestic and leisure activities. Underfoot accidents were identified by the first unforeseen event perceived by the patient. The relationship between underfoot events and the type of spectacles worn by the patient at the time of accident was analysed. In both studies there was a significant association between accidents where the first event was ‘missed edge of’ (step) and wearing bifocal/varifocal spectacles. Corporal movements reported in both studies indicated that ‘stepping down’ when wearing bifocal/varifocal spectacles, increased the risk of ‘missed edge’ accidents. In the work environment corporal movements associated with manual handling of loads also increased the risk of ‘missed edge’ accidents when wearing bifocal/varifocal spectacles.