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Peripheral visual field loss correlates with poorer balance performance and sensory strategies in patients with glaucomaPeripheral Vision Loss Linked to Poorer Balance in Glaucoma Patients

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Key Takeaway
Note that greater peripheral visual field loss correlates with poorer sensory strategies for balance in patients with PVL.

This systematic review and meta-analysis evaluated the impact of peripheral visual field loss (PVFL) on balance performance in 2456 adults. The study synthesized data regarding both sensory and motor strategies to determine how vision loss affects stability.

The analysis found that individuals with PVFL exhibit poorer overall balance compared to age-matched controls. Specifically, these individuals showed a reduced contribution from the visual system and an increased reliance on the somatosensory system. While a positive correlation was found between the severity of PVL and poorer sensory strategies for balance, the relationship between motor strategy and PVL remained inconclusive.

A primary limitation noted by the authors is that the link between motor strategy and peripheral visual field loss was not clearly established. These findings suggest that patients with conditions like glaucoma or retinitis pigmentosa may require targeted rehabilitation focusing on proprioceptive and motor-strategy training rather than generic exercises to address specific sensory-motor deficits.

How this fits prior evidence

This meta-analysis addresses a gap in understanding the specific sensory-motor mechanisms of balance impairment in patients with peripheral visual field loss. While previous coverage has focused on pharmacological treatments for glaucoma, such as brinzolamide/timolol and preservative-free latanoprost, this study provides evidence on the functional impact of vision loss on mobility and balance.

A large review of data from 2,456 adults found that people with peripheral visual field loss (PVFL) have poorer balance compared to healthy individuals. This condition is often seen in patients with glaucoma or retinitis pigmentosa. The study looked at how the body uses different senses to stay upright.

The findings show that when vision is limited, the body relies more on somatosensory input—information from touch and body position—while using less information from the visual system. Specifically, a greater loss of peripheral vision was linked to a poorer sensory strategy for maintaining balance.

While the study showed clear links between vision loss and sensory strategies, the results regarding motor strategies were not conclusive. Because these findings come from an observational meta-analysis, they show a link rather than a direct cause. These results suggest that patients with vision loss may need specific training focused on touch and movement rather than general exercise.

What this means for you:
People with peripheral vision loss often rely more on touch to balance because their visual system provides less input.

Common questions

How does vision loss affect balance?

People with peripheral visual field loss show poorer overall balance compared to those with full vision. The study found that as vision in the outer edges of the eyes decreases, the body's sensory strategy for staying upright also becomes less effective.

Which senses are used more when vision is limited?

When peripheral vision is lost, the body shows an increased contribution from the somatosensory system. This means the body relies more on touch and internal physical cues to maintain balance because the visual system provides less information.

Does this mean motor skills are also affected?

The study found that people with vision loss had poorer overall balance, but the specific relationship between motor strategies and peripheral vision loss was inconclusive. This means more research is needed to understand how muscle coordination specifically changes.

Study Details

Study typeMeta analysis
Sample sizen = 2,456
EvidenceLevel 1
Follow-up216.0 mo
PublishedJul 2026
View Original Abstract ↓
BACKGROUND: Although peripheral visual field loss (PVFL) affects balance, previous research has produced mixed results and has not clearly distinguished the independent roles of different systems in balance impairment. This systematic review with meta-analysis is the first to comprehensively evaluate the proportion and contribution of different systems to balance in adults with PVFL, providing new insights for rehabilitation strategies. METHODS: A systematic search was performed in five databases (PubMed, AMED, Scopus, CINAHL, and Web of Science) from 2003 to 2023, with a manual search covering 2024 to 2025. The review focused on observational studies in adults (≥18 years) with PVFL because of glaucoma or retinitis pigmentosa. Data were synthesized by summarizing the balance function into two aspects: sensory strategy and motor strategy. The sensory strategy was defined as the motor response to changes in altering visual, vestibular, or somatosensory inputs to maintain balance, whereas the motor strategy was defined as the response to other conditions besides visual, vestibular, or somatosensory conditions, such as response to external perturbation, muscle coordination, and reaction time. The meta-analysis was conducted where appropriate. RESULTS: Seventeen studies comprising a total of 2456 participants were analyzed. The meta-analysis revealed that individuals with PVFL exhibited poorer balance than age-matched controls. Specifically, PVFL was associated with a reduced contribution from the visual system, an increased contribution from the somatosensory system, and poorer motor strategies in maintaining balance. Greater peripheral visual field loss correlated with poorer sensory strategy for balance, whereas the relationship between motor strategy and peripheral visual field loss remained inconclusive. CONCLUSIONS: Adults with PVFL demonstrate significant balance impairments compared to healthy peers, relying more on somatosensory input to compensate for visual deficits. These findings underscore the need for comprehensive balance assessments and targeted rehabilitation strategies. Further research should focus on identifying the most predictive balance parameters and developing targeted, evidence-based rehabilitation strategies for this population. TRANSLATIONAL RELEVANCE: By identifying the specific sensory-motor mechanisms of balance impairment in patients with PVFL, this study bridges the gap between clinical vision assessment and rehabilitation. The finding that these patients rely heavily on somatosensory compensation provides a strong clinical rationale to transition from generic balance exercises to personalized, targeted rehabilitation strategies (such as proprioceptive and motor-strategy training), ultimately reducing fall risks and improving mobility in patients with PVFL.
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